• A lump in the testicle which may or may not be painful
• Swollen or enlarged testicles
• Dull ache in the groin, genitals or lower abdomen
•  A feeling of swollen heavy testicles for unknown reason
• Feeling of pain or discomfort in the testicles
• A feeling of fluid build-up in the testicles
• Decreased sexual desire
• Enlargement or tenderness of the breast tissue due to the hormones produced by certain type of tumors which stimulate breast development.

 
Testicular cancer spreading to other organs can also lead to other symptoms including:

• Lower back pain or stomachache
• Headache, dizziness
• Stabbing pain, numbness or weakness in the thighs
• Breathing difficulty, coughing and tight chest

• A monthly testicular self-examination during reproductive age helps screen for testicular cancer at an early stage, especially for those with risk factors. The testicular exam is best performed when the scrotum is relaxed such as after a warm bath.
• While examing, hold the penis out of the way and then gently roll the testicles between your thumbs and fingers to check for any lumps.

 
However, it is normal if the two testicles are different in size, at different levels, and tiny bumps may also be found on the outside of the upper and middle parts of the testicles.
 

Currently, the exact causes of many types of cancer, have not yet been identified, including testicular cancer. However, studies have found the following risk factors:

• Undescended testicles, a condition where one or both testicles do not descend into the scrotum before birth, which increases the risk of testicular cancer by about 10-40%
• Chromosomes 1 and 12 abnormalities
• Testicular atrophy
• Carcinoma in situ, a comdition with abnormal cells that may become cancerous
• Previous injury or inflammation in the testicles due to various causes
• Immunodeficiency, such as HIV infection
• Men with infertility face a higher risk of  developing testicular cancer

• Medical history and symptoms
• Physical examination by feeling both testicles
• Ultrasound imaging of the scrotum and testicles, showing the general appearance and location of the lump
• Blood test to measure the level of tumor markers; whereby, while normal, a change in the levels of tumor markers may indicate abnormalities
• Surgery to remove the testicle is recommended when the tumor has been diagnosed as highly cancerous for further examination and diagnosis of the type of testicular cancer.

 
When a cancerous tumor is diagnosed, further tests as follows are performed to determine the cancer stage and to find out if the cancer has spread to other organs.

• CT scan to check if cancer cells have spread to other organs
• Blood tests: The purpose is to check if there are still cancer cells remaining after testicular surgery. The levels of tumor markers shown in the blood test should gradually decrease if the cancerous tumor has been successfully removed. However, if the levels of tumor markers remain the same or probably increase, it is suggested that cancer cells still remain.

Categorizing testicular cancer into the following three stages helps the doctor to plan for proper and most effective treatment.

Stage 1 – cancer is confined to the testicle; the cure rate is 90-100%.
Stage 2 – cancer has spread outside the testicle to nearby lymph nodes in the abdomen; the cure rate is about 80-90%.
Stage 3 – cancer has spread to lymph nodes outside the abdomen; with high tumor marker levels, it often spreads to the brain and the lungs; but the cure rate is yet 50-70%.
 

• Surgery: This is a surgery on the affected testicle only. Cancer cells are then examined and the stage of the cancer determined. The patient's health is also considered in providing continuous treatment.
• Radiation therapy: Radiation is directed at the lymph nodes in the abdomen, the chest, or areas where the cancer has spread to.
• Chemotherapy: After surgery, chemotherapy may be considered as further treatment or it may be administered at the same time as radiation therapy.

Testicular cancer treatment may have side effects, especially in patients who smoke, drink alcohol, or have underlying diseases such as diabetes, high blood pressure, and high cholesterol, as well as in the elderly. Side effects include the following:

• the loss of a testicle from surgery, infected surgical wound, or the effects of anesthesia
• radiation side effects on the skin or the tissues on the area of treatment
• common chemotherapy side effects like hair loss, nausea, vomiting, and low platelet level

 
Complications of testicular cancer
Patients with testicular cancer may experience symptoms other than those indicating testicular cancer if the cancer cells have spread to other organs, generally to the lymph nodes near the testicle and the lungs. In few cases, cancer cells spread to the liver, brain, and bones. Symptoms that may occur in patients with advanced testicular cancer include the following.

• Lower back pain if the cancer has spread to lymph nodes in the back of the abdomen
• Shortness of breath, chest pain, chronic cough, or coughing up blood if the cancer has spread to the lungs
• Abdominal pain if the cancer has spread to the liver
• Headache or dizziness if the cancer has spread to the brain

After the testicular cancer treatment is complete, the doctor will schedule follow-up appointments probably for several years to observe whether there are any signs of cancer returning. Patients experiencing any unusual symptoms should consult the doctor immediately.
 
Patients with testicular cancer should make lifestyle changes to enhance their health and reduce the risk of cancer returning as follows:

• Maintain a standard weight, as being overweight can increase the risk of diseases and cancer. In considering standard weight, the body mass index (BMI) may be used as reference.
• Exercise, possibly doing some activities that require physical energy such as housework
• Eat healthy foods, vegetables and fruits. Opt for low-calorie items. Consume less sugar and the right amount of food.
• Limit alcohol consumption or avoid drinking alcohol.
• Avoid cigarette smoke. Cancer patients should avoid smoking and cigarette smoke as cigarette smoke increases the risk of many types of cancer.

 
Currently, there is no way to prevent and screen for testicular cancer from the beginning. So, the best approach is to monitor your testicles. If you find a lump or any abnormality, you should see a doctor immediately for diagnosis and proper treatment.