The most common sign of testicular cancer is

The scrotum is the sack of skin that surrounds your testicles. These symptoms can be similar to other conditions that affect the testicles, such as infections. But see a doctor if you have:

• any of these symptoms
• symptoms that are unusual for you
• symptoms that don’t go away or don’t improve

Your symptoms are unlikely to be cancer but it is important to get them checked by a doctor. Try not to be embarrassed. Doctors are used to discussing intimate problems and will try to put you at ease.

A lump or swelling in the testicle

A lump or swelling in part of one testicle is the most common symptom of a testicular cancer. It can be as small as a pea, but may be much larger.

Most testicular lumps are not cancer. But do contact your doctor so you can be checked.

Your doctor may shine a strong light through your scrotum. This test is called transillumination. This is useful because:

• light shows through a harmless, fluid filled cyst (for example a hydrocoele)
• light can't show through a cancer, which is a solid lump

It is usual for some men to have different size testicles. But see your doctor if the size changes, or you notice an unusual difference in size between one testicle and the other. 

A heavy scrotum

Your scrotum may feel heavy. Or you might notice that your scrotum feels firmer or harder.

Discomfort or pain in a testicle or the scrotum

Testicular cancer is not usually painful. But the first symptom for some men is a sharp pain in the testicle or scrotum.

Less common symptoms

If the cancer has spread to lymph nodes (glands)

Sometimes testicular cancer cells can spread into lymph nodes at the back of the tummy (abdomen). This can cause backache or a dull ache in the lower tummy. Your doctor may call these lymph nodes the retroperitoneal lymph nodes.

Less often testicular cancer spreads into lymph nodes lower down, such as the pelvic lymph nodes.

The cells can also spread to lymph nodes in the centre of your chest between the lungs – in an area called the mediastinum. If this happens you could have one or more of the following:

• a cough
• difficulty breathing
• difficulty swallowing
• a swelling in your chest

If testicular cancer has spread to lymph nodes in other parts of the body you might feel lumps there, such as around the collarbone or in the neck

If the cancer has spread to the lungs

Sometimes testicular cancer spreads to the lungs. It rarely spreads to other organs in the body. If it has spread to the lungs you may have a cough or feel breathless. 

Testicular cancer can usually be cured, even if it has spread when it is diagnosed.

Symptoms due to hormones

Many testicular cancers make hormones that can show up in blood tests. Occasionally, men with testicular cancer have tender or swollen breasts because of these hormones.

• Get tips on seeing your GP

References

• EAU Guidelines on Testicular Cancer
  MP Laguna and others
  European Association of Urology, 2021

• Testicular seminoma and non-seminoma: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up
  J. Oldenburg and others
  Annals of Oncology, 2022 Volume 33, Issue 4, pages 362 - 375

• Suspected cancer: recognition and referral
  National Institute of Health and Care Excellence (NICE), June 2015 (updated 2021)

• Scottish referral guidelines for suspected cancer
  Scottish Government, January 2019 (updated 2020)

• The management of acute testicular pain in children and adolescents
  MT Jefferies and others
  British Medical Journal, 2015.350:h1563, Pages 1-8 350

• The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact [email protected] with details of the particular issue you are interested in if you need additional references for this information.

  Testicular cancer originates in the testicles, a pair of small male reproductive organs held in a loose pouch of skin (scrotum) that hangs underneath the penis. The testicles produce male hormones, such as testosterone, and sperm.

  Although testicular cancer is relatively uncommon, it is still the most frequently diagnosed malignancy in American males between the ages of 15 and 35. However, when a tumor is caught early, it can often be effectively treated and even cured. For these reasons, it is important for all boys and men to learn to identify the warning signs of testicular cancer.

  What does testicular cancer look like?

  Most testicular tumors can be found in their early stages before the cancer has spread, when more treatment options are generally available. In some men, early-stage testicular cancer causes noticeable symptoms that lead them to seek medical attention. The first sign is often a small, painless lump (similar to a marble) in a testicle.

  What does testicular cancer feel like?

  Other testicular cancer signs to watch for include:

  • Swelling or enlargement of one or both testicles
  • Pain or numbness in a testicle or the scrotum
  • A feeling of heaviness in the scrotum
  • A dull ache or pressure in the groin, pelvis or low back
  • A general feeling of malaise, which may include unexplained fatigue, fever, sweating, coughing, shortness of breath and/or mild chest pain
  • Headache and mental confusion

  In boys, testicular cancer can also cause early signs of puberty, such as the growth of facial and body hair and accelerated voice deepening.

  Most experts agree that a testicular examination should be performed during a general physical exam or routine check-up. What’s more, many physicians recommend that all men examine their testicles at least monthly after puberty. This can make it easier to notice any changes soon after they occur.

  
  

  How to check for testicular cancer at home

  The best time for a man to examine his testicles is during or immediately after a warm shower or bath, when the scrotal skin is usually relaxed. Here’s how:

  • Move the penis to the side and examine each testicle separately.
  • Position the index and middle fingers underneath one testicle and the thumbs on top.
  • Gently but firmly roll the testicle between the fingers and thumbs to feel for any hard lumps or nodules (smooth rounded masses) or any change in its size, shape or consistency.

  Moffitt Cancer Center's approach to testicular cancer

  If you have questions about testicular cancer or would like personalized advice, you are welcome to consult with a specialist in the Urologic Oncology Program at Moffitt Cancer Center. To request an appointment call 1-888-663-3488 or complete a new patient registration form online. We provide every new patient with rapid access to a cancer expert within one day, which is faster than any other cancer hospital in the nation.

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  RELATED STORY

  Find answers to a few of the most frequently asked questions patients and caregivers have about testicular cancer in our Testicular Cancer FAQs. 

  What are the 2 most common signs of testicular cancer?

  Usually, an enlarged testicle or a small lump or area of hardness are the first signs of testicular cancer.

  What is the most common presentation of testicular cancer?

  Most testicular cancers present as a mass confined to the testicle. Therefore, the most common presentation is a painless testicular mass. Most of these masses are palpable and of significant size (a few to several centimeters).

  Which of the following is a warning sign of testicular cancer?

  Usually, an enlarged testicle or a small lump or area of hardness are the first signs of testicular cancer. Any lump, enlargement, hardness, pain, or tenderness should be evaluated by a doctor as soon as possible.