Key Points
- Testicular cancer is the most common cancer in young men (aged 15-49)
- When caught early, it's one of the most curable cancers — over 95% survive
- Regular self-examination helps you know what's normal for you
- Most lumps are not cancer, but all lumps should be checked by a doctor
of men with testicular cancer survive when caught early
Why Self-Examination Matters
Unlike many cancers, testicular cancer often affects young, otherwise healthy men. There's no screening programme, so knowing what's normal for you is the best way to catch changes early.
Checking your testicles only takes a few minutes and could save your life.
How to Check Your Testicles
- Do it after a warm bath or shower — The scrotum will be relaxed, making it easier to feel
- Hold your scrotum in your palms — Feel the size and weight of each testicle
- Feel each testicle individually — Roll it gently between your thumb and fingers
- Feel for lumps — Check the whole surface of each testicle
- Find the epididymis — This is the soft, tube-like structure at the back of each testicle. It's normal.
- Compare sides — It's normal for one testicle to be slightly larger or hang lower
Check yourself once a month. Get to know what's normal for you, so you'll notice if something changes.
What to Look For
Usually Normal
- One testicle slightly larger than the other
- One testicle hanging lower
- The epididymis (soft tube at back)
- Slight tenderness if pressed hard
- Small cysts (feel like a third testicle)
See Your GP If You Notice
- A lump or swelling in a testicle
- A testicle getting bigger
- A heavy feeling in the scrotum
- A dull ache in the lower abdomen or groin
- Sudden fluid collection in scrotum
- Any change from what's normal for you
Testicular Torsion — An Emergency
Testicular torsion is when a testicle twists on its blood supply. It causes:
- Sudden, severe pain in one testicle
- Swelling
- Nausea and vomiting
- The testicle may be higher than normal
This is a surgical emergency. Go to A&E immediately. The testicle can be saved if treated within 6 hours.
Common Causes of Lumps and Swelling
Most testicular lumps are not cancer. Common causes include:
Epididymal Cyst
A fluid-filled sac in the epididymis (the tube behind the testicle). Very common and harmless. Feels like a small, smooth lump separate from the testicle itself.
Varicocele
Swollen veins in the scrotum, similar to varicose veins. Often described as feeling like a "bag of worms." Usually on the left side. More noticeable when standing.
Hydrocele
Fluid around the testicle causing swelling. The testicle itself feels normal inside. Often painless.
Epididymitis/Orchitis
Infection or inflammation of the epididymis or testicle. Usually causes pain, swelling, and sometimes fever. May need antibiotics.
Remember
Even though most lumps aren't cancer, you should always get any new lump checked by a doctor. They can usually tell what it is with an examination and ultrasound scan.
Testicular Cancer
Testicular cancer is rare overall (about 2,400 cases per year in the UK), but it's the most common cancer in men aged 15-49.
Risk Factors
- Undescended testicle — Even if corrected in childhood
- Family history — Brother or father with testicular cancer
- Previous testicular cancer — In the other testicle
- Infertility — Some link, though most infertile men don't get it
Symptoms
- A lump or swelling in part of one testicle
- A testicle getting bigger or changing shape
- A heavy feeling in the scrotum
- A dull ache in the lower abdomen or groin
- Rarely: breast tenderness or swelling (from hormones)
Diagnosis
- Physical examination — Your GP will examine your testicles
- Ultrasound scan — Shows if a lump is solid (possible cancer) or fluid-filled (usually benign)
- Blood tests — Tumour markers (AFP, hCG, LDH)
- CT scan — If cancer is confirmed, to check if it has spread
Testicular Cancer Is Very Treatable
Even if it has spread, testicular cancer responds very well to treatment. Overall, more than 95% of men survive. Survival is even higher when caught early.
Treatment usually involves removing the affected testicle (orchidectomy), sometimes followed by chemotherapy or radiotherapy.
After Treatment
If you have a testicle removed:
- You can still have children — One testicle produces enough sperm and testosterone
- You may be offered sperm banking — Before chemotherapy if needed
- A prosthetic testicle — Can be inserted if you want, for appearance
- Regular follow-up — To check for any recurrence
When to See Your GP
Make an appointment if you notice:
- A lump or swelling in a testicle
- A change in the size or shape of a testicle
- A heavy feeling in the scrotum
- Aching in the lower abdomen or groin
- Any change from what's normal for you
Don't be embarrassed — GPs examine testicles regularly. It's a quick examination and can put your mind at rest or catch problems early.