Testicular cancer is the most common cancer in men aged 15 to 49 in the UK. The good news is that it’s also highly treatable when detected early. Understanding how to check for testicular cancer and recognising early testicular cancer symptoms is a simple, practical way to protect your health. Most lumps or changes are not cancer but knowing the early signs of testicular cancer can help you spot anything unusual quickly and confidently.
In this guide, we’ll walk you through the key signs of testicular cancer, a step-by-step testicular self-examination, and when to seek medical advice if you find a lump on your testicle. We also explain how Ramsay Health Care’s diagnostic services can support you if you’re concerned about any changes, including a testicular cancer lump or pain in the testicle.
What is testicular cancer?
Testicular cancer develops when abnormal cells grow uncontrollably in one or both testicles, forming a tumour. Although it accounts for around 1% of all male cancers, it is the most common cancer in younger men aged 15 to 49 in the UK. Understanding the typical testicular cancer symptoms can help ensure early detection.
There are two main types of testicular cancer:
- Seminomas - tend to grow more slowly
- Non-seminomas - often develop earlier and spread more quickly
Both types are highly treatable, especially when diagnosed early. You can read more about treatment options on our testicular cancer page.
Importantly, survival rates are excellent, with most men making a full recovery when the cancer is detected and treated promptly.
Who is at risk of testicular cancer?
Anyone with testicles can develop testicular cancer, including trans-women, and non-binary people, but certain factors can increase the likelihood of it occurring.
These include:
- Undescended testicles (cryptorchidism) - the strongest known risk factor; men with a history of undescended testicles have around a 3-times higher risk.
- Family history - having a father with testicular cancer increases risk around 4-fold, and having a brother affected increases risk up to 8-fold.
- Previous testicular cancer - men who have had cancer in one testicle have a significantly higher risk of developing it in the other.
- Ethnicity - testicular cancer is more common in white males compared with other ethnic groups.
- HIV/AIDS - is associated with a higher risk of developing testicular cancer.
- Klinefelter’s syndrome - a genetic condition linked to increased risk.
Being aware of these factors can help you stay alert to early signs of testicular cancer and understand when to seek advice.
Signs and symptoms of testicular cancer
Testicular cancer often causes noticeable changes in one testicle, but symptoms can vary. Most lumps are not cancer, but it’s important to be aware of the typical testicular cancer symptoms so you can seek help promptly if something feels unusual.
Common signs of testicular cancer
- A painless swelling or lump in one testicle (pea-sized or larger) - the most common early sign
- A testicle that becomes larger or firmer than usual
- A heavy or aching feeling in the scrotum
- A dull ache or intermittent pain in testicle or scrotum
Less common or advanced symptoms
These symptoms may appear if the cancer has spread to nearby lymph nodes or other parts of the body. They are uncommon but recognising them helps ensure you know when to seek urgent medical advice.
- Lower back pain
- Swollen legs (due to lymphatic blockage)
- Unexplained weight loss
- Breast tenderness or growth (caused by hormone changes)
- Breathlessness or a persistent cough
Is pain in the testicle always a sign of cancer?
Experiencing pain in the testicle can be worrying, but it is not usually a sign of testicular cancer. While pain can occur in some cases, many testicular cancers are completely painless, with a lump or swelling being the most common early symptom.
Testicle pain is far more often caused by non-cancerous conditions, including:
- Infection, such as epididymitis
- Injury or trauma
- Fluid-filled cysts (epididymal cysts)
Even though pain in the testicle is rarely linked to cancer, any unexplained or persistent testicle pain should be checked by a GP to rule out infection, injury or other causes and to give you peace of mind.
How to check for testicular cancer: step-by-step self-examination
Regular self-examination is one of the most effective ways to spot changes early. There is no national screening programme for testicular cancer in the UK, so understanding how to check for testicular cancer is an important part of protecting your health.
When and how often should you check your testicles?
Most experts recommend checking your testicles once a month, starting from puberty onwards.
The best time to do a self-check is during or just after a warm shower or bath, when the scrotal skin is relaxed and the testicles are easier to examine.
Step 1 - Prepare
- Stand in front of a mirror if possible
- Have a warm shower beforehand to relax the scrotal skin
- Take a few minutes in a calm, well-lit setting
This helps you see and feel any changes more clearly.
Step 2 - Examine each testicle
- Hold your scrotum gently in the palm of one hand
- Use your thumb and index finger of your other hand to roll each testicle gently between your fingers
- Check the size, shape, weight and texture of each testicle
- Remember: it is normal for one testicle to be slightly larger or to hang lower than the other
- Feel for the epididymis, the soft, coiled tube at the back of each testicle. This is a normal structure and not a lump
The goal is to become familiar with your usual anatomy so you can spot any changes over time.
Step 3 - Know what you're feeling for
You’re looking for changes, not perfection. Key things to check for include:
- Any lumps, bumps or hard swellings on the surface of a testicle
- Any change in size, shape or firmness compared with the previous month
- Any new heaviness, discomfort or tenderness
Regular monthly checks help you build a baseline of what’s normal for you, helping recognise early signs of testicular cancer and understand how to check for testicular cancer confidently.
Lump on testicle - is it always cancer?
Finding a lump on a testicle can be alarming, but the important thing to know is that most scrotal and testicular lumps are not cancerous. Testicular cancer is relatively rare, and many lumps are caused by benign (non-cancerous) conditions that can be easily diagnosed and managed.
Causes of scrotal lumps that are not cancer
- Epididymal cyst - a very common, harmless fluid filled sac on the epididymis (the tube behind the testicle).
- Hydrocele - a build-up of fluid around the testicle, usually painless and benign.
- Varicocele - enlarged veins in the scrotum, often described as feeling like a “bag of worms”.
- Epididymitis - inflammation or infection of the epididymis, which can cause pain, swelling and tenderness.
You can read more about benign scrotal lumps and treatment options here.
How doctors tell the difference
Doctors use a combination of simple examinations and tests to determine whether a lump is benign or potentially cancerous:
- Transillumination - shining a light through your scrotum.
- Fluid-filled cysts glow (light passes through).
- Solid lumps do not, which may suggest a tumour.
- Scrotal ultrasound - the main diagnostic tool. It shows whether a lump is solid or fluid-filled and helps identify its cause.
- Blood tests - check for tumour markers such as AFP, HCG and LDH, which can support a diagnosis of testicular cancer.
You should never try to self-diagnose a testicular lump. Any new, unexplained or persistent lump should be assessed by a healthcare professional, even if it isn’t painful. Early assessment provides clarity, reassurance and, if needed, fast access to treatment.
When should you see a doctor about a scrotal lump?
Most scrotal and testicular lumps are benign, but it’s always worth getting any change checked for reassurance and early diagnosis if needed.
You should see your GP promptly if you notice:
- Any new lump or swelling on a testicle
- A change in the size, shape or feel of a testicle
- Unexplained pain, discomfort or heaviness in your scrotum lasting more than two weeks
- Any of the less common or advanced symptoms listed above, such as lower back pain, breast tenderness or unexplained weight loss
GPs deal with these symptoms regularly. However, if you prefer, you can also attend a sexual health clinic, where staff are equally experienced in assessing testicular and scrotal concerns.
If your GP suspects testicular cancer, they can refer you through the NHS two-week wait urgent referral pathway, ensuring you are seen by a specialist and receive an ultrasound quickly.
Early assessment provides clarity, reassurance and, if needed, fast access to treatment.
Testicular cancer diagnosis and treatment at Ramsay Health Care
If you’re worried about a lump, change or persistent symptom, Ramsay Health Care offers fast-access private and discreet consultations bypassing long waiting times. Our hospitals provide rapid assessment, diagnosis and treatment, giving you clarity and support as quickly as possible.
You’ll be cared for by an expert multidisciplinary team, including urologists, radiologists, pathologists and oncologists, who specialise in diagnosing and treating testicular cancer.
Across our UK hospital network, we offer:
- Scrotal ultrasound for accurate imaging
- Blood tests for tumour markers (AFP, HCG, LDH)
- Specialist urology and oncology referrals
- Comprehensive treatment pathways, tailored to your needs
We welcome self-pay and private medical insurance patients, with flexible payment options available.
Find out more about testicular cancer, our men’s health and urology services or book online.