Testicular cancer is not an anomaly. It is the most diagnosed cancer in men 30 to 39 years oldwith an average age of detection around 33 years.
“About 1 in 250 men develop testicular cancer each year, resulting in approximately 9,990 new cases in the United States each year,” explained Dr. Christopher Sweeneymedical oncologist at the Dana-Farber Cancer Institute and a member of the World Cancer Advisory Board for Movember.
Testicular cancer is highly treatable when diagnosed before it reaches an advanced stage, and like most cancers, early detection is essential to help fight it. That’s why doctors recommend that men familiarize themselves with the symptoms and perform routine self-examinations.
“If detected early, cure rates can exceed 95% for most versions of testicular cancer,” said Dr. Doug Flora, executive medical director of St. Elizabeth Healthcare Cancer Center in Edgewood, Kentucky. In fact, when detected early, he pointed out that doctors can “expect to cure more than 90% of patients with testicular cancer in a single treatment.”
But detection can be difficult if you don’t know what to look for, especially if you are in a younger age group. “Most physicians and providers don’t typically think of cancers when dealing with healthy young patients, so heightened vigilance for subtle warning signs is in order,” Flora said.
Below, doctors break down a few of those red flags:
A lump on the testicles
The most common sign of testicular cancer is a firm lump or mass that can be felt in the testicle.
“Most testicular cancers are diagnosed when patients feel the lump themselves,” explained Dr. Ali Zhumkhawala, Surgical Oncologist Urologist at City of Hope in Los Angeles. He stressed that any lump that looks new or abnormal in the testicle should be brought to your doctor’s attention.
“This sign of cancer is usually painless,” added Dr. Jordan R. Luskin, urologist at Good Samaritan Medical Center in Florida. At least 90% of men will exhibit this sign, which is usually found by self-examination.
“It could also be felt by a sexual partner,” Luskin said. If you feel a lump or anything suspicious in your testicles, see your doctor right away.
Testicles that feel “different”
Changes in the sensation of a testicle, with or without a lump, can also be a warning sign. “Testicular cancer begins as a painless mass growing in the testicle,” says Dr Rodwell Mabaera, oncologist at Dartmouth Cancer Center in Lebanon, New Hampshire.
Although a distinct hard lump is often present, Mabaera said many cases present as subtle differences in testicle sensation. “The cancer can be hidden below the surface of the testicle or affect the entire testicle, making it difficult to feel a distinct lump,” he explained.
“Any severe and sudden onset of testicular pain should prompt urgent evaluation as it may be a sign of testicular torsion, a condition in which the testicle twists and cuts off its blood supply,” Zhumkhawala said.
But more progressive and persistent pain should also be evaluated, as this can be a sign of testicular cancer. “Patients can perform a self-examination at this stage to see if there is a new mass or nodule,” Zhumkhawala added.
If in doubt, it is best to consult your doctor.
Abdominal, back or flank pain
Many people attribute lower back pain to an intense workout, a weekend house project, or simply aging. “While all of this may be true, persistent pain shouldn’t be out of control, especially if you’re in relatively good physical shape and don’t regularly engage in strenuous activity,” Luskin said.
Back pain can occur when testicular cancer spreads to lymph nodes in the back of the abdomen. “These lymph nodes are often called para-aortic or retroperitoneal lymph nodes,” Luskin said.
He recommended patients seek medical attention if back pain persists for weeks or months, or when it begins to affect other normal activities, such as household chores, driving or sitting at a desk. Any new severe pain in the abdomen, back or flank should be evaluated by your doctor or treated urgently.
Swelling of the legs or scrotum
Swelling in these areas can be a rare sign of advanced testicular cancer, according to Zhumkhawala.
“It happens when enlarged lymph nodes in the back of the abdomen block the flow of blood or lymphatic fluid from the legs, causing fluid to build up,” he said.
Zhumkhawala explained that heart failure in older men can also show swelling in the legs, much like a blood clot in the legs. Since all of these conditions can be dangerous, new leg swelling warrants medical evaluation.
Cough, headache, or vision changes
“A new cough can be a manifestation of a variety of causes and is a very rare sign of advanced testicular cancer that has spread to the lungs,” said Dr Michael KarellasDirector of Urology at Stamford Hospital.
Likewise, there are multiple causes of headaches and even blurred vision. However, rare forms of testicular cancer that are advanced and have spread to the brain can cause visual changes, new headaches, or even seizures.
“These are rare findings, but in this setting a testicular exam should be done as well as evaluation with blood tests and imaging studies,” Karellas said.
Breast enlargement or tenderness
These can be rare indicators of possible testicular cancer. “This happens due to the production of a hormone called human chorionic gonadotropin (hCG) from the cancer itself,” Zhumkhawala said. “This hormone is normally present in high levels in pregnant women and can lead to breast tissue growth and is a rare symptom of testicular cancer.”
Nipple tenderness or rare discharge from the nipple in an otherwise healthy young man can also be a warning sign, Karellas said. All men who experience it should be seen by their GP or urologist.
hCG is also the pregnancy hormone. “Sometimes a person with testicular cancer can produce the hormone that makes a pregnancy test positive,” Luskin said. But that, he pointed out, is very rare. “We do not recommend using a home pregnancy test to test for or diagnose testicular cancer,” he added.
How to Perform Self-Checks for Testicular Cancer
It is recommended that men perform routine self-testicular examinations, especially between the ages of 18 and 40, and pay close attention to any new findings such as changes in testicle size, differences with new firm areas or bumps that weren’t there before. .
“Whether or not you visit the doctor regularly, anyone with testicles should administer a home check every month or so,” said Dr. Jeffrey Dlott, medical director of Quest Direct.
It’s super simple and can be done in the shower, as the hot water will help relax the scrotum. “Using your fingers, gently move them over each testicle, looking for any lumps, abnormalities, or changes in size,” Dlott explained. “You know your groin best, so feel everything that wasn’t there before.”
An initial evaluation by a doctor will often include an examination, an ultrasound of the testicles and/or a blood test. “Certain blood tests can diagnose testicular cancer and can quickly help confirm the diagnosis,” Karellas added.
“The key is to be vigilant and report anything you think is unusual to your medical team,” Flora said. “The average man waits about five months before saying anything, which delays important treatments.”