What men, particularly under 40 years of age, must know about testicular cancer?

By: Rajiv Tewari, based on inputs from Dr. Shafiq Ahmed & Dr. Ashish Detailed introductions are shared towards the end of this article.

Testicular cancer has a higher rate of occurrence in white men but is rare among Africans & Asians. Indian men have one of the lowest incidence of testicular cancer with less than 1 man per 100,000 population affected by this condition. This type of cancer is easily diagnosable and is highly treatable with a high survival rate even when it has spread beyond the testicle. 

Testicular cancer is painless and therefore awareness about how to diagnose this type of cancer is so important. A monthly self-examination can easily indicate if there is any abnormality in the testicles area. If anything feels abnormal in the form of bumps, ridges or a mass in the testicle area then simply ensure that it is examined by a doctor for a final diagnosis.

Signs & Symptoms:

1. Painless lump in either testicle.

2. Feeling of heaviness in scrotum.

3. Lump or swelling in either testicle.

4. Family history of testicular cancer.

5. Swelling or fluid build-up in scrotum.

6. Dull ache in groin or lower abdomen.

7. Pain or discomfort in the scrotum or either testicle.

8. Enlargement or tenderness of the breast tissue or back pain.

9. Shrinking testicle or if a testicle did not fully descend at birth.

10. Apart from these symptoms, a small percentage of men may have gynaecomastia (enlargement of male breasts).

No need to panic if you notice these symptoms or signs as few other conditions can also have similar symptoms. These symptoms may occur due to many other conditions like epididymal cysts, testicular microlithiasis and appendix testis which may be painful but non-cancerous however your doctor needs to rule these out through evaluation and diagnostic tests; if required. Simply consult your doctor and rest assured that this is a highly curable disease; however an early detection will help in early recovery.


There’s no way to prevent testicular cancer but an early diagnosis is possible by doing a testicular self-examination and consult a specialist doctor to identify these changes in the testicles.

How to perform a Testicular Self-Exam (TSE)?

You can complete a testicular self-exam (TSE) in as little as two minutes. Simply check out with both of your hands; after a bath; to check for any abnormality once a month. While checking out each testicle, one may notice a cord-like structure on top and in the back. This is called the epididymis which stores and transports sperm. Please do not confuse it with a lump. Just feel for any lumps. These lumps can be pea-sized or larger. If you notice a lump please contact your doctor. Best would be to do a monthly check and include this check-up in your yearly health check-up plan.

Risk Factors

1. Family history of testicular cancer.

2. An undescended testicle increases the risk. Testes form during fetal development & typically descend into the scrotum before birth. If anyone has a testicle that never descended the risk factor increases even if such a person has had surgery to move the testicle to the scrotum.

3. Testicular cancer can happen at any age. Teens and young adults between 15 and 45 are considered to be in the high risk category.

4. Infertile men may have higher incidence of testicular tumour. This factor is still under research but several doctors have mentioned it as a factor on the basis of their experience.

Stages of Testicular Cancer

Stage 0: Abnormal cells have developed inside the testicles where sperm cells are generated but have not spread outside of this area.

Stage I: Cancer is confined to the testicle but may include blood or lymph vessels. Tumour markers may or may not show elevation.

Stage II: Cancer has spread to the lymph nodes in the back of your abdomen but is confined in that area only. If one has cancer in the lymph nodes along with moderately or highly elevated tumour markers, then it is stage III rather than stage II.

Stage III: Cancer has spread to lymph nodes beyond your abdomen or to one or more of the organs.

This part is being shared only for basic knowledge. The important action point; after diagnosis; is to find the right doctor and the right hospital. You may refer to our article on this important point by clicking here.

About Dr. Shafiq Ahmed

Dr. Shafiq Ahmed is Director and Senior Consultant, Urology & Renal Transplant at the Narayana Super-speciality Hospital, Gurugram though he visits all the centers of the group hospitals across North India. He is an US credentialed robotic uro-oncologist and specializes in robotic radical prostatectomy, robotic radical cystectomy and robotic partial nephrectomy for treatment of patients suffering from prostate, urinary bladder and kidney cancers in addition to general urologic problems in men and women. An MBBS, MS (Surgery), DNB (Urology), MNAMS with 15 publications, including 3 book chapters, to his credit in leading medical journals and with work experience at some of the most respected hospitals in India.

About Dr. Ashish Kumar

Dr. Ashish Kumar is Consultant Urologist at Narayana Hospital, Gurugram. Dr. Ashish Kumar has more than 9 years of experience in urology. After completing MBBS, he was trained from India’s most premier medical institution (AIIMS, New Delhi), where he completed his M.S (General Surgery) and M.Ch. (Urology). He was chosen for Singapore Travel Fellowship. He is trained in Endo-Urology, Andrology & Male Infertility, Uro-Oncology, minimally invasive urology (laparoscopic and Robotic). He has been a part of renal transplant program. Apart from these he has presented many papers in zonal & national conferences. He is a Life Member of the Urological Society of India (USI) & Life Member of North Zone – Urological Society of India (NZ-USI).