Testicular Cancer

Symptoms and diagnosis

Symptoms and diagnosis

What are the symptoms?

As testicular cancer grows, you might feel a lump or swelling in part of one testicle (Figure 1). This is the most common symptom. You might have pain in a testicle or the scrotum, but testicular cancer is not usually painful.

If testicular cancer has spread to other part of the body (metastasis), you might have dull aches or feel lumps in other areas.

Remember: Most lumps are not cancer! However, if you have one of these symptoms, it is important to see your doctor right away. The sooner testicular cancer is caught, the better the chance of cure.

Examining your testicles is easy

Examine your testicles regularly, especially if you have a risk factor for testicular cancer.

The best time to examine your testicles is right after a hot bath or shower. The scrotal skin will be relaxed, and the testicles can be felt more easily. It takes only a few minutes.

Do the exam standing:

  • Look for swelling in the scrotum.
  • Gently feel the scrotal sac to find a testicle.
  • Examine the testicles one at a time. Firmly and gently feel each testicle between the thumb and fingers of both hands over the whole surface.
  • It is normal for one testicle to be slightly larger than the other. It is also normal to feel a cord-like structure (the epididymis) on the top and back of each testicle.
Fig. 1: Self examination.
Fig. 1: Self examination.

If you find a lump, swelling, or other change, see you doctor. Changes are not always cancer, but if it is cancer and you catch it early, you have the best chance of cure.

How is testicular cancer diagnosed?

Your doctor will give you a physical exam and ask about your medical history. Depending on your symptoms and risk factors, blood tests and ultrasound may be ordered to check for testicular cancer.

Testicular Cancer Tests

Test Purpose
Blood test Blood is tested to check for high levels of certain proteins that suggest testicular cancer (tumour markers).
Ultrasound Sound waves are used to view the inside of the testicles, including any growths.
Microlithiasis If small white spots (called “microliths”) are seen with ultrasound, your doctor might take tissue from the testicles (biopsy). The tissue will be examined to look for precancerous cells.
MRI In special cases, your doctor might use MRI for additional images to decide whether surgery is needed.

Questions to ask your doctor about diagnosis

  • Which tests are you going to do?
  • Are the tests painful?
  • Can I go home after the tests?
  • How long does it take to get the results?
  • Will you know for sure whether I have cancer?
  • If I have cancer, will you know whether it has spread?

What is staging?

Cancer is classified in stages. The stages describe a tumour’s size and whether the cells have spread to other tissues or organs (Figure 2). This information helps you and your doctor understand how serious the cancer is and how to treat it.

Stages of testicular cancer:

  • Stage 1: Cancer is only in the testicle.
  • Stage 2: Cancer has spread to the lymph nodes in the abdomen.
  • Stage 3: Cancer has spread beyond the lymph nodes in the abdomen. The cancer may have spread to parts of the body far from the testicles, such as the lungs or liver.
Fig. 2: Metastatic spread.
Fig. 2: Metastatic spread.


What is my prognosis?

Your prognosis is your risk of the cancer growing and/or coming back after treatment. The type and stage of testicular cancer will help you and your doctor understand this.

Your doctor will look at:

  • Your personal and family history of testicular cancer
  • Cancer type (seminoma vs. non-seminoma)
  • Whether the cancer cells have spread to other tissues or organs (metastasis)
  • Levels of tumour markers in blood tests, especially for non-seminomas, which are aggressive