What You Need to Know About Testicular Cancer: Symptoms, Screening, and Treatment

Aaron S. Weinberg MD, MPhil
November 19, 2021
4 min

Movember” is an annual monthly event that raises awareness about health issues that affect some men and people who were assigned male at birth, such as prostate cancer and testicular cancer. Each year, it’s estimated that between 8,000 and 10,000 people will be diagnosed with testicular cancer. Fortunately, testicular cancer is very treatable, especially when it is detected early, and is curable in about 95 percent of cases. Regular testicular self-exams are a key detection method.

What Is Testicular Cancer?

Testicular cancer is a cancer of the testicles, or testes, which are located inside the scrotum, a loose sack of skin underneath the penis. The primary purpose of the testicles is to produce male sex hormones and sperm for reproduction. Testicular cancer most commonly affects men and people assigned male at birth who are of European descent and are between the ages of 20 and 35. There are different types of testicular cancer, but most are curable with treatment. When testicular cancer is treated early, death rates from testicular cancer are very low.

What causes testicular cancer is still not exactly clear. It occurs when abnormal cells grow out of control in the testicles and crowd out normal cells. These abnormal cells accumulate and form a mass in the testicles. They can also spread to other organs and parts of the body.

Risk Factors for Testicular Cancer

There are several factors that can increase a person’s risk of testicular cancer. Some of these risk factors include:

     • Age — Testicular cancer is more common for people in their 20s and 30s, though it can occur at any age.

     • Family history — People with family members who have had testicular cancer may be at an increased risk.

     • Background — Testicular cancer is more common in white people, though it can occur in people of any ethnic group or race.

     • An undescended testicle — People who have a testicle that never descended after birth may be at an increased risk of developing testicular cancer. (However, most people who develop testicular cancer do not have a history of an undescended testicle.)

     • Abnormal testicle development — Conditions that cause the testicles to develop abnormally may increase risk of testicular cancer.

Common Symptoms of Testicular Cancer

A primary symptom of testicular cancer is a mass or lump (often painless) in the testicle. Other symptoms may also be present — many of these symptoms can be caused by other things, but if they persist or accompany a mass or lump, they may merit medical investigation:

     • A heavy feeling in the scrotum

     • Pain, discomfort, or achiness in the scrotum

     • Aching or discomfort in the lower abdomen, groin, or anal region

     • A collection of fluid or swelling in the scrotum

It's important to notify your healthcare provider as soon as possible if you detect a lump or any other symptoms of testicular cancer. It's estimated that many men wait an average of five months to bring symptoms to the attention of a healthcare provider. Since cancer can spread during this time period, it’s vital to report any abnormal symptoms, especially if they last longer than two weeks.

Screening for Testicular Cancer

Testicular self-exams are a key defense against testicular cancer. They are best performed in a standing position (if possible), in front of a mirror, and after a warm bath or shower (which may help relax the skin of the scrotum). First, the scrotum and testicles should be visually examined for any skin changes or visible swelling.Then, with the thumb placed on the upper surface and the index and middle finger placed on the lower surface, each testicle can be rolled gently between the thumb and fingers to feel for lumps or abnormalities. (Note that a soft, tube-like structure called the epididymis runs behind each testicle; it shouldn’t be mistaken for an abnormal finding.) 

If you or your healthcare provider detect a lump in a testicle, your healthcare provider may order tests to determine whether the lump is cancerous. 

An ultrasound may be done to determine the nature of the lump and whether it is solid or fluid-filled. An ultrasound can also determine whether the lump is inside or outside the testicle.

A blood test may be ordered to test the levels of tumor markers in your blood. (Tumor markers are proteins and hormones made by some cancers.) Lab results may indicate that surgery is required to remove a lump or mass, which will be sent to a lab for further testing.

Treatment for Testicular Cancer

Treatment for testicular cancer may include a combination of surgery, chemotherapy, and/or radiation. 

If it's determined that a lump in your testicle is cancerous, your healthcare team may recommend surgically removing the testicle and nearby lymph nodes. 

Chemotherapy treatment involves a drug that is used to kill cancer cells.

Radiation therapy uses high-powered energy beams to kill cancer cells; the energy beams are pointed toward specific points on your body. 

Many men with testicular cancer are concerned about the effects of treatment on their ability to become a father in the future. It’s important to discuss these concerns with a healthcare provider, as it may affect how treatment proceeds, as well as other decisions such as storing sperm, before treatment, for future use. 

With treatment, testicular cancer is very curable.

Celebrate Movember by taking charge of your testicular health. At any age, you can start performing monthly testicular self-exams and talking to your healthcare provider about your risk factors. Contact a Carbon Health healthcare provider today for an in-person or virtual appointment.

Carbon Health’s medical content is reviewed and approved by healthcare professionals before it is published, but it is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Talk to your healthcare provider about questions you may have regarding your health or a medical condition, and before making changes to your healthcare routine.

Aaron S. Weinberg MD, MPhil

Aaron S. Weinberg, MD, MPhil, is Director of Program Development at Carbon Health and triple board-certified in Pulmonary, Critical Care, and Internal Medicine.