Less-Harmful Conditions That Share the Symptoms of Testicular Cancer

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If you feel a lump or notice swelling in your scrotum, you may be worried that you have testicular cancer. However, there are other conditions that share the same symptoms.

Conditions That Can Present as Testicular Swelling

Before jumping to any conclusions, know that there are other less-threatening diagnoses that can present as a lump or swelling.

Hydrocele

At any point in life, fluid can accumulate around the testes, causing the scrotum to swell. This is known as a hydrocele.

Some hydroceles (called “reactive hydroceles”) can be caused by inflammation, infection, or trauma to the testis or epididymis (the tube that is connected to the prostate and stores and carries sperm). These issues are usually resolved when the underlying conditions are treated. In children, hydroceles are caused by normal communication between the peritoneal cavity and the sac around the testes, which continues after birth.

The usual adult hydrocele does not need any treatment unless it becomes large or uncomfortable due to its weight and size. When necessary, hydroceles can be treated in a minor outpatient surgical procedure that involves making a slit in the scrotum to drain the fluid. The sac holding the fluid is then removed to prevent the hydrocele from recurring.

Infections

The epididymis runs along the back of each testicle. Bacterial infections in the epididymis (epididymitis) or testicles (orchitis) will cause swelling or pain in the scrotum.

When these infections are caused by the bacteria Neisseria gonorrhoeae and Chlamydia trachomatis, they are known as gonorrhea and chlamydia. Having sex while infected with these bacteria will transmit the infection. A regular sexual partner will need simultaneous antibiotic treatment to prevent becoming infected. If that partner is already infected and not taking any antibiotics, they could prevent you from being cured while you are taking antibiotics. Guidelines from the CDC indicate that prompt treatments of antibiotics are necessary to prevent complications and transmission of the infections.

It may take several weeks for the bacteria to be eradicated. It is very important that you take all the antibiotics as prescribed. Failure to complete the regimen may cause the bacteria to become resistant to antibiotics, resulting in an infection that cannot be cured.

In some men, orchitis is caused by a virus and may occur in those with active mumps infections. In these cases, antibiotics will not be effective. Ice packs and non-steroidal anti-inflammatory medications (NSAIDs) may be used as needed for pain relief while the disease runs its course.

Cysts and Benign Tumors

A lump in the testis can signify testicular cancer. The lump is generally, but not always, painless. However, lumps that can be felt through the scrotum can also occur outside the testes; these are usually benign.Testicular cancer is rare, but most common in men between the ages of 15 and 35.

A simple ultrasound can help distinguish between a lump that is likely to be testicular cancer and a lump that is likely to be harmless. If it appears to be testicular cancer, surgery to remove the testis is indicated. A lump outside the testis is usually simply observed.

Small, solid masses located in the epididymis are assumed to be adenomatoid tumors. No biopsy is needed, as these tumors are rarely, if ever, cancerous.

Cysts are simply benign fluid-filled pockets. They are harmless and require no treatment.

What to Do If You Have a Scrotal Lump, Pain, or Swelling

Although the diagnosis may not be testicular cancer, you should never try to make the distinction yourself. Let your doctor know immediately if you have a lump, pain, or swelling in your scrotum. He or she will determine what the problem is with an ultrasound. If the answer is not clear, a biopsy or CT scan will be the next step.

If you do have testicular cancer, take comfort in knowing that it is one of the most treatable forms of cancer and is very curable when caught early. Testicular cancer is rare, and testicular cancer that has spread (metastasized) is even rarer. However, a delay in diagnosis can potentially lower survival rate, as the cancer may have spread by the time it is discovered.

Metastatic testicular cancer is often overlooked because its symptoms can be easily mistaken for those of more common conditions. These symptoms may include fatigue, nausea and vomiting, loss of appetite, poor sleep, and other symptoms indicative of systemic disease.

How to Protect Yourself Against Testicular Cancer

The best protection against testicular cancer is to conduct a monthly self-exam in the shower when the scrotal skin is loose and thin. Learn what your normal testes feel like. Since no two paired organs in the body are exactly alike, one testicle (usually on the right side) may hang lower than the other. The testicles may be slightly different in size and shape, as well.

Feeling your testicles monthly will allow you to identify any change in your normal contours—for example, a lump that wasn’t there before, an enlarged testicle, or swelling anywhere in your scrotum. If you notice the presence of something new, see your primary care physician.

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