Understanding Testicular Cancer

Testicular Cancer Signs and Symptoms: Early Warnings and Advanced Indicators

Last updated and reviewed on June 28, 2026.

Testicular cancer is one of the cancers where self-awareness can make a real difference. Unlike many cancers that develop silently deep inside the body and are hard to detect without specialized tests, testicular cancer often produces a noticeable change in the testicle that a man can feel himself. The most important sign is a new lump or swelling in one testicle, and finding it early generally leads to a very good outcome. This is one of the reasons that knowing your own body and knowing what to watch for matters so much.

At the same time, testicular cancer can sometimes be easy to dismiss or delay investigating. Some men are embarrassed to seek medical attention. Some attribute scrotal symptoms to an old injury. And some symptoms, like a dull ache in the groin, are common enough in everyday life that they seem minor. If something in your testicle does not feel normal, getting it checked promptly is always the right call. Testicular cancer is one of the most curable cancers in medicine, especially when found early.

The key message: A new, painless lump on or in one testicle is the most important warning sign of testicular cancer. Any new scrotal lump, swelling, or change in how a testicle feels should be evaluated by a doctor. Do not wait to see if it goes away on its own.

What Are the Signs and Symptoms of Testicular Cancer?

Signs and symptoms of testicular cancer come from the tumor itself, from the hormones or proteins the tumor may produce, and from where the cancer has spread when it is at a more advanced stage. The symptoms of early testicular cancer are usually related to the testicle itself, while the symptoms of more advanced disease reflect the cancer having spread to lymph nodes, lungs, or other organs. Because most testicular cancers are caught at an early stage due to the accessibility of the testicles, many men are diagnosed before they develop the symptoms of advanced disease.

What Are the Most Common Symptoms of Testicular Cancer?

• A painless lump or swelling on or inside a testicle: This is the most common and most important early sign of testicular cancer. The lump is usually found on one testicle and feels firm and hard, though it can vary in size from very small to large. The word "painless" is important here because about 90 percent of testicular cancer lumps do not hurt when pressed. This is actually what makes them easy to miss or dismiss. Any new lump on a testicle, regardless of whether it hurts, should be evaluated by a doctor.

• A feeling of heaviness or fullness in the scrotum: As a tumor grows, it can make one side of the scrotum feel noticeably heavier than the other. This sensation of fullness or weight in the scrotum is a common symptom that men sometimes attribute to muscle strain or minor injury.
• A dull ache or pain in the lower abdomen, back, or groin: Pain in the lower abdomen or groin, or a dull ache in the affected testicle, can occur as the tumor grows or after the cancer has spread to the lymph nodes at the back of the abdomen. This is easy to mistake for a pulled muscle, a hernia, or a back problem, which is one reason testicular cancer can sometimes take a while to diagnose correctly.
• A change in the size or shape of a testicle: One testicle that has become noticeably larger, firmer, or a different shape than it used to be is a potential warning sign. It is normal for one testicle to be slightly larger than the other, but a sudden or progressive change in size is worth investigating.
• A feeling of tightness or discomfort in the scrotum: Some men describe a vague discomfort or tightness in the scrotum rather than a distinct lump, particularly in earlier stages of the disease.

What Are the Less Common Symptoms of Testicular Cancer?

Beyond the most typical symptoms, testicular cancer can cause a range of less common signs, some of which are caused by the hormones that certain types of tumors produce.

• Breast tenderness or growth (gynecomastia): Some testicular tumors, particularly certain types of nonseminomas like choriocarcinoma and mixed germ cell tumors, produce large amounts of human chorionic gonadotropin (hCG), a hormone that can stimulate breast tissue to grow in men. A man may notice breast tenderness, nipple sensitivity, or actual breast tissue growth. While gynecomastia has many causes in men, when it occurs alongside other scrotal symptoms, it is an important clue.
• Back pain: When testicular cancer spreads to the retroperitoneal lymph nodes, the lymph nodes at the back of the abdomen near the major blood vessels of the spine, it can cause pain or discomfort in the lower or mid-back. This symptom is sometimes the first thing that drives a man to see a doctor, and it typically indicates more advanced disease.
• Shortness of breath or cough: If testicular cancer has spread to the lungs, it can cause shortness of breath, a persistent cough, or occasionally chest discomfort. Lung metastases are more common with nonseminoma types, particularly choriocarcinoma, which spreads rapidly through the bloodstream.
• Headache or confusion: In rare cases, testicular cancer can spread to the brain. Brain metastases from testicular cancer are uncommon but can cause headaches, vision changes, confusion, or neurological symptoms.
• Fluid buildup around the testicle (hydrocele): A hydrocele, a collection of fluid in the sac surrounding the testicle, can sometimes develop alongside a testicular tumor. While most hydroceles are benign, a new hydrocele in an adult man should prompt an ultrasound evaluation to rule out an underlying tumor.
• Early onset puberty in boys: Certain testicular tumors, particularly Leydig cell tumors, produce excess testosterone and can cause abnormally early puberty in young boys, including early development of body hair, deepened voice, and genital growth.

What Are the Symptoms of Advanced (Metastatic) Testicular Cancer?

When testicular cancer has spread beyond the testicle to distant parts of the body, symptoms reflect the organs that are involved. The good news is that even metastatic testicular cancer responds very well to chemotherapy in most cases, and many men with advanced disease are cured.

• Spread to the retroperitoneal lymph nodes: The back of the abdomen is the most common first site of spread. Enlarged lymph nodes here can cause a dull ache or pressure in the lower back or abdomen, though they often cause no symptoms at all and are detected only on imaging.
• Lung metastases: Can cause a persistent dry cough, shortness of breath, or chest pain. They may also be detected on chest X-ray or CT scan during routine staging, even when they are causing no symptoms yet.
• Liver metastases: Can cause pain in the upper right abdomen, nausea, or a feeling of fullness. Significant liver involvement can cause jaundice.
• Other sites, including the brain, bones, or distant lymph nodes: Less common and generally indicates very advanced disease. However, it is important to remember that even widely spread testicular cancer is often curable. Men with metastatic testicular cancer, including those with brain metastases, have been cured with aggressive chemotherapy and sometimes additional surgery or radiation.
• A general sense of not feeling well: Unexplained fatigue or significant weight loss can also accompany advanced testicular cancer as the body responds to the demands of fighting a significant tumor burden.

If you notice any lump, swelling, or change in a testicle, or if you develop new back pain, shortness of breath, or other unexplained symptoms, please see a doctor promptly. The earlier testicular cancer is found, the easier it is to treat.

Sources:

1. American Cancer Society. Testicular Cancer Signs and Symptoms. https://www.cancer.org/cancer/types/testicular-cancer/detection-diagnosis-staging/signs-symptoms.html
2. National Cancer Institute. Testicular Cancer Treatment (PDQ) Patient Version. https://www.cancer.gov/types/testicular/patient/testicular-treatment-pdq
3. Feldman DR, Bosl GJ, Sheinfeld J, Motzer RJ. Medical Treatment of Advanced Testicular Cancer. JAMA. 2008;299(6):672-684. https://jamanetwork.com/journals/jama/fullarticle/181433?utm_source=chatgpt.com
4. American Cancer Society. Can Testicular Cancer Be Found Early? https://www.cancer.org/cancer/types/testicular-cancer/detection-diagnosis-staging/detection.html