Testicular cancer cells

Testicular cancer: What do I do if I find a lump or swelling?

Testicular cancer is a fairly uncommon type of cancer that will affect approximately 1 in 250 men in their lifetimes. While the American Cancer Society estimates that there will be more than 9,000 new diagnoses of testicular cancer in 2023, the estimated number of deaths due to the disease is fairly low, at about 470. This makes testicular cancer one of the more curable types of cancer, especially if it is identified and treated early. 

Most men are already aware of the importance of monthly self-examinations for testicular cancer, but may be unsure of how to perform an examination, or what to do in the case of abnormalities. It’s quick and easy to perform a self-examination, especially during a shower, when the skin is most relaxed and loose. But what should you do in the event you detect unusual swelling, a lump or feelings of pain, heaviness or tenderness? Here are the first four steps to take after a self-examination reveals something that just doesn’t seem right: 

Be sure that what you’re feeling isn’t normal. While performing a self-exam for testicular cancer, especially for the first time, remember that there is often a small lump where the epididymis, the soft, tubelike structure that carries sperm, attaches to the testicle. If you’ve never performed a self-examination before, it’s common to mistake this natural lump for something more malicious. Remember that cancerous lumps usually are found on the sides of the testicle but can also show up on the front. Lumps on or attached to the epididymis are not cancerous. 

Don’t panic. If you notice an unusual lump or swelling, or have tenderness or pain, remember that there are many causes for testicular abnormalities that have nothing to do with cancer. Many times, lumps or swellings can be caused by something else, such as a viral or bacterial infection, a sexually transmitted disease, a dilated vein called a varicocele or the formation of a hydrocele, a condition where fluid collects around the testicle

Schedule an appointment with your doctor. If you’ve noticed something unusual or new during a self-exam, it’s important to make an appointment with your doctor right away. Don’t wait, and don’t feel embarrassed; your doctor will perform a routine physical exam, including your testicles, your abdomen, lymph nodes and other parts of your body, and can often tell you right away if there’s something that needs to be examined further. Your doctor may order a series of additional tests, including an easy and painless ultrasound of the testicles or blood tests that can reveal other cancer tumor markers. 

Remember that testicular cancer is highly treatable and curable. If the lump on your testicles is determined to be cancerous, remember that the disease is curable, with a low impact on quality of life when detected early. Depending on the stage of the cancer, your doctor may recommend a course of action as minor as “active surveillance,” where the cancer is carefully monitored for signs of spreading, through surgery to remove the testicle, chemotherapy and/or radiation treatment. For most men, cancer develops in only one testicle, which should not impact fertility of hormone production. Talk to your doctor about the potential side effects from cancer treatment, and whether fertility will be affected; your health care team will advise you about the potential necessity for a prosthetic testicle, sperm banking or hormone replacement therapy, as needed. Remember that the combined five-year survival rate for most types of testicular cancer is over 95 percent, and that for early-stage testicular cancer patients, recurrence is fairly unusual