Symptoms and diagnosis of testicular cancer

Symptoms

The most common symptoms of testicular cancer are:

• A painless lump or swelling in a testicle
• Pain or discomfort in a testicle or in the scrotum
• An enlarged testicle or a change in the way it feels
• A heavy feeling in your scrotum

If the cancer has spread, you may get:

• A dull ache in your back
• Breast tenderness
• Stomach ache
• Shortness of breath
• A painless lump in the side of your neck

Even though these symptoms can be caused by conditions other than cancer, get them checked by your doctor. For more information, contact the National Cancer Helpline 1800 200 700. Remember most testicular cancers are curable. If they are found early, they can be treated very easily.

Screening

Checking for testicular cancer when you have no symptoms is called screening. There is no national testicular screening programme in Ireland at present as testicular cancer is rare. Talk to your GP if you feel you or your family are at risk.

Self-check of testicles

It can help to examine your testicles yourself every month. The best time to do this is after a warm bath or shower, when the skin of your scrotum is relaxed.

• Hold your scrotum in the palms of your hands.
• Use your fingers and thumb on both hands to examine your testicles.
• Gently feel each testicle, one at a time, for any change in size or weight.
• The testicle itself should be smooth with no lumps or swellings.
• It is normal to feel a soft tube at the top and back of the testicle.
• It is common for one testicle to be slightly larger or to hang lower than the other.

If you notice any swelling, lump, or experience a different sensation than normal, visit your GP as soon as possible.

Diagnosis

Visit your GP first if you are worried about any symptoms. He or she will do a physical exam. If your GP has any concerns about you, he or she will refer you to a hospital. There, you will see a specialist called a urologist, who might arrange more tests. These include:

• Ultrasound of your scrotum and testicles
• Blood tests
• Chest X-ray
• Removing your testicle

Ultrasound of your scrotum and testicles: An ultrasound uses sound waves to build up a picture of the tissues inside your scrotum. A gel is spread over the area to be scanned first. A probe that makes sound waves is then used to take the scan. The sound waves are changed into a picture by a computer and can show if there is a mass in your testicles. But it cannot tell if it is cancer or not.

Blood tests: Bloods tests may be done to check your general health. Other blood tests may check if you have tumour markers. See ‘further tests’ for more details on tumour markers.

Chest X-ray: This test checks your general health and if the cancer has spread to the lymph nodes in your chest.

Removing the testicle (orchidectomy): The only way your doctor can tell if the lump or swelling is cancer is by removing the lump. The cells can then be examined under a microscope. It is not possible to remove some tissue without taking your whole testicle. Only taking a sample may cause the disease to spread or come back. The operation to remove your testicle is called an orchidectomy.

Further tests

If you have testicular cancer, your doctor will do more tests. These tests are important as they will show if the disease has spread to other parts of your body or not. The results of these tests will also help you and your doctor to decide which treatment is best for you.

Blood tests: Some testicular cancers make chemicals that can be found in your bloodstream. These are called blood tumour markers or biomarkers. They include alpha-fetoprotein (AFP), beta human chorionic gonadotrophin (bHCG) and lactate dehydrogenase (LDH). During your treatment and follow-up, blood samples will be taken regularly to check the levels of these markers.

CT scan: This is a special type of X-ray that builds up a picture of the tissues inside your scrotum and testicles. You may be given a special drink that helps to show up certain areas on the scan. The test does not hurt and you can go home afterwards.

Learn more about the above tests

Call our National Cancer Helpline

Freephone 1800 200 700 to talk to a specialist cancer nurse
It's open Monday-Thursday from 9am to 7pm and Friday from 9am to 5pm