Testicular Cancer: Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

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Men with testicular cancer may experience a variety of symptoms or signs. Sometimes, men with testicular cancer do not show any of these symptoms. In addition, these symptoms can be caused by another condition that is not cancer.

The first sign of testicular cancer is often enlargement of the testicle or a small lump or area of hardness on the testicle, but an increase in size or a lump may also be caused by the following noncancerous conditions:

  • A cyst called a spermatocele that develops in the epididymis. The epididymis is a small organ attached to the testicle that is made up of coiled tubes that carry sperm away from the testicle.
  • An enlargement of the blood vessels from the testicle called a varicocele.
  • A buildup of fluid in the membrane around the testicle called a hydrocele.
  • An opening in the abdominal muscle called a hernia.

Other symptoms of testicular cancer may go unnoticed until the cancer has spread to other parts of the body. Monthly testicular self-examinations, performed after a warm shower, can help detect the cancer at an early stage, when it is more likely to be successfully treated.

Symptoms of testicular cancer may include:

  • Painless lump or swelling on either testicle. If detected early, a testicular tumor may be about the size of a pea or a marble, but it can grow much larger. Any lump, enlargement, hardness, pain, or tenderness of the testicle should be evaluated by a doctor as soon as possible.
  • Pain or discomfort, with or without swelling, in a testicle or the scrotum. Pain can be caused by many different conditions, including an infection, injury, twisting, and cancer. Infection of the testicle is called orchitis. Infection of the epididymis is called epididymitis. If infection is suspected, a patient may be given a prescription for antibiotics. If antibiotics do not solve the problem, tests for testicular cancer are often needed.
  • Change in the way a testicle feels or a feeling of heaviness in the scrotum. For example, one testicle may become more firm than the other testicle. Or, testicular cancer may cause the testicle to grow bigger or to become smaller.
  • Dull ache in the lower abdomen or groin
  • Sudden buildup of fluid in the scrotum
  • Breast tenderness or growth. Although rare, some testicular tumors produce hormones that cause breast tenderness or growth of breast tissue, a condition called gynecomastia.
  • Lower back pain, shortness of breath, chest pain, and bloody sputum or phlegm can be symptoms of later-stage testicular cancer, but many other diseases can also cause these symptoms.
  • Swelling of one or both legs or shortness of breath from a blood clot can be symptoms of testicular cancer. A blood clot in a large vein is called deep venous thrombosis or DVT. A blood clot in an artery in the lung is called a pulmonary embolism and causes shortness of breath. For some young or middle-aged men, developing a blood clot may be the first sign of testicular cancer.

Finding testicular cancer early

Most often, testicular cancer can be detected at an early stage, and men often find the cancer themselves while performing self-examinations. Some doctors recommend that men ages 15 to 55 perform a monthly self-examination to identify any changes. However, some testicular cancers may not cause symptoms and may go undetected until they have spread to other parts of the body. Men who notice a lump, hardness, enlargement, pain, or any other change in one or both of their testicles should visit their doctor immediately.

If you are concerned about one or more of the symptoms or signs on the list above, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

The next section helps explain what tests and scans may be needed to learn more about the cause of the symptoms. Use the menu on the side of your screen to select Diagnosis, or you can select another section, to continue reading this guide.