Apr 15, 2015 4 min read

Q.I don’t know who else to go to with this. I found a lump in one of my testicles. Is it possible that it’s cancer? I’m terrified. What if it is? If it is cancer and I get treated, will I still be OK to be a dad someday? And you can put this in your column. I don’t think I’m the only guy who’s confused and scared about this.

18-year-old

Mary Jo’s response: Telling someone is important; thank you for your trust. Taking care of your body shows your maturity. I admire your courage.

A testicular lump should be checked out, but it may not be cancerous. Even if it is, testicular cancer is treatable. All cancers are not the same. If discovered early, testicular cancer responds well to treatment and can typically be cured. I recommend seeing a doctor right away; the lump may not be cancer, but if it is, the sooner treatment begins the more likely it is to work.

First, let’s talk about your body. A man’s testicles (also called testes) are two egg-shaped glands inside the scrotum (a sac of loose skin directly below the penis). Each testicle is usually a little smaller than a golf ball. The testicles are the male reproductive glands. They have two main functions: They produce the male hormones (androgens) like testosterone, and they make sperm, the male cells needed to fertilize a female’s egg to start a pregnancy.

According to the American Cancer Institute, testicular cancer is rare (about 1 in 263 men will develop it), but it is most common in men between the ages of 15 and 35.

The most common symptom of testicular cancer is a painless lump in one or both of the testes. A testicle may become swollen or enlarged, even without a lump. One testicle is normally slighter larger than the other, and it’s also normal for one to hang lower than the other. A testicle contains a small coiled tube called the epididymis, which can feel like a small bump on the upper or middle outer side of the testicle. A healthy testicle also contains blood vessels and the spermatic cord. These body parts can feel bumpy and be confusing. Seeing a doctor is important to rule out cancer.

Signs and symptoms of possible testicular cancer include:

• A lump or enlargement in either testicle;

• A feeling of heaviness in the scrotum;

• A dull ache in the abdomen or groin;

• A sudden collection of fluid in the scrotum;

• Pain or discomfort in a testicle or the scrotum;

• Enlargement or tenderness of the breasts; and

• Back pain.

Some other conditions that could cause a testicular lump, swelling or pain include:

• Injury

• Infection

• Hydrocele

• Varicocele

• Epididymal cyst

• Inguinal hernia

• Torsion of the testicle

• Kidney stone

Your doctor will ask you questions, including when you noticed the lump. You will probably have an ultrasound test. An ultrasound image can help your doctor determine the nature of any testicular lump. A blood test may also be ordered. If the lump is cancerous, surgery to remove the testicle may be recommended. Testicular cancer rarely occurs in both testes; removal of one does not affect a man’s ability to father a child. The remaining testicle will produce hormones and create sperm.

I’d also like to encourage you to share your concerns with an adult in your family. Even though you’re old enough to make an appointment with a doctor, support helps. I’ll be happy to help you tell someone. Talking about private body parts can be embarrassing – it’s OK to feel awkward. Safeguarding your health is a vital life goal. Try to remember how amazing your body is; would you hesitate to tell a parent about a lump found in your knee? You’ve done nothing wrong to cause this lump, and only a doctor can help you know exactly what it means.

If the lump is cancerous, and you have surgery, you will need support. Emotionally the loss of a testicle can be frightening. It’s possible your peers may not understand the need for surgery or the importance of treatment. Education can help; your willingness to share your experience in this column may encourage other young men to seek medical care. You are a person of worth; treating cancer doesn’t change who you are.

Have a question? Send it to Dr. Mary Jo Podgurski’s email at podmj@healthyteens.com.