Testicular Cancer Detection & Diagnosis

In many cases, the first sign of testicular cancer is a lump or swelling in one testicle. Some men discover this change on their own during a self-exam or while showering, while others learn about it during a routine physical exam or when a partner notices a difference. Because testicular cancer often develops without significant pain in its earliest stages, recognizing subtle changes and seeking prompt medical evaluation is extremely important.

Early detection plays a critical role in treatment success. When identified in its earliest stages, testicular cancer is highly treatable and often curable. For this reason, any new lump, swelling, or persistent change in the testicles should be evaluated by a medical professional as soon as possible.

Signs and Symptoms of Testicular Cancer

Although some cases are not diagnosed until the disease has progressed, many men experience noticeable symptoms early on. These changes may be painless at first, which can make them easy to ignore. However, even mild or subtle symptoms should not be dismissed.

Common signs and symptoms of testicular cancer include a painless lump or swelling in either testicle, a change in how the testicle feels, or a difference in size between the two testicles. Some men report a dull ache in the lower abdomen or groin area, while others experience discomfort or a feeling of heaviness in the scrotum. In certain cases, there may be a sudden buildup of fluid in the scrotum.

It is important to understand that these symptoms can also be caused by noncancerous conditions such as infections or injuries. However, only a proper medical evaluation can determine the cause. Addressing symptoms early improves the likelihood of detecting cancer at an earlier stage, when treatment is most effective.

At-Home Self-Exams for Early Detection

Regular self-examination can help men become familiar with what is normal for their bodies and make it easier to detect changes. While not all medical organizations formally recommend routine self-exams for every man, they may be particularly helpful for those with known risk factors, such as a history of an undescended testicle or a family history of testicular cancer.

A self-exam takes only a few minutes and is best performed during or after a warm shower or bath, when the scrotal skin is relaxed. Each testicle should be examined separately using both hands. Gently rolling the testicle between the thumbs and fingers allows you to feel for any lumps, firm areas, or changes in surface texture. It can also be helpful to stand in front of a mirror to look for visible swelling.

Men should be aware that a normal testicle contains a soft, tube-like structure called the epididymis, located along the back or upper portion of the testicle. This structure can feel like a small bump and should not be mistaken for a tumor. It is also normal for one testicle to be slightly larger or hang lower than the other.

If you notice any new lump, swelling, firmness, or persistent discomfort, it is important to schedule an appointment with a physician promptly.

Testing for Testicular Cancer

If you experience symptoms or identify anything unusual during a self-exam, see your primary care physician, who will begin with a thorough evaluation. This typically includes a physical examination of the testicles, scrotum, abdomen, and surrounding lymph nodes.

Diagnostic Tests

Imaging

Imaging tests are the most likely next step, allowing the physician to see if there is a tumor growing in the testical or near it. Scrotal ultrasound is usually the first imaging study performed because it can clearly distinguish between solid masses and fluid-filled cysts. In some cases, additional imaging such as CT scans, PET scans, or MRI may be recommended to determine whether the cancer has spread beyond the testicle.

Blood Tests

Blood tests are also performed to measure serum tumor markers. These markers, which may include alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-hCG), and lactate dehydrogenase (LDH), can provide important information about whether cancer is present and what type it may be. Tumor marker levels are also used later to monitor treatment response.

Surgery to Confirm Diagnosis

Unlike many other cancers, a traditional biopsy is generally not performed to diagnose testicular cancer. This is because inserting a needle into the testicle could potentially spread cancer cells. Instead, when blood tests and imaging strongly suggest cancer, the standard approach is surgical removal of the affected testicle in a procedure known as a radical inguinal orchiectomy.

During this procedure, the surgeon removes the testicle through an incision in the groin. The tissue is then sent to a pathologist for detailed examination to determine the exact type of testicular cancer and whether it has spread beyond the testicle. In some cases, additional imaging studies are performed either before or after surgery to evaluate nearby lymph nodes and other organs.

Next Steps After a Testicular Cancer Diagnosis

Once the diagnosis is confirmed, you will choose a cancer care team who will determine the stage of the cancer and discuss the most appropriate treatment plan. Rocky Mountain Cancer Centers GU oncologists are here to guide you through the next steps on your cancer journey.

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