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New or concerning changes in a testicle are worth discussing with a GP, but a lump or ache does not by itself mean cancer. Testicular cancer is cancer in one or both testicles; assessment may include an examination, ultrasound and blood tests, and treatment is chosen according to the cancer and the person’s health.
What is testicular cancer?
Testicular cancer begins in one or both testicles. The US National Cancer Institute says almost all cases begin in germ cells, the cells that make sperm. The two main germ-cell types are seminomas and nonseminomas; they can behave differently and may call for different treatment approaches. The NCI says testicular cancer can usually be cured, including in late stages, but that general statement cannot predict an individual outcome. National Cancer Institute: Testicular Cancer Treatment
Which changes should prompt a medical check?
Contact a GP about a new or concerning change, such as:
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- a testicle becoming larger;
- an ache or pain in a testicle; or
- a scrotum that feels heavy, firm or hard.
These symptoms can have many causes, and most are not necessarily cancer. A symptom alone cannot diagnose it. The NHS recommends contacting a GP if you notice a change. NHS: Testicular cancer symptoms
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How can you check your testicles?
Pay attention to changes in how your testicles look or feel, including a new lump, swelling, change in size, ache, or unusual heaviness or firmness. If you notice something concerning, arrange a GP assessment rather than trying to diagnose the cause yourself. Checking for changes is not a diagnostic test and does not replace medical review. NHS: Testicular cancer symptoms
What happens at a GP appointment?
A GP may ask about the change and examine your testicles and nearby lymph nodes. Depending on the findings, the GP may refer you for further assessment. An appointment or referral does not itself mean you have cancer. NHS: Getting diagnosed
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What tests may be used to investigate a testicular lump?
Ultrasound
Ultrasound is often the first imaging test when testicular cancer is suspected, according to the American Cancer Society. It helps clinicians assess the testicle and the nature of a lump. American Cancer Society: How Is Testicular Cancer Diagnosed?
Blood tests
Blood tests can measure tumor markers. These results can contribute to diagnosis and help clinicians assess disease extent or monitor treatment and follow-up; they are considered alongside examination and imaging, not as a stand-alone diagnosis. American Cancer Society: How Is Testicular Cancer Diagnosed?
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Surgery and laboratory examination
A biopsy is rarely used for a suspected testicular tumor. If suspicion is high, a clinician may recommend removing the affected testicle, called an orchidectomy, so it can be examined in a laboratory by a pathologist. Your clinical team will explain why this is being considered and what the assessment involves. American Cancer Society: How Is Testicular Cancer Diagnosed?
How is testicular cancer treated?
Removal of the affected testicle is the main treatment described by the NHS. Depending on the individual case, surgery may be enough, or the team may also recommend chemotherapy or radiotherapy. The plan depends on the tumor type and size, whether the cancer has spread, and the person’s general health; the specialist team determines the appropriate treatment. NHS: Treatment for testicular cancer
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What about fertility?
Some treatment can affect fertility. The NHS says sperm collection and storage can be offered before treatment. Ask the specialist team about fertility and preservation options before treatment begins, so the discussion can take account of the proposed treatment and your circumstances. NHS: Treatment for testicular cancer
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