Testicular lumps – checking, and why speed matters

Testicular cancer is unusual among cancers in that it mostly affects men between roughly 15 and 45 — an age group that generally does not think about cancer and rarely sees a doctor. It is also among the most curable cancers there is when found early, and highly treatable even when it has spread.

Most testicular lumps turn out to be something else entirely: a cyst, a collection of fluid, varicose veins or an infection. That is reassuring and is not a reason to wait — the distinction is made by examination and an ultrasound, not by hoping.

1. 1Do it after a warm shower or bath, when the skin is relaxed.
2. 2Hold one testicle at a time, rolling it gently between thumb and fingers.
3. 3Feel for a hard lump, swelling, or a change in size, weight or firmness.
4. 4Learn what is normal for you. It is normal for one to be slightly larger or to hang lower than the other.
5. 5The soft tube at the back — the epididymis — is normal anatomy and is a common false alarm.
6. 6Check every month or so, and act on anything new rather than watching it for a season.

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Assessment usually means an examination, an ultrasound and blood tests for tumour markers. If cancer is confirmed, treatment usually starts with removing the affected testicle, sometimes followed by chemotherapy or radiotherapy depending on the type and stage.

• One remaining testicle is generally enough for normal hormone levels and fertility.
• Sperm storage should be discussed before treatment that could affect fertility — ask about it early rather than after.
• A prosthesis can be fitted if wanted.
• Cure rates are high, and they are highest when the disease is found early — which is entirely down to how quickly someone acts on a lump.