Signs and symptoms of testicular problems

Like other parts of the body, the testicles can be affected by certain conditions and diseases, which can lead to symptoms. The most common signs and symptoms in the testicles and scrotum are:

• Lumps (masses)
• Swelling
• Pain

Some conditions that affect the testicles can also cause a heavy or aching feeling in the lower belly (abdomen), or can even cause nausea and vomiting.

Cancer is one possible cause of testicular symptoms, but more often these symptoms are caused by infection, injury, or something else. It is important to see a doctor about any changes you notice in your testicles as soon as possible. This way the cause can be found and treated, if needed. Other conditions (besides cancer) that affect the testicles can still be serious and need to be treated.

If you're reading this, your main concern is probably whether you have testicular cancer. This is why symptoms of testicular cancer will be discussed first. Then we will talk about some of the other, non-cancer causes of testicular symptoms.

Common symptoms of early testicular cancer

You can't be sure whether or not you have testicular cancer based on symptoms alone, so it is important to see a doctor about any testicular symptoms that bother you. Don't wait. (For more details on the tests doctors may use to diagnose testicular cancer, call us for a copy of our document called Testicular Cancer or find it on www.cancer.org.)

The most common symptom of testicular cancer is a painless lump on a testicle. In some cases the lump isuncomfortable, but severe pain is rare. Sometimes the testicle may be enlarged or swollen without a lump. Men with testicular cancer may also have a heavy or aching feeling in the lower belly or scrotum.

Each normal testicle has an epididymis, which feels like a small bump on the upper or middle outer side of the testis. Normal testicles also contain blood vessels, supporting tissues, and tubes that carry sperm (see the drawing in the section, “What are testicles?”). All these things can feel bumpy, and sometimes men confuse these structures with cancer. If you have any doubts, ask a doctor. The doctor may get an ultrasound test to look inside the scrotum. (To learn more, see our document called Testicular Cancer) This is an easy and painless way of finding out whether there is a tumor.

Symptoms of testicular cancer that has spread (advanced cancer)

Even when testicular cancer has spread outside the testicle (called metastasis), many men have no symptoms from the metastases before the cancer is diagnosed. If the cancer has spread to the lymph nodes in back of the belly (called retroperitoneal lymph nodes), it may cause low back pain or belly pain. Normally, lymph nodes are small, bean-shaped collections of immune system tissue. Cancer can spread to lymph nodes and cause them to enlarge. If the cancer has spread to the lungs, problems like shortness of breath, chest pain, or cough (even coughing up blood) may develop. In rare cases, testicular cancer spreads to the brain and can cause headaches or confusion.

Types of testicular cancer and the symptoms they can cause

There are different types of testicular cancer. Certain types can cause symptoms in other parts of the body, too.

Germ cell tumors

Germ cell tumors are the most common type of testicular cancer. They start in the cells that make sperm. The 2 main types of male germ cell cancers are seminoma and non-seminoma. There are many sub-types of non-seminoma. Often, tumors contain a mixture of both semonoma and non-seminoma. The most common symptom of a testicular germ cell tumor is a lump on the testicle. These tumors sometimes make a hormone called human chorionic gonadotropin (HCG). A very high level of HCG can cause a man's breasts to grow larger or become tender.

Stromal tumors

Cancer can also develop in the supportive and hormone-producing tissues, or stroma, of the testicles. These tumors are known as gonadal stromal tumors. These are much less common than testicular germ cell tumors. The 2 main types are Leydig cell tumors and Sertoli cell tumors.

Leydig cell tumors start in the Leydig cells that normally make male sex hormones. This type of tumor can make androgens (male sex hormones) or estrogens (female sex hormones) leading to certain symptoms:

• Estrogen-producing tumors: In men these tumors can cause loss of sexual desire or make the breasts grow.
• Androgen-producing tumors: These might not cause symptoms in men, but in boys they can cause growth of facial and body hair at an abnormally early age.

Sertoli cell tumors develop from normal Sertoli cells, which support and nourish the sperm-producing germ cells. These tumors do not make hormones, and again the main symptom is a testicular lump.

Last Medical Review: 06/05/2012
Last Revised: 06/05/2012