The most common symptom of testicular cancer is a painless lump or swelling in one of the testicles [1]. A change in how the testicle feels or a firmer testicle, a feeling of heaviness in the scrotum, a dull ache in the lower abdomen or groin, a sudden build-up of fluid in the scrotum, or pain or discomfort in a testicle can also occur [1, 5]. This cancer mostly affects men aged 20 to 40 and can usually be cured even when it has spread [2]; but show any new change in a testicle to a doctor promptly, because cancer that has not spread needs lighter treatment with fewer side effects [3].
Key points
- The most common symptom is a painless lump or swelling in one testicle [1]; the absence of pain does not mean it is harmless.
- This cancer mostly affects men aged 20 to 40 and is the most common cancer in men of this age [2].
- Testicular cancer can usually be cured even when it has spread [2, 4].
- Coming early still matters: if the cancer has not spread, less chemotherapy and surgery are needed and there are fewer side effects [3].
- Most often the man himself finds the change; get to know your testicles and tell a doctor about any change [3, 5].
Symptoms of testicular cancer
| Symptom | Explanation | What to do |
|---|---|---|
| A painless lump or swelling in one testicle | The most common symptom [1] | Show it to a doctor promptly |
| A change in how the testicle feels, or a firmer testicle | A symptom [1, 5] | Show it to a doctor promptly |
| A feeling of heaviness in the scrotum | A symptom [5] | If it continues, see a doctor |
| A dull ache in the lower abdomen or groin | A symptom [1] | If it continues, see a doctor |
| A sudden build-up of fluid in the scrotum | A symptom [1]; sometimes a lump is hidden behind it [6] | See a doctor; an ultrasound scan helps |
| Pain or discomfort in a testicle or the scrotum | Having pain does not rule out cancer [1, 6] | Sudden severe pain: go to an emergency department straight away |
| Back pain, a lump in the neck, cough or shortness of breath, swollen or tender breasts | When the cancer has spread [5] | See a doctor soon |
This table does not replace an examination by a doctor; swelling of the scrotum has other causes too, such as infection, a build-up of fluid or enlarged veins in the scrotum [5].
When should I call my doctor?
Show any new lump, swelling or hardness in a testicle to a GP or a urologist promptly; do not wait for it to go away and do not let embarrassment delay you [1, 3].
If you were given antibiotics for an "infection" and the swelling has not gone after treatment, go back and ask about an ultrasound scan [5].
Sudden severe pain in a testicle may be a twisted testicle (torsion) and needs emergency care straight away.
Checking your testicles at home
Regular self-examination is not formally recommended for men without symptoms, because no study has shown that it saves more lives; one reason is that this cancer can usually be cured at any stage [3, 8]. But knowing your own body helps you notice a new change early; most testicular cancers are found by men themselves [3]. If you choose to check [5]:
- 1
Standing, at the same time each month
Do the check standing up, at about the same time every month [5].
- 2
Roll each testicle separately
Place your thumb on top of the testicle and your index and middle fingers underneath, and gently roll it between your fingers several times, feeling for lumps, hardness or swelling [5].
- 3
Know what normal feels like
A healthy testicle is egg-shaped and smooth, and the soft tube you can feel behind it (the epididymis) is normal [5].
- 4
If you notice a change
See a doctor; the first test is usually an ultrasound scan of the scrotum [5].
The path to diagnosis
- 1
Examination
The doctor examines the testicles and scrotum for lumps, swelling or pain [5].
- 2
Testicular ultrasound
A simple scan that is the first test for a testicular lump and shows whether the lump is inside the testicle itself [5].
- 3
Blood tests for tumour markers
Three substances in the blood (AFP, beta-hCG and LDH) are measured before surgery to help with diagnosis, staging and follow-up [4]. Read more: what is a tumour marker?
- 4
Surgery to remove the testicle
If the lump is suspicious, the whole testicle is removed through a cut in the groin (not through the scrotum) and examined under a microscope; this operation is both the diagnosis and the first treatment [4].
- 5
Staging
A CT scan of the abdomen and chest imaging show whether the cancer has spread [5]. Before chemotherapy or radiotherapy, talk to your doctor about storing sperm [4]. Read more: Testicular cancer
Who is at higher risk?
These factors increase the risk of testicular cancer [4]:
- An undescended testicle: a testicle that did not come down into the scrotum in childhood. Surgery before puberty may lower the risk, but this is not certain [4].
- testicular cancer in the family, especially in a father or brother
- previous cancer in the other testicle
This cancer mostly affects young and middle-aged men [4]. If one of these factors applies to you, pay extra attention to changes in your testicles and talk to your doctor about follow-up.
Frequently asked questions
My testicular lump does not hurt. Does that mean it is nothing serious?
Can testicular cancer be cured?
Yes, it is one of the most curable cancers. When the cancer is confined to the testicle, almost all patients recover, and even at advanced stages it can usually be cured [2, 4]. In a large international study, of every 10 men with spread disease in the low-risk group, more than 9 were alive five years later [9].
Do I need to check my testicles every month?
It is not formally recommended for men without symptoms, because no study has shown that it saves more lives [3, 8]. But most testicular cancers are found by men themselves, so get to know your body and report any change [3]. If you have had an undescended testicle or testicular cancer before, talk to your doctor about follow-up [4].
My testicular swelling did not get better with antibiotics. What should I do?
Does testicular cancer affect fertility?
Most men can father children after treatment [4]. But chemotherapy, radiotherapy and some operations can reduce fertility, so storing sperm is offered before these treatments [4]. Read more: fertility and sex during cancer treatment
Can a knock to the testicles cause cancer?
Can cancer also appear in the other testicle?
It is uncommon. In the 15 years after diagnosis, about 1 in every 50 treated men develops cancer in the other testicle as well [4]. That is why examining the remaining testicle and regular follow-up are important.
Referral criteria and assessment (for physicians)
For physicians
NICE NG12 (updated 15 April 2026). Non-painful enlargement or change in shape or texture of the testis: consider a suspected cancer pathway referral (diagnosis or exclusion within 28 days; recommendation 1.6.7). Unexplained or persistent testicular symptoms: consider an urgent direct access ultrasound scan (within 2 weeks; 1.6.8) [7]. The USPSTF recommends against screening (clinician or self-examination) in asymptomatic adolescent and adult men (grade D) [8].
Value of symptoms in primary care. In a case-control study of 1,398 cases and 4,956 controls (aged 17 and over), the strongest associations were testicular swelling (OR 280; 95% CI 110 to 690), testicular lump (OR 270; 100 to 740) and scrotal swelling (OR 170; 35 to 800). The positive predictive value of a testicular lump at age 17 to 49 was 2.5% (1.1 to 5.6%), and combining a lump with testicular swelling or pain gave 17% and 10% respectively. Painful testicular enlargement does not exclude cancer, and some initial hydrocele diagnoses were wrong; ultrasound is useful when a hydrocele diagnosis is uncertain [6].
Assessment. Scrotal ultrasound is the first test for a testicular mass; an intratesticular mass needs urology referral for orchidectomy, abdominal CT and chest imaging. A mass treated as presumed epididymitis that does not respond to antibiotics should be re-evaluated [5]. AFP, beta-hCG and LDH should be measured before orchidectomy; radical inguinal orchidectomy with high ligation of the spermatic cord is the procedure of choice for diagnosing and treating a malignant testicular mass. Offer sperm banking before any treatment other than orchidectomy [4].
Prognosis (updated IGCCCG, treated 1990 to 2013). Metastatic non-seminoma (9,728 patients): 5-year overall survival 96% in the good, 89% in the intermediate and 67% in the poor prognosis group; LDH above 2.5 times the upper limit of normal, older age and lung metastases are additional adverse factors [9]. Metastatic seminoma (2,451 patients): 5-year overall survival 95% in the good and 88% in the intermediate prognosis group; LDH above 2.5 times the upper limit of normal is an additional adverse factor [10]. In low-stage disease the cure rate approaches 100%, and the cumulative risk of a contralateral testicular cancer over 15 years is about 2% [4]. See the BEP regimen.
Related cancer types
References
10 referencesShow all references, 1 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
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- 7Suspected cancer: recognition and referral. NICE guideline NG12: Recommendations organised by site of cancer (last updated 15 April 2026)
- 8
- 9Predicting Outcomes in Men With Metastatic Nonseminomatous Germ Cell Tumors (NSGCT): Results From the IGCCCG Update Consortium
- 10Survival and New Prognosticators in Metastatic Seminoma: Results From the IGCCCG-Update Consortium
This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
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