The most common symptom of testicular cancer is a lump felt in your testicle, but there are other symptoms of testicular cancer, which include:
- swelling in a testicle, usually painless. Sometimes the swelling may suddenly increase in size and become painful, and
- A dull ache or pain, or heaviness in your scrotum.
If testicular cancer is advanced and has spread to your lymph nodes or other parts of your body, some of the following symptoms may be felt:
- Pain in your back, groin, or lower abdomen. This is possibly caused by the spread of the cancer to lymph nodes in the abdomen;
- A cough, breathlessness, or difficulty swallowing if lymph nodes in your chest area or your lungs are affected, and
- Nipple tenderness or swelling (gynaecomastia). This is not a common symptom, but can be caused by hormones produced by the cancer.
Testicular cancer can be easier to treat if it’s found early. This is why it’s important to check your testicles at least once per month for anything unusual, like a lump or swelling.
By checking your testicles regularly, you get to know what feels normal for you. The best time to check your testicles is during or after a warm bath or shower, when the scrotum is soft and relaxed. Cup your scrotum gently in the palm of your hand, and carefully use your fingers and thumb to feel each testicle for lumps, anything unusual, or differences between your testicles.
A normal testicle should feel smooth and firm, but not hard. Remember that it’s normal for the testicles to be slightly different in size and for one testicle to hang lower than the other.
If you feel anything unusual, it’s important that you get it checked out by your doctor as soon as possible.
Diagnosing testicular cancer
It’s important to know that most testicular lumps are not cancerous, but you must have the lump checked. This is because any treatment for testicular cancer is much more effective when it’s started earlier.
As well as asking about your symptoms, your GP will carry out a physical examination of your testicles. If your GP suspects the lump in your testicle may be cancerous, you will be referred for one or some of the following tests:
A scrotal ultrasound scan is a painless procedure that uses high-frequency sound waves to see inside your testicle. It is one of the main ways your health professional can tell whether or not the lump is cancerous (malignant) or non-cancerous (benign).
To confirm any diagnosis, you might need a series of blood tests to detect certain hormones in your blood, known as 'markers'. Testicular cancer often produces these markers, so having them in your blood may be an indication that you have the disease.
To confirm a case of testicular cancer, you’re likely to require a biopsy of the tumour, so that cells can be examined in a laboratory to determine whether or not the tumour is cancerous.
For most cases, the only way to safely take a biopsy is to remove the affected testicle completely. This is because specialists consider the risk of the cancer spreading to be too high for a conventional biopsy.
If your specialist feels it necessary, you might need more tests to see if testicular cancer has spread. If cancer of the testicle spreads, it commonly affects the lymph nodes and lungs, so you may require a chest X-ray to check for signs of a tumour.
Stages of testicular cancer
After your tests, your doctor or consultant will tell you what stage your testicular cancer is at. This describes the size of your tumour and how far it’s spread, and will influence the type of testicular cancer treatment you’re offered.
There are four stages of testicular cancer:
- Stage one – the cancer is contained inside your testicles
- Stage two – the cancer has spread from the testicles into the lymph nodes in your abdomen and pelvis
- Stage three – the cancer has spread into the lymph nodes in your upper chest
- Stage four – the cancer has spread into another organ, such as your lungs.