Testicular Cancer: Symptoms, Diagnosis and Treatment

A new lump or change in a testicle is understandably worrying. The reassuring fact is that most testicular lumps are not cancer. However, a lump within the testicle itself needs prompt assessment because testicular cancer can grow quickly and early treatment is extremely effective.

Testicular cancer is uncommon overall, but it predominantly affects younger men and is most common between the ages of 15 and 49. Around 2,300 men are diagnosed in the UK each year. It is also one of the most curable cancers we treat: more than 95% of men diagnosed with testicular cancer survive for at least five years, and cure is expected in almost all men with disease confined to the testicle.

Testicular cancer at a glance

Testicular cancer usually presents as a new painless lump, swelling or change in one testicle. Ultrasound is the most important first investigation, together with blood tests for tumour markers. If the scan strongly suggests cancer, the affected testicle is usually removed through an incision in the groin — a procedure called a radical inguinal orchidectomy.

For many men, that operation is the only treatment required. Others may need chemotherapy or, less commonly, further surgery or radiotherapy depending on the precise tumour type and whether it has spread.

The important message is simple: if you notice a new lump or change in a testicle, have it assessed promptly rather than waiting to see whether it disappears.

Key points

• A painless lump or swelling within a testicle is the classic symptom of testicular cancer.
• Pain does not exclude cancer — some men present with discomfort or aching.
• Testicular cancer most commonly affects men aged 15 to 49, although it can occur at any age.
• Around 2,300 men are diagnosed each year in the UK.
• More than 95% of men survive for at least five years, making it one of the most curable cancers.
• The first investigation for a suspicious testicular lump is usually a scrotal ultrasound.
• Treatment normally begins with radical inguinal orchidectomy — removal of the affected testicle through the groin.
• Fertility and sperm banking should be discussed before treatment, particularly if chemotherapy may be required.
• Many men with early-stage disease need no chemotherapy after surgery and can instead be monitored with active surveillance.
• Sudden severe testicular pain is different: it can indicate testicular torsion and requires same-day emergency assessment.

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What is testicular cancer?

The testicles, or testes, sit within the scrotum and have two principal functions: producing sperm and producing the male hormone testosterone.

Testicular cancer develops when cells within a testicle begin to divide abnormally and form a tumour.

Around 90–95% of testicular cancers arise from the germ cells, the cells involved in sperm production. These cancers are therefore known as germ cell tumours.

A smaller proportion arise from other cells within the testis. In older men, particularly over the age of 60, a new testicular mass may represent lymphoma rather than the germ-cell cancers more typical of younger men.

Germ-cell tumours behave differently from many other cancers. They can grow quickly, particularly some types of non-seminoma, but they also tend to spread in a relatively predictable way.

Lymphatic drainage from the testicle first travels to lymph nodes deep in the abdomen, known as the retroperitoneal lymph nodes. This reflects the testicle’s embryological development near the kidneys before it descends into the scrotum.

When testicular cancer spreads further, the lungs are another common site.

One major reason outcomes are so good is that germ-cell cancers are particularly sensitive to cisplatin-based chemotherapy. As a result, cure can remain achievable even when testicular cancer has already spread at the time of diagnosis.

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What are the different types of testicular cancer?

Testicular germ-cell tumours fall into two main groups:

Seminoma

Seminoma tends to occur slightly later than non-seminoma, commonly affecting men in their thirties and forties.

It generally grows more slowly and is extremely sensitive to chemotherapy. Radiotherapy can also be effective in seminoma, although its use has reduced considerably because of concerns about long-term adverse effects in men with otherwise excellent life expectancy.

Non-seminomatous germ-cell tumour

Non-seminomatous germ-cell tumour (NSGCT) tends to occur at a younger age and includes several different tumour types:

• embryonal carcinoma
• yolk sac tumour
• choriocarcinoma
• post-pubertal teratoma

Several components may occur together within the same tumour.

Non-seminomas often grow and spread more quickly than seminomas but remain highly curable with modern treatment.

If a tumour contains a non-seminomatous component, even when much of the tumour is seminoma, it is generally managed as a non-seminoma.

Why the word “teratoma” can be confusing

Older UK terminology sometimes used the word teratoma much more broadly for what we would now call non-seminomatous germ-cell tumour.

Internationally, teratoma has a narrower meaning. It describes a particular component containing differentiated tissues which, importantly, is relatively resistant to chemotherapy.

This matters because residual teratoma after chemotherapy may continue to grow and usually needs to be removed surgically.

If you have been given a pathology report containing the word teratoma, it is reasonable to ask your team exactly what it means in the context of your diagnosis.

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How common is testicular cancer?

Testicular cancer accounts for only around 1% of cancers diagnosed in UK men, but its age distribution makes it unusual.

Around 2,300 cases are diagnosed in the UK each year, with incidence highest in men aged 30–34. Almost one in five cases occurs within this five-year age group.

The estimated lifetime risk for a UK male is approximately 1 in 220.

Incidence increased considerably over previous decades — by approximately 25% since the early 1990s — although UK rates have been broadly stable over the past decade.

The reason for the historical increase is not completely understood and may involve developmental influences acting before birth rather than lifestyle choices made in adulthood.

The most important counterpoint is survival. More than 95% of men now survive testicular cancer for at least five years, and predicted ten-year survival across all ages is approximately 96.5%.

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What are the symptoms of testicular cancer?

What is the most common sign of testicular cancer?

The classic presentation is a painless lump or swelling in one testicle.

The absence of pain is important. Men sometimes assume that something serious would hurt, when in fact early testicular cancer is often completely painless.

Symptoms can include:

• a new firm or hard lump within a testicle
• enlargement of one testicle
• a change in the shape or firmness of a testicle
• a feeling of heaviness in the scrotum
• a dull ache in the testicle, groin or lower abdomen
• discomfort or pain in the testicle
• a new collection of fluid around the testicle

Some cancers are found incidentally during an ultrasound performed for another reason.

Can testicular cancer hurt?

Yes.

Although a painless lump is the classic presentation, pain can occur. It may be an ache, tenderness or occasionally more significant pain. Current European guidance specifically recognises scrotal, abdominal or back pain as possible presentations.

Pain therefore does not rule out testicular cancer.

Less obvious symptoms

More advanced testicular cancer can occasionally present with symptoms away from the testicle, including:

• persistent lower back or abdominal pain from enlarged retroperitoneal lymph nodes
• breast enlargement or tenderness (gynaecomastia) caused by hormones produced by some tumours
• breathlessness or persistent cough if disease has spread to the lungs
• a lump above the collarbone or in the neck caused by enlarged lymph nodes

These presentations are much less common than finding a change in the testicle itself.

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What should I do if I find a testicular lump?

Arrange an appointment with your GP or a urologist promptly.

NICE recommends urgent investigation or referral when there is a non-painful enlargement or change in the shape or texture of a testicle, and urgent ultrasound plays an important role when the cause of scrotal swelling is uncertain.

The majority of scrotal lumps are benign, so finding a lump does not mean you have cancer.

But it is much better to establish what it is with an examination and ultrasound than to watch a potentially significant lump for several weeks or months.

If you would prefer private assessment, my Rapid Access Scrotal Lumps Clinic provides specialist assessment of new testicular and scrotal lumps, with ultrasound arranged where appropriate.

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Is every testicular lump cancer?

No. In fact, many lumps and swellings in the scrotum are caused by benign conditions.

Common examples include:

Epididymal cyst or spermatocele

A smooth, fluid-filled swelling arising from the epididymis, usually felt above or behind the testicle.

These are extremely common and benign.

Hydrocele

A collection of fluid around the testicle. This can make the whole side of the scrotum appear enlarged.

Most hydroceles are benign, although a new hydrocele can occasionally make examination of the underlying testicle more difficult, which is one reason an ultrasound may be appropriate.

Varicocele

Enlarged veins around the testicle, most commonly on the left.

On examination, a varicocele is traditionally described as feeling like a “bag of worms”.

Epididymo-orchitis

Inflammation or infection involving the epididymis and sometimes the testicle itself. It is generally painful and tender and may be accompanied by urinary symptoms or fever.

Inguinal hernia

A portion of abdominal contents passing down towards the scrotum through the inguinal canal.

The important distinction is whether a lump is within the testicle itself or outside it.

A suspicious testicular tumour usually produces a firm intratesticular abnormality which cannot be separated from the testicle on examination.

But examination alone cannot provide certainty. Ultrasound is used because it can accurately determine whether a mass is within or outside the testicle.

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What increases the risk of testicular cancer?

Several factors are associated with an increased risk.

Undescended testicle

An undescended testicle (cryptorchidism) is one of the strongest recognised risk factors.

Correcting an undescended testicle during childhood reduces some of the associated risks and makes subsequent examination easier, but it does not completely remove the increased risk of cancer.

Family history

Men with a brother or father who has had testicular cancer have an increased risk themselves, with the association particularly strong between brothers.

Previous testicular cancer

Having previously had cancer in one testicle increases the risk of subsequently developing a new primary tumour in the other testicle.

It remains uncommon, but it is one reason continued awareness of the remaining testicle is sensible.

Subfertility

Reduced fertility and abnormal semen quality are associated with an increased incidence of testicular germ-cell tumours.

Germ-cell neoplasia in situ

Germ-cell neoplasia in situ (GCNIS) is the precursor lesion from which most post-pubertal testicular germ-cell cancers develop.

It may occasionally be discovered during investigation of men with particular risk factors or fertility problems.

Ethnicity

Testicular cancer occurs significantly more frequently in white men than in several other ethnic groups, although the reason for this difference is not fully understood.

Testicular microlithiasis

Testicular microlithiasis describes tiny calcium deposits that can be seen within a testicle on ultrasound.

It frequently causes anxiety when mentioned in an ultrasound report.

Microlithiasis alone, in a man with no additional risk factors and a normal testicular examination, usually does not require repeated surveillance ultrasound.

The presence of additional testicular cancer risk factors changes that assessment and should be discussed individually.

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Does lifestyle cause testicular cancer?

Testicular cancer is not clearly linked to the usual potentially preventable cancer risk factors. Cancer Research UK currently lists no clearly established preventable risk factor for the disease.

There is no convincing evidence that testicular cancer is caused by:

• sporting injury
• cycling
• tight underwear
• masturbation
• sexual activity
• vasectomy

An injury occasionally draws a man’s attention to a lump that was already present. The injury did not cause the cancer — it simply led to its discovery.

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How should I check my testicles?

The most useful principle is testicular awareness: knowing roughly what is normal for you so that you notice a change.

The NHS advises men to become familiar with the normal appearance and feel of their testicles. Testicular cancer most often affects one testicle, and normal testicles are not necessarily identical in size or position.

A warm bath or shower makes examination easier because the scrotal skin is relaxed.

How to check

1. Look for a change

Notice whether either testicle appears larger or has changed shape.

2. Feel each testicle gently

Roll it carefully between your fingers and thumb.

A normal testicle should feel generally smooth and firm rather than rock-hard.

3. Identify the epididymis

The epididymis is a softer, slightly irregular tube that sits behind and above the testicle.

It is normal anatomy and probably the structure most frequently mistaken for an abnormal lump.

4. Look for a change from your own baseline

The important findings are:

• a new hard lump
• an area of unusual firmness
• increasing size
• a change in shape
• unexplained heaviness or discomfort

The purpose is not to become expert at diagnosing lumps yourself. It is simply to recognise when something has changed and get it checked.

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How is testicular cancer diagnosed?

Examination

The first step is a clinical examination.

I assess whether the abnormality appears to arise from within the testicle or from one of the surrounding structures such as the epididymis.

The abdomen and lymph-node areas may also be examined when testicular cancer is suspected.

Scrotal ultrasound

A high-frequency testicular ultrasound is the key imaging investigation.

It is quick, painless and does not involve radiation.

Ultrasound can determine:

• whether a lump is inside or outside the testicle
• whether it is solid or fluid-filled
• its size and position
• whether there are abnormalities in the other testicle

European guidelines recommend high-frequency ultrasound when testicular cancer is suspected. They also recognise that very small incidentally detected intratesticular lesions are sometimes benign, which is why scan findings need to be interpreted in their clinical context.

Blood tumour markers

Three blood tumour markers are particularly important and should usually be measured before orchidectomy and repeated afterwards.

AFP — alpha-fetoprotein

AFP can be raised in non-seminomatous germ-cell tumours.

A pure seminoma should not produce a significant rise in AFP. A clearly raised AFP therefore raises concern for an occult non-seminomatous component, even if the initial pathology appears predominantly seminomatous.

Small stable elevations can occasionally have other explanations, so results must always be interpreted in context.

hCG — human chorionic gonadotrophin

hCG can be elevated in several germ-cell tumour types, including some seminomas.

LDH — lactate dehydrogenase

LDH is less specific but can indicate tumour burden and disease activity.

Importantly, normal tumour markers do not exclude testicular cancer.

Markers are particularly valuable for assessing stage, monitoring response to treatment, and detecting some relapses during follow-up.

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How is testicular cancer staged?

Staging establishes whether cancer remains confined to the testicle or has spread elsewhere.

A CT scan of the chest, abdomen and pelvis is normally used when staging is required, with particular attention paid to lymph nodes at the back of the abdomen.

Where tumour markers are elevated, or there is clinical concern about metastatic disease, current European guidance recommends staging imaging before orchidectomy. With a small or indeterminate testicular lesion, staging CT can sometimes reasonably wait until the pathology confirms malignancy.

Brain imaging is not routinely needed for every man. MRI of the brain is generally reserved for particular situations, such as neurological symptoms or features associated with a higher risk of brain metastases.

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What is miR-371a-3p?

One of the most interesting developments in testicular cancer is a blood biomarker called microRNA-371a-3p, often abbreviated to miR-371.

Research suggests it may detect active germ-cell tumour considerably more accurately than conventional tumour markers in many situations.

Its major limitation is teratoma, which may not produce the marker.

miR-371 is likely to become increasingly important in testicular cancer diagnosis and surveillance, but it is not yet a replacement for established tumour markers, imaging and clinical follow-up in routine UK practice.

For patients reading about miR-371 tests online, it is best regarded as an important emerging technology rather than an established standard of surveillance.

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How is testicular cancer treated?

Treatment depends on:

• whether the tumour is seminoma or non-seminoma
• the pathological features of the tumour
• tumour marker levels
• whether the cancer has spread
• the patient’s general health and priorities

A specialist multidisciplinary team normally plans care.

For the great majority of men with a suspicious testicular tumour, treatment begins with a radical inguinal orchidectomy.

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What is a radical inguinal orchidectomy?

A radical inguinal orchidectomy is an operation to remove the affected testicle and spermatic cord through an incision in the groin.

It is both:

1. the definitive way of establishing exactly what the tumour is, and
2. the first treatment for the cancer.

It is commonly performed as a day-case or short-stay procedure under general anaesthetic.

Why is the testicle removed through the groin?

This is important.

The testicle has a very specific lymphatic drainage pattern. Routine biopsy or removal of a suspicious testicular tumour through the scrotum can disrupt those natural lymphatic pathways.

For that reason, clinicians do not routinely needle-biopsy a suspicious intratesticular tumour through the scrotum.

Instead, the testicle is approached through the groin and removed intact.

The pathology laboratory can then determine the tumour type and identify features that help predict recurrence risk.

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Should I bank sperm before treatment?

Fertility should be discussed with every man of reproductive age before treatment for testicular cancer begins.

Men with testicular cancer can already have reduced sperm counts before receiving any cancer treatment.

Removing one testicle will not normally make a previously fertile man infertile, but chemotherapy and some other treatments can significantly reduce sperm production.

For this reason, sperm banking should be discussed before treatment and should particularly be considered before chemotherapy or radiotherapy.

Where clinically appropriate, it can sometimes be arranged before orchidectomy, although urgent cancer treatment should not be unnecessarily delayed.

The NHS also advises discussing fertility preservation before treatment for testicular cancer.

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Can I have a testicular prosthesis?

Yes.

A testicular prosthesis is a silicone implant designed to replace the appearance and weight of the removed testicle.

It can usually be inserted:

• during the orchidectomy, or
• during a later operation

Some men strongly prefer to have one, while others prefer not to.

There is no medical requirement to have a prosthesis. It is entirely a personal decision.

As with any implant, there are small potential risks, including infection, discomfort, displacement, and dissatisfaction with its position or feel; these should be discussed before surgery.

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Can part of the testicle be removed instead?

Occasionally.

Testis-sparing surgery may be considered for carefully selected small testicular masses, particularly when:

• the imaging appearance is not clearly malignant
• tumour markers are normal
• there is only one functioning testicle
• both testicles contain abnormalities
• preservation of testicular function is particularly important

An intra-operative frozen-section examination can sometimes help determine whether a small lesion is benign or malignant.

This is a specialist decision.

For a typical solid testicular mass strongly suspicious for germ-cell cancer, radical inguinal orchidectomy remains the standard treatment.

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What happens after the testicle has been removed?

The pathology report, post-operative tumour markers and staging scans are considered together.

The cancer is then classified by:

• tumour type
• pathological stage
• presence or absence of particular risk features
• whether lymph nodes or other organs are involved

The next step may simply be surveillance — or further treatment may be recommended.

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Treatment of Stage I seminoma

Stage I means the cancer appears confined to the testicle.

For most men with Stage I seminoma, the preferred strategy is active surveillance.

This means there is no immediate chemotherapy or radiotherapy after surgery. Instead, the patient enters a structured programme of examinations, tumour-marker measurements and scans.

Current European guidance identifies surveillance as the preferred approach for Stage I seminoma where the patient is able and willing to comply with follow-up.

A minority of men will subsequently relapse, but those relapses are usually detected during surveillance and remain highly curable.

Carboplatin

A single cycle of carboplatin chemotherapy can be considered as an alternative to surveillance for selected men.

It reduces the risk of recurrence but means treating many men who would already have been cured by surgery alone.

Radiotherapy

Radiotherapy was previously used much more frequently for Stage I seminoma.

It now has a very limited role because of concern about long-term toxicity, including the risk of second cancers and cardiovascular disease, in a group of men whose life expectancy after treatment is otherwise very long.

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Treatment of Stage I non-seminoma

For Stage I non-seminomatous germ-cell tumour, one of the most important findings in the pathology report is lymphovascular invasion (LVI).

LVI means tumour cells have been seen within small blood vessels or lymphatic channels in or around the tumour.

It is an important predictor of recurrence.

Without LVI, the risk of relapse with surveillance is relatively low.

Where LVI is present, recurrence risk is substantially higher — approaching 50% in some groups.

Men may therefore choose between:

• active surveillance, accepting the possibility of needing more intensive treatment if the cancer returns, or
• one cycle of BEP chemotherapy, which substantially reduces the risk of recurrence

BEP contains:

• Bleomycin
• Etoposide
• Platin — cisplatin

The choice is not simply between “treatment” and “no treatment”.

It is a balance between avoiding unnecessary chemotherapy now and reducing the risk of needing more treatment later.

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How is testicular cancer treated if it has spread?

Testicular cancer remains unusual among solid cancers because metastatic disease is often still curable.

The principal treatment is cisplatin-based chemotherapy.

The most established regimen is BEP: bleomycin, etoposide and cisplatin.

Patients with metastatic germ-cell cancer are divided into prognostic groups using the International Germ Cell Cancer Collaborative Group (IGCCCG) classification.

This takes account of factors including:

• tumour type
• site of the original tumour
• sites to which it has spread
• AFP level
• hCG level
• LDH level

Depending on the tumour and prognostic group, treatment commonly involves three or four cycles of BEP.

For example, European guidance recommends three cycles of BEP for good-prognosis metastatic seminoma and four cycles for intermediate-prognosis disease. Metastatic non-seminoma is treated similarly, according to the IGCCCG risk group.

Even some men presenting with extensive metastatic disease can therefore achieve long-term cure.

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What happens if a mass remains after chemotherapy?

This depends critically on whether the original cancer was seminoma or non-seminoma.

Residual mass after non-seminoma

After chemotherapy for non-seminomatous germ-cell cancer, a residual mass can contain:

• scar tissue or necrosis
• persistent cancer
• teratoma

This distinction is important because teratoma does not reliably respond to chemotherapy.

Current European guidance recommends surgical removal of visible residual masses greater than 1 cm after chemotherapy for NSGCT when tumour markers have normalised or are appropriately normalising.

The operation is usually a retroperitoneal lymph-node dissection (RPLND).

Post-chemotherapy RPLND can be major and technically demanding surgery and is best performed in specialist centres with substantial experience.

Residual mass after seminoma

The situation is different after seminoma.

Residual masses are frequently scar tissue rather than active cancer and are initially monitored with imaging and tumour markers.

For a residual mass larger than 3 cm, an FDG-PET/CT may provide useful additional information.

Importantly, current 2026 European guidance recommends waiting at least two months after chemotherapy before performing PET because treatment-related inflammation can otherwise produce misleading positive results.

A negative PET scan is reassuring.

A positive PET is less definitive and should not automatically trigger further treatment or surgery, because false-positive results occur.

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Will losing one testicle affect testosterone or sex?

For most men, one healthy testicle is sufficient to maintain normal testosterone production.

Removal of one testicle should not directly affect:

• erections
• sexual sensation
• orgasm
• libido, provided testosterone remains normal

The remaining testicle generally compensates.

The psychological effect of losing a testicle can nevertheless be important, particularly in younger men, and should not be dismissed simply because physical sexual function is normal.

A prosthesis can help some men but is not essential.

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Will testicular cancer treatment affect fertility?

After orchidectomy alone, many men retain normal fertility.

However, some men already have reduced semen quality at the time they are diagnosed.

Chemotherapy can then produce a substantial temporary reduction in sperm production.

Recovery is common but may take several years and is not guaranteed in every patient.

That is why fertility preservation needs to be discussed before systemic treatment, rather than after it.

Where future fertility matters, semen analysis after recovery can establish what has actually happened rather than assuming either fertility or infertility.

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Can RPLND affect ejaculation?

Yes.

The nerves responsible for ejaculation travel through the retroperitoneum close to the area involved in RPLND.

Damage can result in dry ejaculation, where orgasm still occurs but little or no semen emerges through the urethra.

Modern nerve-sparing surgical techniques have substantially reduced this risk in appropriately selected patients, particularly when experienced specialist teams perform the operation.

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Can testicular cancer treatment cause low testosterone?

It can.

Most men maintain adequate testosterone after losing one testicle, but a minority develop testosterone deficiency either following orchidectomy or as a later consequence of treatment.

Symptoms can include:

• reduced libido
• tiredness
• low mood
• loss of morning erections
• reduced muscle mass
• difficulty concentrating

These symptoms can easily be attributed to recovering from cancer itself.

Persistent symptoms therefore justify checking a morning testosterone level and discussing the result with your clinical team.

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What does follow-up after testicular cancer involve?

Follow-up depends on the tumour type, stage and treatment received.

It may involve:

• clinical review
• AFP, hCG and LDH tumour markers
• CT or MRI scans
• other investigations where clinically indicated

Follow-up is most intensive in the first few years because this is when most relapses occur.

For a man managed with active surveillance, follow-up is not simply an administrative exercise — it is an integral part of the treatment strategy.

Surveillance works because recurrence can be detected and treated while cure rates remain extremely high.

Missing repeated appointments therefore undermines the strategy.

If you move to another part of the country, change jobs or go to university, make sure your surveillance is formally transferred rather than simply stopping.

Can testicular cancer return after five years?

It can, but very late relapse is uncommon.

Current European guidance estimates relapse more than five years after treatment at approximately 0.5%.

Beyond five years, routine imaging is generally not recommended for most men, and follow-up increasingly focuses on survivorship and awareness of possible late effects.

A previous history of testicular cancer should nevertheless remain part of your medical history permanently.

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What are the long-term effects of testicular cancer treatment?

For most men treated with orchidectomy alone, there are relatively few long-term physical consequences.

For men requiring chemotherapy or radiotherapy, survivorship deserves greater attention.

Possible longer-term effects of cisplatin-based chemotherapy include:

• increased cardiovascular risk
• high blood pressure
• changes in cholesterol
• metabolic syndrome
• peripheral neuropathy, causing tingling or numbness
• hearing loss or tinnitus
• reduced kidney function
• Raynaud’s phenomenon
• testosterone deficiency

Bleomycin can cause lung toxicity in a minority of patients, so previous bleomycin treatment should always be mentioned to doctors and anaesthetists caring for you in the future.

Previous cancer treatment may also slightly increase the risk of developing a second malignancy later in life.

This is not a reason to avoid treatment when it is needed. The treatments are given because they can be lifesaving and curative.

It does mean, however, that long-term survivors should take cardiovascular health seriously — including:

• not smoking
• maintaining a healthy weight
• exercising regularly
• checking blood pressure
• monitoring cholesterol
• discussing symptoms of testosterone deficiency

Current European follow-up guidance specifically highlights cardiovascular risk factors and testosterone deficiency as issues to address during survivorship.

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What is the survival rate for testicular cancer?

The outlook is exceptionally good.

Across all stages combined, more than 95% of men survive testicular cancer for at least five years. Predicted ten-year survival in the UK is approximately 96.5%.

For cancer confined to the testicle, cure is expected in almost all men.

Even when the cancer has spread, modern cisplatin-based chemotherapy can still produce cure in the majority of patients.

Testicular cancer is therefore one of the clearest examples in modern oncology where the word cure can appropriately remain the objective even after metastatic disease has developed.

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When should I see a doctor?

Arrange prompt assessment if you develop:

• a new lump within a testicle
• an area of testicular hardness
• enlargement of one testicle
• a change in testicular shape or texture
• unexplained scrotal heaviness
• persistent testicular discomfort
• a new hydrocele or unexplained scrotal swelling

Most of these symptoms will turn out not to be testicular cancer.

But an examination and ultrasound can usually establish the cause quickly.

When is testicular pain an emergency?

Sudden, severe testicular pain requires same-day emergency assessment.

One important cause is testicular torsion, where the spermatic cord twists and cuts off the blood supply to the testicle.

This is a surgical emergency and is different from the usual presentation of testicular cancer.

Do not wait for a routine clinic appointment if severe testicular pain has developed suddenly.

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Found a testicular lump or noticed a change?

Most testicular and scrotal lumps are benign, but it is important to establish whether a new lump arises within the testicle itself.

I provide specialist private assessment for men with new testicular lumps, swellings and unexplained scrotal symptoms through my Rapid Access Scrotal Lumps Clinic, with scrotal ultrasound arranged where appropriate.

You do not need to wait several weeks to see whether a lump disappears.

View clinic locations

Fees & insurance

If you develop sudden severe testicular pain, please seek urgent emergency assessment rather than waiting for a private clinic appointment.

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Frequently asked questions about testicular cancer

Symptoms and diagnosis

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Treatment and prognosis

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Fertility and life after treatment

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Medical disclaimer

This article provides general information about testicular cancer and is not a substitute for individual medical assessment, diagnosis or treatment.

If you have found a new testicular lump, swelling or change in a testicle, please arrange assessment by your GP or a urologist.

Sudden severe testicular pain requires urgent same-day medical assessment because testicular torsion must be excluded.

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About Mr Neil Haldar

Mr Neil Haldar MBBS MD FRCS (Eng) FRCS (Urol) is a Consultant Urological Surgeon with more than 20 years’ experience in urology and uro-oncology. His practice includes the assessment and surgical management of testicular cancer and other testicular and scrotal conditions.

GMC No. 3683914.

Last medically reviewed: August 2026.