Testicular cancer: what should every man know?

Who gets testicular cancer?

Unusually for cancer, this is a young man's disease. Most cases worldwide are diagnosed between the ages of about 15 and 40, making it the most common solid cancer of that age group — the years when men are least likely to imagine cancer could apply to them, and least likely to be anywhere near a doctor.

Incidence has been rising in many countries for decades, for reasons that are only partly understood. The known risk factors are an undescended testicle in childhood (even when corrected), a previous testicular cancer on the other side, and a family history in a father or brother. Most men who develop it, however, have no identifiable risk factor at all — which is why awareness matters for everyone, not just men on a list.

What are the warning signs?

The classic first sign is a painless lump or swelling in one testicle. Other changes worth taking seriously:

• One testicle becoming noticeably larger, firmer or heavier than before.
• A dull ache or dragging sensation in the testicle, scrotum or groin.
• A sudden collection of fluid in the scrotum.
• Rarely, breast tenderness or swelling, caused by hormones some tumours produce.

Two misconceptions do real harm. The first is "it doesn't hurt, so it can't be serious" — in testicular cancer, painlessness is typical. The second is confusing the epididymis, the soft tube running along the back of each testicle, with a lump; learning your own anatomy is exactly what self-checks are for.

How do I check myself?

Once a month is enough, and the best moment is during or after a warm bath or shower, when the scrotal skin is relaxed.

• Support each testicle in turn with one hand and roll it gently between the thumb and fingers of the other.
• Feel for lumps, hard areas or anything new. A normal testicle is smooth, oval and slightly firm, like a hard-boiled egg without the shell.
• It is normal for one testicle to sit lower or be slightly larger than the other — what matters is change.

The point of the routine is not to diagnose anything yourself; it is to know your own normal so that a change registers early. Men who find their own tumours usually find them this way.

What happens if I find something?

See a doctor promptly — within days, not months. The first step is an examination and a scrotal ultrasound, a painless scan that usually settles the question quickly, supported by blood tests for tumour markers. Most lumps turn out to be benign: cysts, fluid collections (hydroceles), enlarged veins (varicoceles) and infections are all far more common than cancer.

If cancer is confirmed, the affected testicle is removed through a small incision in the groin. Depending on the type and stage, treatment after surgery ranges from careful surveillance alone to chemotherapy or radiotherapy. Outcomes are among the best in all of oncology: survival rates are high overall and highest when the disease is confined to the testicle at diagnosis — which is precisely what early detection achieves.

What about sex, fertility and life afterwards?

One healthy testicle normally produces enough testosterone and sperm to maintain erections, desire and fertility. Because chemotherapy and radiotherapy can affect sperm production, sperm banking before treatment is standard practice and worth insisting on. For men who want it, a silicone prosthesis can be placed so the scrotum looks and feels much as before. Hormone levels are monitored afterwards, and testosterone replacement is available in the minority of men who need it.

The psychological side deserves the same attention: a cancer diagnosis in your twenties or thirties is disorienting, and talking to a counsellor or a survivors' group is a strength, not an admission.

When to see a doctor

Any new testicular lump, swelling, firmness or persistent ache should be examined promptly — and a quick resolution is the likeliest outcome. If something has already been changing for weeks and you have been hoping it will go away, make that appointment today; our article on why men delay seeing a urologist is about exactly this habit, and it costs some men dearly.

Questions men also ask

How do I check my testicles?

Once a month, after a warm bath or shower when the scrotum is relaxed, roll each testicle gently between thumb and fingers. You are feeling for lumps, swelling, or a change in size, firmness or weight. The soft, slightly tender cord-like structure at the back (the epididymis) is normal.

Is a testicular lump always cancer?

No — most are not. Cysts, fluid collections, varicoceles and infections are all more common than cancer. But no lump can be safely diagnosed by touch alone, so every new one should be examined, usually with an ultrasound.

Does treatment mean losing fertility or sex life?

The affected testicle is removed surgically, but one healthy testicle usually maintains testosterone, erections and fertility. Because some treatments can affect sperm, banking sperm before treatment is routinely offered. A prosthesis can restore the appearance if a man wishes.

Sources & further reading

1. Nature Reviews Disease Primers Testicular cancer (opens in a new tab) (2018) Cheng L, Albers P, Berney DM, et al.
2. EAU Guidelines Office EAU Guidelines on Testicular Cancer (opens in a new tab) (2025) European Association of Urology.
3. NHS website Testicular cancer (opens in a new tab) (2024) NHS.

This article is general health information. It does not replace an individual medical consultation, examination or diagnosis. Read our editorial policy and medical review policy.