Testicular lumps - what are the chances of cancer?

Dear Ask The Doctor: Hi there i have two lumps in my testicals 1 on each i have been 2 the gp before and he said they where sists i have had 1 for 6 year and 1 for 4 could they b cancer they change in size often when i have sex.

Dear Andrew: I do understand your concern for testicular cancer. Lumps in the testicles could be caused by cysts, epididymitis, injury/trauma, orchitis, varicocele and testicular cancer.

It is important to rule out testicular cancer if a lump is found on examination. A family history of testicular cancer, past history of tumor of testicle and an undescended testicle increase the risk of testicular cancer.

Most cases of testicular cancer present as painless scrotal mass and are often misdiagnosed as epidydimitis. The other symptoms include fullness in the scrotum, dull ache or scrotal pain. Signs of metastasis may include neck mass, back ache, unilateral or bilateral leg swelling or an abdominal mass. Gynecomastia may be present in 5-10% of cases.

Diagnosis and staging of testicular cancer is based on assessement of tumor markers - AFP and beta HCG, CT scan of the pelvis and exclusion of distant metastasis by chest x-ray and CT - thorax. The diagnosis of testicular cancer is based on the pathology.

According to the history that you have given, the fact the the swelling increases during sex indicates an infection of the testis or epididymitis. If appropriate antibiotics is unable to reduce the swelling, I would suggest further investigation by your doctor.