If you have any of these signs or symptoms, see your doctor without delay. Many of these symptoms are more likely to be caused by something other than testicular cancer. But if a tumour is the cause, the sooner it is found, the sooner you can start treatment and the more effective it is likely to be.

Lump or swelling in the testicle

Most often, the first symptom of testicular cancer is a lump on the testicle, or the testicle becomes swollen or larger. (It’s normal for one testicle to be slightly larger than the other, and for one to hang lower than the other.) Some testicular tumours might cause pain, but most of the time they do not. Men with testicular cancer can also have a feeling of heaviness or aching in the lower abdomen or scrotum.

Breast growth or soreness

In rare cases, germ cell tumours can make breasts grow or become sore. This occurs because certain types of germ cell tumours secrete high levels of a hormone called human chorionic gonadotropin (HCG), which stimulates breast development. Some Leydig cell tumours can make estrogens (female sex hormones), which can cause breast growth or loss of sexual desire.

Early puberty in boys

Some Leydig cell tumors can make androgens (male sex hormones). Androgen-producing tumors may not cause any specific symptoms in men, but in boys they can cause signs of puberty at an abnormally early age, such as a deepening voice and the growth of facial and body hair.

Symptoms of advanced testicular cancers

Even if testicular cancer has spread to other parts of the body, many men might not have symptoms right away. But some men might have some of the following symptoms:

• Low back pain, from cancer spread to the lymph nodes (bean-sized collections of immune cells) in back of the belly
• Shortness of breath, chest pain, or a cough (even coughing up blood) may develop from cancer spread in the lungs.
• Belly pain, either from enlarged lymph nodes or because the cancer has spread to the liver.
• Headaches or confusion, from cancer spread in the brain.

A number of non-cancerous conditions, such as testicle injury or inflammation, can cause symptoms similar to those of testicular cancer. Inflammation of the testicle (known as orchitis) and inflammation of the epididymis (epididymitis) can cause swelling and pain of the testicle. Both of these also can be caused by viral or bacterial infections.