Quick answer
What could testicular lump mean?
Any lump or swelling in a testicle needs same-day GP assessment. Testicular cancer mainly affects men aged 15 to 45 and is one of the most treatable cancers when found early. Most lumps are not cancer — cysts and varicoceles are common — but never ignore a new testicular lump or change.
Never ignore a testicular lump
Any new lump, swelling, or change in a testicle needs prompt GP assessment — ideally the same day or within a few days. Testicular cancer is the most common cancer in men aged 15 to 45, but it accounts for only about 1% of all male cancers. The good news: it is one of the most treatable cancers, with cure rates over 95% when found early.
Most testicular lumps are not cancer — but only a doctor can tell the difference.
What to look for
See a GP for:
- a hard lump on the testicle itself — pea-sized or larger
- change in size or shape of a testicle
- heaviness or dragging sensation in the scrotum
- dull ache in the testicle or lower abdomen
- difference between the two testicles that is new
Testicular cancer lumps are usually on the testicle, not the scrotal skin or epididymis (tube at the back).
How to self-check
There is no formal NHS screening programme, but testicular awareness helps:
- Check monthly — after a warm bath when the scrotum is relaxed
- Roll each testicle gently between thumb and fingers
- Feel for hard lumps, change in consistency, or swelling
- The testicle should feel smooth and firm — like a hard-boiled egg without the shell
- The epididymis (soft tube behind each testicle) is normal — learn to recognise it
Report any change from your normal.
Common non-cancer causes
Epididymal cyst — fluid-filled lump at the back of the testicle; very common, harmless.
Varicocele — enlarged veins; feels like a “bag of worms” above the testicle; usually left side.
Hydrocele — fluid collection around the testicle; smooth swelling; transilluminates with torch.
Epididymo-orchitis — infection; painful, often with fever and urinary symptoms; needs antibiotics.
Inguinal hernia — bowel protruding into scrotum; cough impulse; different from testicular lump.
A GP examination and ultrasound scan distinguish these from cancer.
Testicular cancer facts
- most common in men 15 to 45, but can occur at any age
- usually presents as a painless lump
- risk factors include undescended testicle in childhood, family history, previous testicular cancer in the other testicle
- highly curable — even if spread, treatment is often successful
What happens after GP referral
Urgent referral to a urologist. Assessment includes:
- ultrasound scan of scrotum — distinguishes solid lumps from fluid
- blood tests — tumour markers (AFP, HCG, LDH)
- if cancer suspected → surgical removal of testicle (orchidectomy) for diagnosis and treatment
Removing one testicle does not usually affect sexual function or fertility long-term.
Sudden severe pain — different emergency
Sudden severe testicular pain with swelling — especially in teenagers and young men — may be testicular torsion (twisted testicle), a surgical emergency needing treatment within hours. Call 999 or go to A&E — this is not cancer but threatens the testicle if untreated.
Gradual painless lump → GP same day. Sudden severe pain → emergency department.
After treatment
Testicular cancer treatment is highly effective. Men may need:
- surveillance with blood tests and scans
- chemotherapy or radiotherapy for some stages
- prosthetic testicle if desired after orchidectomy
- fertility counselling and sperm banking before treatment if needed
Support organisations — Macmillan, Movember — provide information and peer support.
Overcoming embarrassment
Many men delay reporting testicular symptoms due to embarrassment. GPs and urologists examine scrotal problems daily. Days matter for testicular cancer outcomes — same-day GP assessment is the right response to any new lump.
Check both testicles
Cancer usually affects one testicle. Always compare sides and report asymmetry that is new.
Common questions
- How do I check my testicles?
- After a warm bath or shower when the scrotum is relaxed, roll each testicle gently between thumb and fingers. Feel for hard lumps, changes in size, or new swelling. Know your normal — the testicle should feel smooth and firm, not hard like a stone.
- What does testicular cancer feel like?
- Usually a painless hard lump on the testicle itself — not the scrotal skin. The testicle may feel heavier or larger. Some men notice a dull ache or heaviness rather than a distinct lump. Pain is less common but possible.
- What else causes testicular lumps?
- Epididymal cysts (fluid-filled, often at the back of the testicle), varicocele (enlarged veins — "bag of worms" feeling), hydrocele (fluid around testicle), and infection (epididymo-orchitis — usually painful with fever). A GP or ultrasound distinguishes these.
- How is testicular cancer treated?
- Surgical removal of the affected testicle (orchidectomy) is the first step and confirms diagnosis. Further treatment — chemotherapy or radiotherapy — depends on cancer type and stage. Fertility and hormone function can often be preserved with one testicle remaining.
- Will I still be fertile with one testicle?
- Often yes — one healthy testicle usually produces enough sperm and testosterone. Sperm banking before treatment is offered if both testicles are affected or chemotherapy is needed. Discuss fertility with your specialist team.