How do I know if the lump on my testicle is cancerous?

Special to The Globe and Mail

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The question: I’m a 34-year-old male and I’m embarrassed to talk about it – but I’ve recently found a lump on my testicle. It doesn’t hurt and isn’t causing me any symptoms, but I’m worried about what this could be? What should I do?

The answer: I had a young male patient come in a few weeks ago with a mild issue that we quickly worked through. But when we finished, he paused and seemed to linger a little longer. When I asked if he had any other questions, he blushed and made a comment: “Oh, also, I have a bump that I’m worried about.” And then, in a quiet voice: “On my testicle.”

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It quickly became clear that this was the main reason for his visit, but it was difficult for him to address due to its sensitive nature. We discussed his concern, I ordered an ultrasound and some blood tests and, in the end, it turned out to be a benign issue. But it highlighted how difficult it can be to bring these concerns to attention.

Listen: It’s not easy to talk about sex in general and, by extension, the organs that we have sex with – but if you’ve noticed something has changed, it’s important to seek care.

While there are many benign causes of lumps in the testicles (the male sex glands that are located behind the penis), it’s important to rule out something more serious. So, my first bit of advice to you is to call your doctor and make an appointment to get checked out.

Cancer is the first thing that we should rule out in a young male with a new lump in the testicle. Testicular cancer is relatively rare, but it is the most common cancer in men aged 15 to 29. It is 80 to 90 per cent curable if detected early, so seeking care quickly is important.

Other potential causes of lumps in the testicles range from blockage of fluid (hydrocele) or sperm (spermatocele), enlarged veins (varicocele), an infection (epididymitis) or inflammation (orchitis), or a hernia. Depending on the cause, treatment can amount to surgery, antibiotics or close monitoring of benign lumps. If you’ve had treatment with antibiotics and the lump persists, seek care again to ensure it’s not more serious.

Now that you’ve made an appointment, prepare for the visit by thinking about these questions that can help your doctor understand what may be happening:

  • 1. How long has it been there?
  • 2. Is it on both sides or just one?
  • 3. Does it hurt?
  • 4. Have you recently had any damage or injury to the area?
  • 5. Have you ever had surgery in the area?

It’s important that you’ve noticed this change and you’re acting on it. For tips on what to look for when you examine yourself, and for support and information on testicular cancer, check out Testicular Cancer Canada.

Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens’ Health Centre, works as a staff physician at St. Michael’s Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women’s Habitat Shelter in Etobicoke.

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