Symptoms & Diagnosis

NHS

Typical symptoms are a painless swelling or lump in 1 of the testicles, or any change in shape or texture of the testicles.

The swelling or lump can be about the size of a pea, but may be larger. Most lumps or swellings in the scrotum are not in the testicle and are not a sign of cancer, but they should never be ignored.

Other symptoms

Testicular cancer can also cause other symptoms, including:

  • an increase in the firmness of a testicle
  • a difference in apperance between 1 testicle and the other
  • a dull ache or sharp pain in your testicles or scrotum, which may come and go
  • a feeling of heaviness in your scrotum

See a GP as soon as possible if you notice a swelling, lump or any other change in 1 of your testicles.

Most lumps within the scrotum are not cancerous, but it's important to get checked as soon as possible.

Treatment for testicular cancer is much more effective when started early.

Physical examination

As well as asking you about your symptoms and looking at your medical history, a GP will usually need to examine your testicles.

They may hold a small light or torch against your scrotum to see whether light passes through it.

Testicular lumps tend to be solid, which means light is unable to pass through them. A collection of fluid in the scrotum will allow light to pass through it.

Tests for testicular cancer

If you have a non-painful swelling or lump, or a change in the shape or texture of 1 of your testicles, and a GP thinks it may be cancerous, you'll be referred for further testing within 2 weeks.

Some of the tests you may have are described below.

Scrotal ultrasound

A scrotal ultrasound scan is a painless procedure that uses high-frequency sound waves to produce an image of the inside of your testicle.

It's 1 of the main ways of finding out whether or not a lump is cancerous (malignant) or non-cancerous (benign).

During a scrotal ultrasound, your specialist will be able to determine the position and size of the abnormality in your testicle.

It'll also give a clear indication of whether the lump is in the testicle or separate within the scrotum, and whether it's solid or filled with fluid.

A fluid-filled lump or collection around the testis is usually harmless. A more solid lump may be a sign the swelling is cancerous.

Blood tests

To help confirm a diagnosis, you may need a series of blood tests to detect certain hormones in your blood, known as markers.

Testicular cancer often produces these markers, so it may indicate you have the condition if they're in your blood.

Markers in your blood that'll be tested for include:

  • alpha feto-protein (AFP)
  • human chorionic gonadotrophin (HCG)

A third blood test is also often carried out as it may indicate how active a cancer is.

It's called lactate dehydrogenase (LDH), but it's not a specific marker for testicular cancer.

Not all people with testicular cancer produce markers. There may still be a chance you have testicular cancer even if your blood test results come back normal.

Histology

The only way to definitively confirm testicular cancer is to examine part of the lump under a microscope. These tests and reports are called histology.

Unlike many cancers where a small piece of the cancer can be removed (a biopsy), in most cases the only way to examine a testicular lump is by removing the affected testicle completely.

This is because the combination of the ultrasound and blood marker tests is usually sufficient to make a firm diagnosis.

Also, a biopsy may injure the testicle and spread cancer into the scrotum, which is not usually affected. Your specialist will only recommend removing your testicle if they're relatively certain the lump is cancerous. Losing a testicle will not affect your sex life or ability to have children.

The removal of a testicle is called an orchidectomy. It's the main type of treatment for testicular cancer, so if you have testicular cancer, it's likely you'll need to have an orchidectomy.

To learn more, click here.

Useful resources

Cancer Focus NI can provide a wide range of presentations to meet the needs of your...
The important thing to remember when you’re affected by prostate disease is that you’re...
Call us for free, unbiased, confidential support and information. There's no such thing...
Cancer Focus NI, Keeping Well vans are mobile drop-in units which bring health checks,...
We have a team of trained volunteers throughout the UK who carry out talks to groups both...
Each month we run an online support group for men on active surveillance - a form of...
Prostate Cancer UK have a team of trained volunteers throughout the UK who carry out...
Fatigue support is a telephone programme which includes 4 appointments with a Specialist...
There are hundreds of prostate cancer support groups in the UK. We have details of many...
There are a number of health campaigns throughout the year to raise awareness of...
Living with prostate cancer can be hard to deal with emotionally, as well as physically...
We all have good and bad days but what and when we eat can influence our mood, energy,...
‘Engage’ training is a comprehensive one day programme which seeks to address the current...
There is an increasing number of organisations / practitioners who are keen to involve...
Informing Choices NI are currently supported by the Public Health Agency to undertake a...
This programme is a six week training programme for groups of adults and focuses on...
A healthy diet and regular physical activity may help you manage the effects of prostate...
Move for Men is your new monthly fitness and wellbeing membership, designed to help you...
This includes: Raising awareness of depression and Aware NI services at a wide range of...
As part of this community, you can talk about whatever you want, from diagnosis to...
We rely on our incredible volunteers to help us spread the word about prostate cancer,...
Handle stress and anxiety on the go
It’s an easy to follow programme known the world over, and perfect for those new to...
Active 10 is a free and easy to use walking app that tracks your walking and shows you...
Guided meditations
Guided meditations
Food diary, exercise tracker and diet coach
Learn to manage negative thoughts and look at problems differently
Prostate Cancer UK launched a campaign to encourage men at higher risk of prostate cancer...
Your Mind Plan offers practical ideas and advice to help you boost and maintain your mental wellbeing. Answer the quick 5-question quiz and the Every Mind Matters widget will give you 5 tailored actions to help you feel more in control, improve your sleep, deal with stress and anxiety, and boost your mood – as well as the option to easily swap any actions and to save the whole plan via email.