If you’re not touching your junk every day, you ought to start, stat. Because the better you know what your balls feel like, the sooner you can spot any strange bumps and lumps down there.
Such abnormalities can signal testicular cancer—one of the few types of cancer that is more common in younger guys.
In fact, nearly half of all cases of testicular cancer occur in men ages 20 to 34, and nearly 80 percent strike before the age of 45, according to the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER).
Here’s what it means if you feel something weird on your testicles.
The Symptoms of Testicular Cancer
The most common sign of testicular cancer is any kind of lump, hardness, mass, or irregularity inside your testicle. You might notice it randomly, like when you’re scrubbing up in the shower or re-adjusting your junk.
Pay attention to any changes in size, shape, or texture of your testicles. You might not be able to feel the mass itself, but it could make your testicle feel very firm.
You may even notice swelling and tenderness in your breasts, or a discharge from your nipples.
That’s because one of the hormones testicular cancer produces is human chorionic gonadotropin (HCG)—the same hormone that can stimulate breast growth, says Ryan Berglund, M.D., a urologist at the Cleveland Clinic.
Most testicular cancers are painless. But if the cancer has spread to other areas like your gut, spine, or lungs, you may experience symptoms like abdominal aching or pain, back pain, or coughing up blood.
Other Causes of Bumps and Lumps on Your Testicles
Not all irregularities in your testicles point to cancer.
If your balls seem heavy—or if they feel like a bag of worms—this could actually signal varicoceles, which are enlarged veins in your testicles.
About 10 to 15 percent of guys have these, and they generally don’t pose many problems. But men with varicoceles do have a sperm count that’s 41 percent lower than guys without the bulging veins, say Italian researchers.
Bumps could also come from cysts on your epididymis—a tube that connects your testicles to your vas deferens—or a testicular torsion, which is a painful condition where your testicle gets twisted and swells up.
The only way to know exactly what’s up with your nuts is to visit your doctor and get an ultrasound, says Dr. Berglund.
Risk Factors for Testicular Cancer
One of the biggest risk factors for testicular cancer is having an undescended testicle—a condition where your testicle fails to move down your scrotum before birth. This affects about 4 percent of boys born in the U.S., according to a Geisinger Medical Center report.
Having an undescended testicle can raise your risk for testicular cancer by 6 to 10 percent, says Dr. Berglund—though scientists aren’t really sure what’s responsible for the link. Your mom will know if you had this condition.
You’re also more likely to have testicular cancer if the disease runs in your family, and if you’re white: White men are about four times as likely to develop testicular cancer as black and Asian-American men are, according to SEER data.
Fortunately, your overall risk for testicular cancer is very low. About 0.4 percent of men will be diagnosed with it in their lifetime, according to that data.
How to Check For Testicular Cancer
Examine your testicles every month to check for any new abnormalities
Perform your testicular exam while you’re in the shower, says Nicholas Cost, M.D., a urologist and assistant professor at the University of Colorado.
The warmth will relax your scrotum and make it easier for you to feel any abnormalities, he says.
Start at the top of your left testicle. Hold it between your thumb and fingers of both hands, and gently roll it between your fingers as you move down.
You should look for any hard lumps, smooth or rounded bumps, or unusual changes in the size, shape, and consistency of your testicle. Repeat on the right side.
What You Should Do If You Feel a Lump on Your Balls
If you notice a bump or lump that feels different or suddenly appears, schedule an appointment with your urologist right away.
If your doctor suspects it could be testicular cancer, he or she will order a blood test to check for tumor markers, which are proteins testicular cancers make such as alpha-fetoprotein (AFP) or HCG.
You’ll also have an ultrasound of your testicle. While the ultrasound can’t tell you whether or not your testicle is cancerous, the procedure can identify potentially cancerous masses.
But your doctor won’t biopsy these masses, says Darius Paduch, M.D., Ph.D., an associate professor of urology and reproductive medicine at Weill Cornell Medical College in New York City.
That’s because the testicle draining system flows into deep lymph nodes, which can cause cancer cells to spread more easily to other parts of the body, he says.
A pathologist will then examine the tumor under a microscope to determine whether cancer cells are present and if so, how advanced the cancer is.
How Testicular Cancer Is Treated
The next step is surgery. If the tumor is less than 1 centimeter and the tumor markers are negative, specialists may consider only removing the tumor, Dr. Paduch says.
In most cases, however, you’ll undergo a process called radical inguinal orchiectomy, where surgeons remove your testicle through an incision just above your pubic area.
“The surgeon also takes out surrounding tissues, blood vessels, and lymph nodes that could be affected,” Dr. Berglund says.
Depending on the type of testicular cancer that you have and whether it’s spread, you may also receive chemotherapy and/or radiation to treat the cancer and prevent a recurrence.
The good news: Treatment for testicular cancer is extremely effective, says Dr. Berglund.
In fact, the 5-year survival rate for guys diagnosed with testicular cancer is over 95 percent, according to SEER data. And when the cancer is caught early before it has spread, the 5-year survival rate is over 99 percent.