Testicular Cancer: Symptoms, Causes, Diagnosis, Treatment & Prevention

Introduction

A small, painless lump or enlargement in a testicle is sometimes overlooked because it may not seem  serious or cause discomfort. However, not all health problems are painful, and early evaluation of unusual changes can make a significant difference. Although testicular cancer is rare, it is one of the most  treatable cancers when found early. 

This article discusses how understanding testicular cancer, including its types, possible causes and risk factors, symptoms, diagnosis, and treatment options, can support early detection and effective care. 

What Is Testicular Cancer?

Testicular cancer is a cancer that starts in the tissues of one or both testicles. The testicles are male reproductive glands located in the scrotum, the pouch of skin below the penis. They make sperm and the hormone testosterone^1,2. Testicular cancer can occur at any age, but it is most often diagnosed in younger and middle-aged adults. Most cases begin in germ cells, which are the cells that make sperm².

Rates of testicular cancer have increased in recent decades. The condition is important because both the disease and its treatment can affect a person’s long-term health, fertility, and quality of life. With early diagnosis and care from a specialist team, testicular cancer is usually highly treatable³. 

Types of Testicular Cancer

Testicular cancers are mainly of two types, namely²:

• Seminomas: Seminomas usually grow more slowly than non-seminomas and often occur in adults aged about 25 to 45 years. They may spread to nearby lymph nodes. Depending on the stage, treatment may include surgery, careful monitoring, radiation therapy, or chemotherapy. 
• Non-seminomas: These often grow and spread more quickly than seminomas and are more common in teenagers and younger adults. They may contain one or more cell types, including embryonal carcinoma, yolk sac tumour, choriocarcinoma, and teratoma. 

Causes of Testicular Cancer

The exact cause of testicular cancer is often unknown. However, certain factors can increase a person’s risk. Risk factors for testicular cancer include^2,4: 

• Undescended testicle: Being born with a testicle that has not moved down into the scrotum before birth, a condition called cryptorchidism, increases the risk of developing testicular cancer^2,4,5. 
• Previous testicular cancer or family history: Men who have had testicular cancer in one testicle have a higher chance of developing cancer in the other testicle. Also, having a close family member, such as a father or brother, with testicular cancer can increase the risk^2,4,5.
• Abnormal testicle development: Some conditions that affect how the testicles develop may increase the risk of testicular cancer².
• HIV infection: Having HIV or AIDS increases the risk of developing testicular cancer^2,4.
• Chemical exposure and tobacco use: Some sources describe possible links between certain chemical exposures and testicular cancer, but risk is better established for factors such as undescended testicle, previous testicular cancer, and family history. Avoiding tobacco remains important for overall health².
• Chromosomal abnormalities: Certain conditions like Down syndrome and Klinefelter’s syndrome caused by abnormalities in basic genetic material could increase the risk of testicular cancer².

Symptoms of Testicular Cancer

Some people with testicular cancer do not notice symptoms at first. When symptoms or signs of testicular cancer are present, they may include: 

• Painless lump or swelling in a testicle: The most common symptom^2,6. 
• Change in the size or feel of the testicle and scrotum: One testicle may feel or look different than usual, and the scrotum may feel unusually heavy^2,6.
• Pain in the lower abdomen or back: You may notice pain in the lower abdomen and back^2,6.
• Sudden build-up of fluid in the scrotum: Some people may notice a new swelling or a feeling of fluid in the scrotum¹.
• Breast tenderness or enlargement: Rarely, hormone changes related to testicular cancer can cause breast tenderness or swelling in teenage boys².
• Symptoms in other parts of the body: If the cancer has spread outside the testicles, symptoms may also appear in the brain, back, pelvis, abdomen, lungs, or other regions of the body².

How Is Testicular Cancer Diagnosed?

Testicular cancer diagnosis includes: 

• Physical examination: A doctor examines the testicles and scrotum and may also check nearby lymph nodes. In some cases, a light may be shone through the scrotum, a simple check called transillumination, to help assess a swelling^1,2,7. 
• Blood tests: Blood tests may check for substances called tumour markers, such as lactate dehydrogenase (LDH), alpha-fetoprotein (AFP), and beta human chorionic gonadotropin (beta-hCG). These results can support diagnosis, help guide treatment, and monitor response to treatment^1,2,7,8. 
• Ultrasound: An ultrasound of the scrotum is done to detect the presence of growth in the testicles^2,8. 
• CT, MRI, or bone scans: Imaging tests may be used to check whether cancer has spread to areas such as the abdomen, pelvis, chest, brain, or bones. The type of scan depends on symptoms, blood test results, and the doctor’s assessment^2,7.
• Surgery to confirm the diagnosis: Testicular cancer is usually confirmed after the affected testicle is removed through surgery, called an orchiectomy. Doctors generally avoid taking a small needle biopsy from the testicle because of the risk of spreading cancer cells^1,8. 

Stages of Testicular Cancer

The stages of testicular cancer describe how far the cancer has spread. Knowing the stage helps doctors recommend treatment and helps patients understand their options. Stages of testicular cancer include^2,3:

• Stage I: The cancer is only in the testicle and has not spread to nearby lymph nodes or other parts of the body. This is the earliest stage of testicular cancer. 
• Stage II: The cancer has spread to nearby lymph nodes in the abdomen and retroperitoneal lymph nodes but has not spread to distant organs. It is still limited to nearby areas and has not spread to other parts of the body. 
• Stage III: The cancer has spread to distant parts of the body, such as the lungs, liver, brain, or other organs, or to lymph nodes outside the abdomen. This is the most advanced stage of testicular cancer. 

Treatment of Testicular Cancer

Testicular cancer treatment depends on the type of cancer, stage, and your overall health. Your doctor will recommend the most suitable treatment based on these factors. 

1. Surgery

Surgery to remove the affected testicle, called a radical inguinal orchiectomy, is the main treatment for most people with testicular cancer. In some cases, nearby lymph nodes may also be removed^1,2,7.

2. Radiation therapy

High-energy radiation may be used to destroy cancer cells, mainly for some cases of seminoma^1,2,7.

3. Chemotherapy

Chemotherapy medicines may be used to kill cancer cells, especially if the cancer has spread beyond the testicle^1,2,7.

4. Active surveillance or close follow-up

After surgery, some people may not need more treatment straight away. Instead, they may have regular checkups, blood tests, and scans to look for any signs that the cancer has returned^1,7.

Possible Complications of Testicular Cancer

Testicular cancer and its treatment can sometimes cause short-term or long-term effects. These depend on the type and stage of cancer, the treatment used, and the person’s overall health. Possible effects include²:

• Cancer spreading to other parts of the body: Testicular cancer can spread to nearby lymph nodes or to organs such as the lungs, liver, brain, or bones. 
• Effects after surgery: Surgery can cause bleeding or infection. Fertility may be affected, especially if both testicles are removed or if chemotherapy or radiation therapy is also needed. 
• Long-term health effects: Some people may develop conditions such as metabolic syndrome, heart disease, or a return of cancer after treatment. Follow-up care helps doctors monitor and manage these risks. 
• Treatment-related side effects: Some cancer treatments can affect the kidneys, nerves, or hearing. Doctors discuss these risks before treatment and monitor for them during follow-up. 

Tips to Support Early Detection 

Finding testicular cancer early can help doctors start treatment sooner. Being aware of changes in the testicles and seeking medical advice when unusual symptoms appear are important steps for early detection^1,2.

• Check for unusual changes: Look out for signs such as a lump, swelling, a change in testicle size, or a feeling of heaviness in the scrotum^1,2.
• Do not ignore painless changes: A testicular lump may not cause pain. Any new lump, swelling, or change in a testicle should be checked by a doctor^1,2.
• Seek medical advice early: Contact a doctor if you notice any unusual changes².
• Attend regular follow-up appointments if diagnosed: People who have had testicular cancer may need ongoing follow-up, including checkups, blood tests, or scans, as advised by their doctor².

When Should You Consult a Doctor?

Consult a doctor if you notice any unusual changes in your testicles, such as a lump, swelling, change in size or feel, pain, discomfort, or a feeling of heaviness in the scrotum. Although these symptoms may be caused by conditions other than testicular cancer, it is important to get them checked to identify the cause and receive appropriate care^1,2.

Conclusion

Testicular cancer is uncommon but can often be treated successfully, especially when it is diagnosed early. Being aware of changes such as a lump, swelling, pain, or changes in the size and feel of the testicles can help identify possible warning signs. If you notice any unusual changes, do not delay seeking medical advice, as early evaluation can lead to timely initiation of treatment. Regular awareness and understanding of the symptoms are important steps in protecting testicular health. 

Frequently Asked Questions (FAQs)

References

1. Testicular Cancer. Accessed August 6, 2026. https://medlineplus.gov/testicularcancer.html 

2. Testicular cancer: MedlinePlus Medical Encyclopedia. Accessed August 6, 2026. https://medlineplus.gov/ency/article/001288.htm 

3. Gaddam SJ, Bicer F, Chesnut GT. Testicular Cancer. In: StatPearls. StatPearls Publishing; 2026. Accessed August 6, 2026. http://www.ncbi.nlm.nih.gov/books/NBK563159/ 

4. Causes of testicular cancer. nhs.uk. April 22, 2024. Accessed August 6, 2026. https://www.nhs.uk/conditions/testicular-cancer/causes/ 

5. What is testicular cancer? University College London Hospitals NHS Foundation Trust. Accessed August 6, 2026. https://www.uclh.nhs.uk/our-services/find-service/cancer-services/testicular-cancer-1/what-testicular-cancer 

6. Case L. Testicular cancer – be aware of the symptoms and how to check yourself. NHS Shropshire, Telford and Wrekin. April 23, 2024. Accessed August 6, 2026. https://www.shropshiretelfordandwrekin.nhs.uk/news/testicular-cancer-be-aware-of-the-symptoms-and-how-to-check-yourself/ 

7. Sievert D. What Is Testicular Cancer? UCLA Medical School. April 25, 2023. Accessed August 6, 2026. https://medschool.ucla.edu/news-article/testicular-cancer-symptoms-treatment-and-causes 

8. Diagnosing testicular cancer. University College London Hospitals NHS Foundation Trust. Accessed August 6, 2026. https://www.uclh.nhs.uk/our-services/find-service/cancer-services/testicular-cancer-1/diagnosing-testicular-cancer 

9. Baniel J, Foster RS, Gonin R, Messemer JE, Donohue JP, Einhorn LH. Late relapse of testicular cancer. J Clin Oncol Off J Am Soc Clin Oncol. 1995;13(5):1170-1176. doi:10.1200/JCO.1995.13.5.1170 https://pubmed.ncbi.nlm.nih.gov/7537800/

10. Meyts ERD, Znaor A, Skakkebæk NE, Gatta G, Gurney J, Schüz J. Testicular cancer. In: World Cancer Report: Cancer Research for Cancer Prevention. International Agency for Research on Cancer; 2020. Accessed August 6, 2026. https://www.ncbi.nlm.nih.gov/books/NBK606475/ 

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