Quick answer
What could testicular lump mean?
A testicular lump is any new swelling or hard area on a testicle, and it 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, since cysts and varicoceles are common, but never ignore a new 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, and 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.
Signs of a testicular lump to look for
You should see a GP if you notice a hard lump on the testicle itself that is pea-sized or larger, a change in the size or shape of a testicle, a heaviness or dragging sensation in the scrotum, a dull ache in the testicle or lower abdomen, or a new difference between the two testicles. Testicular cancer lumps are usually found on the testicle itself, rather than on the scrotal skin or the epididymis, the tube at the back of the testicle.
How to self-check for a testicular lump
There is no formal NHS screening programme for testicular cancer, but testicular awareness helps you notice changes early. Check monthly, ideally after a warm bath or shower when the scrotum is relaxed, by gently rolling each testicle between your thumb and fingers and feeling for hard lumps, changes in consistency, or swelling. A healthy testicle should feel smooth and firm, rather like a hard-boiled egg without its shell, and the epididymis, the soft tube behind each testicle, is a normal structure that is worth learning to recognise so you do not mistake it for a lump. Report any change from what is normal for you to a GP.
Common non-cancer causes of a testicular lump
An epididymal cyst is a fluid-filled lump at the back of the testicle that is very common and harmless. A varicocele is a collection of enlarged veins that feels like a “bag of worms” above the testicle and usually occurs on the left side. A hydrocele is a fluid collection around the testicle that causes a smooth swelling and lights up when a torch is shone through it. Epididymo-orchitis is an infection that is painful and often comes with fever and urinary symptoms, and it needs treatment with antibiotics. An inguinal hernia involves bowel protruding into the scrotum, often with a cough impulse, and is a different problem from a testicular lump.
A GP examination and ultrasound scan can distinguish all of these conditions from cancer.
Testicular cancer facts
Testicular cancer is most common in men aged 15 to 45, although it can occur at any age. It usually presents as a painless lump, and known risk factors include having had an undescended testicle in childhood, a family history of testicular cancer, or a previous testicular cancer in the other testicle. It is highly curable, and even when the cancer has spread, treatment is often successful.
What happens after GP referral
A GP will make an urgent referral to a urologist for further assessment. This assessment typically includes an ultrasound scan of the scrotum, which distinguishes solid lumps from fluid-filled ones, and blood tests that look for tumour markers such as AFP, HCG, and LDH. If cancer is suspected, surgical removal of the testicle, known as orchidectomy, is carried out both to diagnose and to treat the cancer. Removing one testicle does not usually affect sexual function or fertility in the long term.
Sudden severe testicular pain — a different emergency
Sudden severe testicular pain with swelling, especially in teenagers and young men, may be testicular torsion, where the testicle twists on itself. This is a surgical emergency needing treatment within hours, so you should call 999 or go to A&E straight away. Testicular torsion is not cancer, but it threatens the testicle if left untreated. A gradual, painless lump calls for a same-day GP appointment, while sudden severe pain calls for emergency department attendance.
After treatment for testicular cancer
Testicular cancer treatment is highly effective, though some men need further care afterwards. This can include surveillance with blood tests and scans, chemotherapy or radiotherapy for some stages of the disease, a prosthetic testicle if desired after orchidectomy, and fertility counselling with sperm banking before treatment if this is needed. Support organisations such as Macmillan and Movember provide information and peer support for men going through diagnosis and treatment.
Overcoming embarrassment about testicular symptoms
Many men delay reporting testicular symptoms because of embarrassment, but GPs and urologists examine scrotal problems every day as a routine part of their work. Days matter for testicular cancer outcomes, so a same-day GP assessment is the right response to any new lump.
Checking both testicles
Testicular cancer usually affects only one testicle, so it is worth comparing both sides regularly and reporting any new asymmetry to a GP.
Common questions about testicular lump
- How do I check my testicles?
- Check your testicles after a warm bath or shower, when the scrotum is relaxed, by rolling each testicle gently between your thumb and fingers. Feel for hard lumps, changes in size, or new swelling, and get to know what feels normal for you, since a healthy testicle should feel smooth and firm rather than hard like a stone.
- What does testicular cancer feel like?
- Testicular cancer usually feels like a painless hard lump on the testicle itself, rather than on the scrotal skin, and the testicle may also feel heavier or larger than usual. Some men notice a dull ache or heaviness rather than a distinct lump, and while pain is less common, it is still possible.
- What else causes testicular lumps?
- Testicular lumps can also be caused by epididymal cysts, which are fluid-filled and often found at the back of the testicle, a varicocele, which is a collection of enlarged veins with a "bag of worms" feeling, a hydrocele, which is fluid around the testicle, and infection, known as epididymo-orchitis, which is usually painful with fever. A GP examination or ultrasound scan can distinguish between these causes.
- How is testicular cancer treated?
- Surgical removal of the affected testicle, known as orchidectomy, is the first step and confirms the diagnosis. Further treatment such as chemotherapy or radiotherapy depends on the cancer type and stage, and fertility and hormone function can often be preserved with one testicle remaining.
- Will I still be fertile with one testicle?
- You will often still be fertile with one testicle, since one healthy testicle usually produces enough sperm and testosterone. Sperm banking before treatment is offered if both testicles are affected or if chemotherapy is needed, and it is worth discussing fertility with your specialist team.