A gradual increase in the size of one testicle can be another warning sign.
It is normal for one testicle to hang slightly lower than the other, and small differences in size are common. The concern is a new or noticeable change from the person's usual appearance.
Swelling may develop slowly, making it difficult to identify when it began. Some men only notice that their underwear feels tighter or that one side of the scrotum looks different.
If a testicle becomes larger without a clear explanation, arrange a medical examination.
3. A feeling of heaviness in the scrotum
Some men describe an unusual dragging sensation or a feeling that one side of the scrotum is heavier than normal.
This symptom can occur with several conditions, including testicular cancer, a hydrocele, or a varicocele. It is not specific enough to identify the cause by itself.
A persistent feeling of heaviness, particularly when accompanied by a lump or change in size, should be checked.
4. A dull ache or discomfort in the testicle or scrotum
Testicular cancer is not always painful. In fact, many cases first present as a painless lump or swelling.
Nevertheless, some men experience an ache, tenderness, or discomfort in the testicle or scrotum. The sensation may be intermittent or persistent.
It is not accurate to say that nighttime pain alone is a recognized diagnostic sign. Discomfort may become more noticeable when someone is resting or lying down, but the time of day does not establish whether cancer is present.
Pain can also result from injury, infection, inflammation, or other conditions. A doctor should assess pain that is new, persistent, or unexplained.
5. A dull ache in the lower abdomen or back
In some cases, testicular cancer can spread to lymph nodes in the abdomen or other areas. This may cause a dull ache in the lower abdomen or back.
Other symptoms of more advanced disease can include unexplained weight loss, a persistent cough, difficulty breathing, or swelling in the chest. These symptoms have many possible causes and do not automatically mean cancer.
A combination of testicular changes and unexplained symptoms elsewhere in the body should be discussed with a healthcare professional.
An illustrative consultation about testicular health.
When is pain an emergency?
There is one important warning that should never be confused with routine cancer awareness: sudden, severe pain in one testicle can indicate testicular torsion.
Torsion occurs when the spermatic cord twists and cuts off or reduces blood supply to the testicle. It is a medical emergency because the testicle can be permanently damaged if treatment is delayed.
Seek emergency medical care immediately if there is sudden severe testicular pain, especially if it occurs with nausea, vomiting, abdominal pain, or swelling. Do not wait until the next morning to see whether it improves.
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Recognizing these symptoms does not mean that every man needs to fear cancer. It means that a new change deserves attention and that some types of sudden pain require emergency care.
Chapter 3: What Else Can Cause a Lump or Discomfort in the Testicles?
Finding a lump or swelling in the scrotum can be frightening, especially after reading a headline about cancer. However, testicular cancer is only one possible explanation. Several other conditions can produce similar changes, and many are not cancerous.
This is why a person should not try to identify the cause by looking at a photograph or comparing symptoms with an online checklist.
1. Epididymal cyst
The epididymis is a small, coiled tube located behind each testicle. It stores and transports sperm.
A fluid-filled cyst can develop in or near this structure. It may feel like a small, smooth lump separate from the testicle itself.
Many epididymal cysts are harmless and do not require treatment unless they become painful, enlarge, or cause other problems.
A clinician can use an examination and ultrasound to help distinguish a cyst from a solid mass.
2. Hydrocele
A hydrocele is a collection of fluid around a testicle. It can cause swelling in the scrotum, sometimes making one side look noticeably larger.
Some hydroceles are painless, while others create a feeling of heaviness or discomfort.
Hydroceles can occur in adults and children. They are not the same as testicular cancer, although unexplained swelling should still be assessed to identify the cause.
3. Varicocele
A varicocele occurs when veins in the scrotum become enlarged. It is sometimes described as feeling like a small bundle of soft cords.
It may cause a dull ache or dragging sensation, particularly after standing for a long time or exercising. Some men have no symptoms at all.
Varicoceles are common and are not cancerous, but they can sometimes be associated with fertility problems.
4. Epididymitis and orchitis
Epididymitis is inflammation of the epididymis. Orchitis is inflammation of a testicle. They can occur separately or together.
Possible symptoms include:
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Pain or tenderness in one testicle.
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Swelling and warmth in the scrotum.
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Pain when urinating.
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Frequent or urgent urination.
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Fever or feeling unwell.
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Discomfort during ejaculation.
Some cases are caused by bacterial infections, including sexually transmitted infections. Others may have different causes.
Treatment depends on the underlying cause. Antibiotics may be needed for certain bacterial infections, but they will not treat every form of testicular pain or swelling.