Testicular cancer often presents in sensitive ways. While it only accounts for 1% of male cancer cases, it’s the most diagnosed cancer in young men: on average, diagnosis happens at age 33. White men in the United States are 4 to 5 times more likely than Black men—and 3 times more likely than Asian-American men—to have testicular cancer. According to the American Cancer Society, the reason for these race and ethnic differences are still unknown.
Testicular cancer is very treatable, with an average 95% survival rate after 5 years. Early detection leads to better outcomes, so it’s critical for men to know the symptoms, stay in tune with their bodies and share any changes with their healthcare providers.
Recognizing the signs
#1: Physical changes
The most common sign of testicular cancer is a difference in how a testicle looks or feels. This can be a change in size or firmness in a certain area, or of the entire testicle compared to the other side.
Testicular cancer starts with a lump, which is usually painless and can be felt. However, a lump may not be noticeable because it may be in tissue underneath the testicle’s exterior, or be testicle-wide. Rodwell Mabaera, MD, PhD, research director, Genitourinary Oncology, Dartmouth Cancer Center, reports that 50 to 60% of testicular cancer cases present with these symptoms, but about half don’t experience an obvious lump.
He says these changes are noticed most often after testicular trauma, by a sexual partner or during self-examination.
#2: Heaviness in lower abdomen or groin
Approximately 30 to 40% of men with testicular cancer feel a slowly increasing dull ache or a sensation of heaviness in the lower abdomen, perianal area or in the groin.
“These symptoms are caused either directly by testicular cancer in the scrotum, or as the cancer spreads from the testicle and goes to the lymph nodes in the pelvis and abdomen,” Mabaera explains. “This can sometimes be masked, and be dismissed due to recent injury or perceived injury. Following an obvious injury, any pain that does not respond to rest or over-the-counter treatments within 2 weeks should be evaluated by a doctor.”
#3: Breast enlargement and tenderness
A little known sign of testicular cancer is an equal increase in size of both breasts, along with tenderness. This affects about 15% of men with testicular cancer limited to the testicle and nearly 50% in patients whose cancer has spread to other parts of the body.
Breast changes happen in men when certain testicular cancers produce a pregnancy hormone called human chorionic gonadotropin.
Stay aware and seek care
As with most cancers, early detection can prove lifesaving. Regular self-examinations and seeking medical care when any changes are noticed will help identify and treat testicular cancer. Information on how to conduct monthly self-examinations is available on the Testicular Cancer Awareness Foundation website.
“Any lump, change in feeling, unexplained pain, new discomfort or breast enlargement should be evaluated immediately,” Mabaera says.
For more information about testicular cancer, visit https://cancer.dartmouth.edu/prostate/testicular.