Testicular Cancer

Testicular cancer is cancer that starts in one of the testicles. It most commonly affects younger and middle-aged men, but it can occur at any age. Many cases are highly treatable, particularly when diagnosed early.

The most common first sign is a lump, swelling, or change in the size/feel of a testicle. Any new lump or change should be assessed promptly.

At the Royal Buckinghamshire Hospital, we provide consultant-led assessment, arrange appropriate investigations, and coordinate onward specialist pathways for diagnosis, staging and treatment.

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Types of testicular cancer

Testicular cancers are commonly grouped into:

• Seminomas – often slower growing and very responsive to treatment
• Non-seminomas – may grow and spread more quickly and can include several subtypes

The type helps guide treatment decisions, along with the stage of disease.

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Symptoms of testicular cancer

Testicular cancer can be painless. Symptoms may include:

• A lump or swelling in a testicle
• A testicle getting bigger or a change in shape/texture
• A dull ache or pain in the testicle or scrotum
• A feeling of heaviness in the scrotum
• The testicle feeling firmer or harder than usual (nhs.uk)

Symptoms that may suggest spread

• Persistent back pain
• Breathlessness or chest symptoms
• Unexplained weight loss, fatigue, or feeling generally unwell
• A lump/swelling elsewhere (for example in the neck)

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When to seek urgent help

Seek urgent same-day medical advice if you have:

• Severe sudden testicular pain (this could be testicular torsion, which is an emergency)
• A testicular lump with rapidly worsening swelling, fever, or feeling very unwell
• Shortness of breath, chest pain, collapse, or coughing blood

If a testicular lump is present but you feel otherwise well, you should still seek prompt assessment—don’t wait to see if it goes away.

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Diagnosis at Royal Buckinghamshire Hospital

Assessment usually involves:

Clinical assessment

• Review of symptoms, timing, and any risk factors
• Examination of the testicles and groin, and assessment for lymph node swelling

Ultrasound scan

A scrotal ultrasound is typically the key first scan to assess a lump and help distinguish suspicious masses from benign causes (such as cysts).

Blood tests (tumour markers)

Blood tests may check tumour markers, which can help with diagnosis, staging and monitoring response to treatment.

Next steps if cancer is suspected

If imaging and assessment suggest cancer, the standard next step is usually surgery to remove the affected testicle (orchidectomy) so it can be examined and to treat the primary tumour. Further scans (such as CT) may be arranged to stage the disease.

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Treatment options

Treatment depends on the cancer type, stage, tumour marker levels and overall health.

Surgery (orchidectomy)

Removal of the affected testicle is usually the main initial treatment and also confirms the diagnosis.

Monitoring (surveillance)

For some early-stage cancers, active surveillance may be recommended after surgery, using scheduled scans and blood tests. This aims to avoid extra treatment unless it’s needed.

Chemotherapy

If the cancer has spread beyond the testicle or has higher-risk features, chemotherapy may be recommended after surgery.

Radiotherapy (selected cases)

Radiotherapy is used less commonly than chemotherapy overall, but may be offered in selected situations depending on the cancer type and stage.

Further specialist procedures (selected cases)

Some patients may be offered specialist surgery to remove lymph nodes in the abdomen (in selected circumstances), guided by the specialist urology/oncology team.

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Fertility, hormones and recovery

Many people retain normal testosterone levels and fertility with one testicle, but treatment can affect fertility—particularly chemotherapy and some surgical pathways. You may be offered sperm banking before treatment begins. (nhs.uk)

Your consultant will discuss:

• Likely impact on fertility and sex life
• Hormone symptoms to watch for
• Options such as a testicular implant (prosthesis), if appropriate

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Follow-up and monitoring

Follow-up typically includes a structured plan of:

• Clinical reviews
• Blood tests (including tumour markers where relevant)
• Imaging scans at recommended intervals

This is to detect any recurrence early and manage longer-term effects of treatment.

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If you’ve noticed a lump, swelling, or change in a testicle, contact Royal Buckinghamshire Hospital for assessment and guidance. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.