Signs and Symptoms of Testicular Cancer

Finding a Lump

Finding a lump or other abnormality involving the testicle or scrotum can be a frightening experience. There are many things that can cause such abnormalities, and many of them are benign. Probably one of the biggest concerns is whether it represents cancer or not. This article will explain the findings typical of testicular cancer as well as findings that are indicative of something else.

 For a brief summary of testicular cancer click here.

Signs and Symptoms

Testicular cancer can have a wide variety of signs and symptoms depending on a number of factors: is it confined to the testicle? Has it spread somewhere else? Let's first take a look at how and where it starts to understand what signs and symptoms may be present.

To understand the signs and symptoms of testicular cancer, it’s important to know where it starts. The lump is physically attached to the testicle because these are the cells from which it arises. If the mass is free floating in the scrotum, then it’s almost a surety that it’s something other than testicular cancer.

Given the fact that it starts as a mass on the testicle, the most common presentation of the cancer is to discover just that: a lump on the testicle. The majority of the time it will be painless. However, it is possible to have varying degrees of pain in the scrotum itself as well as in the surrounding regions, including the lower abdomen and pelvis.

It is not uncommon for the mass to be accompanied by scrotal swelling. Sometimes swelling will be the first noted abnormality and can obscure the underlying mass.

If the cancer has already spread, it may have other signs and symptoms beyond what was mentioned above. The most common places for the cancer to spread are the lymph nodes behind the bowel, in a space known as the retroperitoneum, and the lungs.

If the retroperitoneal nodes are involved, symptoms such as lower back pain may be present. If the lungs are involved, coughing, shortness of breath and chest pain may be present. If testicular cancer is causing any of these symptoms, they should be accompanied by the findings mentioned above (lump and/or swelling) as these symptoms can otherwise occur from many other causes.

Age is very important when it comes to evaluating a testicular/scrotal abnormality. Testicular cancer typically affects younger persons. If someone over the age of 50 has a lump, it is likely due to some other cause including other cancers such as lymphoma. Regardless of age, any lump in the scrotum should undergo evaluation by a healthcare provider. For more information on risk factors for testicular cancer, see here.

There are many different types of testicular cancer and, depending on the type, specific signs or symptoms may be present. For example, certain types may release estrogen and result in a condition known as gynecomastia, where breast tissue volume is increased.

Signs and Symptoms Suggestive of Something Else

Many other things may occur involving the genitals which are not indicative of testicular cancer. Signs and symptoms that are suggestive for a cause other than testicular cancer include the following:

  • Blood in the urine
  • Blood in the semen
  • Pain with urination
  • Erectile dysfunction
  • Fevers and/or chills
  • Drainage from the penis
  • Severe pain

Several conditions may be confused with or appear similar to testicular cancer. These include hydroceles, orchitis, spermatoceles, testicular torsion, ​varicocele, and epididymitis. Please see this article for information on these other entities. 

Evaluation for a Lump or Other Abnormality

Regardless, any lump or swelling of the testicle or scrotum needs evaluation by your healthcare provider. A good place to start is with a primary care provider. Workup may include ultrasound and possibly a referral to a urologist for further management. For some tips in finding the right healthcare provider for you, have a look here.

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