Testicular cancer is a relatively rare cancer, but it can cause serious distress in approximately 9,600 American men who are estimated to be diagnosed in 2020. Common (and not very common) symptoms, which may include a lump in the testicle, heaviness in the scrotum, testicular pain, fatigue, back pain, and unexplained weight loss.
By knowing the signs and symptoms of testicular cancer, you can receive early diagnosis and treatment and, in most cases, achieve a complete remission.
The most common sign of testicular cancer (also known as a malignancy of the testicles) is a lump in one and sometimes both testicles. A lump is usually found during the shower during a standard testicular self-exam (TSE). , or your partner during sexual intercourse.
The bumps on the testicles are usually painless, although some are painful. They can also be mobile or stationary. Some tumors may be smaller than a pea, while others may be larger than marble. Many tumors will be hard and stone-like.
Other common signs and symptoms include:
- Feeling of heaviness in the scrotum.
- Dull or sharp pain in the scrotum or lower abdomen.
- Tumor in one testicle and not the other.
- Accumulation of fluid in the testicle.
A lump in your testicle can be scary, but that doesn't necessarily mean you have cancer. There can be many different explanations for this, of which cancer is the least likely. That being said, you should never ignore a testicular tumor or any other symptoms that suggest cancer.
Some men with testicular cancer may be asymptomatic and will only be diagnosed during an unrelated medical exam (such as a fertility test or a routine physical exam) .
There is a rare type called testicular choriocarcinoma that is extremely aggressive and is more likely to spread to the lungs, bones, and brain. Other unusual forms, such as embryonal carcinoma, are also more prone to metastasis.
This type of testicular cancer can cause the overproduction of a hormone known as human chorionic gonadotropin (hCG), also known as "pregnancy hormone." If this happens, the man may develop gynecomastia, an abnormal enlargement of the breast tissue .
Other types can cause gynecomastia by increasing production of the female hormone estrogen . An example of this is Leydig cell tumors, of which 10% will develop into testicular cancer .
Although testicular cancer is extremely rare before the age of 14, it can sometimes occur. If so, early puberty (also known as preterm puberty) may be the first sign. The condition is most often associated with the development of tumors from Leydig cells.
Late stage symptoms
If left untreated and diagnosed, testicular cancer can spread from the original tumor site (known as stage 1 cancer) to nearby lymph nodes (stage 2) and eventually to distant organ systems (stage 3). . The original cancer is called a primary tumor and the site of the new cancer is called a secondary or metastatic tumor.
If metastasis occurs, symptoms may vary depending on the location of the secondary tumor. Possible signs and symptoms include:
- Low back pain can develop if the cancer begins to spread to nearby lymph nodes.
- Swollen lymph nodes in the neck can further spread the cancer to distant organs.
- Swelling and pain in the lower extremities can be a sign of a thrombosis known as deep vein thrombosis (DVT) . As the cancer progresses, a hypercoagulable state develops, which presents a much higher risk of blood clots.
- Shortness of breath ( shortness of breath), chronic cough, or hemoptysis ( hemoptysis ) can occur if the cancer has spread to the lungs. This is usually due to a pulmonary embolism , in which a blood clot enters the lungs from another part of the body, most commonly the legs.
- If a secondary tumor is found in the brain, headaches, confusion, and other neurological symptoms can develop.
- Chronic fatigue and unexplained weight loss are common signs of advanced cancer.
When to contact a healthcare provider
If you find a lump in your testicle, see your doctor as soon as possible. While it is important to be proactive and alert, try not to jump to conclusions or let anxiety take over.
Discussion guide with a testicular oncologist
Get our printed guide to your next doctor's appointment to help you ask the right questions.
According to the National Cancer Institute, only six out of 100,000 American men are diagnosed with testicular cancer each year, making it one of the less common causes of cancer in the United States. Unless you are in a high-risk group, your chances of recovering from cancer are very high.
Some of the most likely causes of testicular hardening are infections and trauma to the testicle itself or to the tube that carries sperm out of the testicle (called the epididymis).
If you have cancer, the treatment is such that more than 95% of cases have a five-year survival rate, including 73% of men diagnosed with metastatic disease.
Frequently asked questions
Of the two types of testicular cancer, seminomas spread faster than non-seminomas, but non-seminomas are more common. However, the rate at which any type of testicular cancer spreads depends on the patient. The American Urological Association cautions that men wait an average of five months to report the symptoms of testicular cancer to their healthcare provider, during which time the cancer can spread.
Several risk factors can increase a man's chance of developing testicular cancer. These include a history of an undescended testicle, a family history of testicular cancer, previous testicular cancer, and HIV. Testicular cancer is most common in men between the ages of 20 and 34, although it can occur at any age and affects white men four to five times more often than black or Asian American men.