Key takeaways

Testicular cancer is the most commonly diagnosed cancer in younger men aged between 15 and 44 and is one of the most treatable types of cancer.
It can cause a testicular lump, swelling, and heaviness in the scrotum, but some people have no symptoms in the early stages.
Testicular cancer is diagnosed using blood tests and a testicular ultrasound.
You can book private testicular ultrasounds without a referral from your GP, and results are usually ready in a few days.

What is testicular cancer?

The testicles are a pair of small egg-shaped organs that sit on either side of the penis in a pouch of skin called the scrotum. Part of the male reproductive system, the testicles (sometimes called testes) are responsible for producing sperm, which mix with seminal fluid to create semen, and manufacturing the male sex hormone, testosterone.

Testicular cancer is a cancer that affects one or sometimes both of the testicles. It can affect anyone who has testicles, and is the most common cancer in young men aged between 15 and 44.

Most testicular cancers develop in the cells that make sperm, called germ cells, and for this reason, they’re also known as germ cell tumours. There are two types of germ cell tumour: seminomas and non-seminomas.

Seminomas grow very slowly and don’t usually spread beyond the testicles (although they may spread to the lymph nodes). Non-seminomas are faster-growing and more common and can spread to other areas of the body, including the lungs, via the lymph nodes.

Even if testicular cancer has spread, it’s one of the most treatable types of cancer, especially if caught early.

Testicular cancer symptoms

The most common symptom of testicular cancer is a lump in the testicle. This lump may be painful or painless. Testicular cancer most commonly affects one side, but it may affect both sides. It may also cause:

A swelling in the testicle
A noticeable increase in testicle size
A heavy feeling, dull ache or pulling sensation in the testicle or scrotum
A painful or aching testicle
Changes to the skin of the scrotum, such as firmness or hardening
Pain when walking or touching the area

If testicular cancer has spread, it may cause pain or swelling in the groin, abdomen or lower back. This can indicate it has spread to the lymph nodes. It may also cause weight loss, chest pain, shortness of breath and a persistent cough if it has spread to the lungs.

Other testicular conditions

Having a lump or pain in your testicle or scrotum doesn’t necessarily mean that you have testicular cancer. There are other conditions that affect the testicles and scrotum, including:

Testicular torsion: Twisting of the tubes that carry sperm, causing pain, often severe, and considered a medical emergency.
Scrotal haematoma: Bruising and an accumulation of blood in the scrotum, usually following direct trauma to the area, such as a knock or a kick.
Inguinal hernia: A hernia that pushes bowel tissue down into the scrotal area, forming a visible lump and enlarging the testicle.
Varicocele: Visible enlargement of the scrotal veins.
Hydrocele: Swelling and fluid build-up in the scrotum.
Spermatocele: A cyst that develops in the epididymis, the tube that carries sperm.
Epididymoorchitis: Inflammation or infection affecting the testicle and epididymis, causing pain, swelling, redness, warmth and tenderness in the scrotum.

If you have any symptoms that concern you, speak to your GP or specialist doctor.

Testing for testicular cancer

There’s no national screening programme for testicular cancer, as there’s currently no routine test that reliably detects the condition before symptoms arise. Therefore, self-examination and awareness of your testicular health are important.

Cancer Research UK suggest feeling your testicles every now and again, checking for lumps or anything that feels different. You may find it easier to do this after a warm shower or bath when the skin is softer and more relaxed. Knowing the size and shape of your testicles will make it easier to spot changes.

If you find anything that concerns you, make an appointment to speak to your GP.

Diagnosing testicular cancer

If you have a lump or other symptoms affecting your testicles or scrotum, your GP or specialist doctor will organise a range of investigations to find out what’s causing them. The tests you have will depend on your symptoms and overall health.

Medical history and symptom review: Your GP will start by asking a few questions about your symptoms, how long you’ve had them and how they’re affecting you. They’ll also ask about your general health and wellbeing, and if you have any previous history or a family history of cancer.
Physical examination: Your doctor will then ask you to undress from the waist down so they can gently feel around your testicles, abdomen and groin. They may also use a stethoscope to listen to your chest.
Blood tests: They’ll organise some blood tests to check your overall wellbeing and to look for signs of inflammation and infection. You’ll also have tumour marker blood tests that look for small fragments of protein in the blood that might suggest cancer or help rule it out. These tests include alpha-fetoprotein (AFP), human chorionic gonadotrophin (HCG) and lactate dehydrogenase (LDH). Testicular cancer cannot be diagnosed with blood tests alone, and not all testicular cancers raise tumour marker levels. Therefore, doctors use blood tests alongside other tests, including scans.
Urine tests: Urine tests are not used to diagnose testicular cancer, but if your doctor thinks something else might be causing discomfort, such as a bladder infection, they may ask you to provide a urine sample to check for signs of infection.
Testicular ultrasound: If your doctor thinks it’s necessary, given your symptoms and/or your tumour marker blood test results, they’ll refer you for an ultrasound of the testicles and scrotum to look for abnormalities.

Biopsies and surgical procedures

If the results from your blood tests and ultrasounds suggest there’s a high chance you have testicular cancer, your medical team will recommend that you have surgery to remove the testicle and its attached spermatic cord.

This type of surgical procedure is called a radical orchiectomy, and it’s performed both as an investigative procedure and treatment.

A biopsy is a procedure in which small samples of cells are taken from an organ or tissue and tested in a laboratory for cancer cells. Taking a biopsy from the testicle while it’s still part of your body can increase the risk of testicular cancer spreading. Therefore, doctors remove the testicle and then take a biopsy. This is usually only done when doctors are confident that cancer is present, using the results of blood tests and ultrasound scans.

Can a testicular ultrasound detect testicular cancer?

Yes, doctors routinely use a testicular ultrasound to check the health of the testicles and scrotum.

They’re quick and painless, and are used to detect abnormalities in the testicles, such as tumours, cysts, nodules, fluid build-up, bruising, hernias and enlarged blood vessels. Ultrasound scans can also assess the composition of lumps and help distinguish between tumours, cysts and nodules.

How does a testicular ultrasound work?

Ultrasound scans use high-frequency sound waves to create real-time images of organs and soft tissues. Unlike X-rays and CT scans, ultrasounds don’t use ionising radiation.

An ultrasound probe, called a transducer, is a small, handheld device that bounces sound waves through the skin. When these sound waves encounter tissues, they bounce an echo back to the transducer.

Ultrasound imaging technology then converts these echoes into images that a radiologist can read to confirm or rule out cancer and other conditions.

What happens during a testicular ultrasound?

When you arrive, you’ll be asked to undress from the waist down and to lie down on your back on a medical table. You’ll be provided with a towel to cover your lower half. A clear gel is then applied to the testicles and scrotum to help conduct the sound waves through the skin and reduce friction.

A medical professional called a sonographer will then slowly move the transducer over the skin of your testicles, capturing images on a nearby screen. It won’t hurt, and it takes just a few minutes.

Afterwards, you’ll be able to remove the conductor gel using tissue and get dressed. You can return to your normal duties the same day and await your results.

Prognosis and treatment

If testicular cancer is diagnosed, sometimes the removal of the testicle is the only treatment required. You’ll have a series of scans and blood tests to make sure all of the cancer has been removed

You may also have a CT scan and a chest X-ray to check if the cancer has spread to your lymph nodes or lungs. Depending on the size and type of cancer you have, and whether it’s spread, you may also need chemotherapy or radiotherapy.

If you’re concerned about your fertility, you may be given the chance to store a sperm sample before you have surgery or begin treatment.

What other testicular scans are available?

An ultrasound scan is used to diagnose testicular cancer, along with blood tests and a biopsy. If cancer is detected, you’ll be referred for a CT scan to see if the cancer has spread to your pelvis, abdomen or chest. You may also have a chest X-ray to check your lungs.

Causes of testicular cancer

Anyone with testicles can develop testicular cancer, including trans women and non-binary people, and it’s most common between the ages of 15 and 44. The cause is unclear, but certain risk factors may put you at slightly higher risk.

Risk factors for testicular cancer include having:

testicular cancer in the past
a close relative, such as a father or a brother, with the condition
undescended testicles, where one or both testicles didn't drop down into the scrotum during puberty
HIV or AIDS

Being from a white background may also slightly increase your risk of developing testicular cancer, as the condition affects more white men than African Caribbean and Asian men. The reason for this is unknown.

Experiencing an injury or a trauma to your testicles, or having a vasectomy, does not increase your risk of testicular cancer.

Why an ultrasound is a good idea

If you have a testicular lump or other symptoms affecting your testicles or scrotum, getting them checked sooner can mean that if something is found, you’ll have more treatment options.

A scrotal ultrasound is quick and painless, and it provides answers so you know what you’re dealing with.

Find an ultrasound scan for testicular cancer

Depending on where you are in the UK, you may need to wait several weeks for a GP appointment, blood tests, and a referral for an ultrasound.

With Scan.com, you can typically book a testicular ultrasound appointment within a week, sometimes sooner, and you’ll have your results in a few days. You don’t need a referral letter from a doctor; we organise that for you, so you won't need to wait for a GP appointment beforehand.

If you have worrying symptoms, get them checked now.

Book your testicular scan