Oncology (General Cancer)/testicle lump

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QUESTION: Randomly over the weekend I started getting anxiety/depression pretty bad again after months of quiet. All this seems to be cropping up because of a place on my left testicle I found several months ago. It has been around 8 months since I remember finding the place and over 4 months since I had a scrotal ultrasound that came back "unremarkable". I keep having off and on pain, which is pretty minor, throughout the day in my left lower back/pelvic area and in my left groin area. Over these 8 or so months, the place hasn't seemed to get any bigger, and my testicle does not feel enlarged or hard feeling, in fact poking and feeling at it last night, it feels totally normal to me other than that spot. I had a doctor and a nurse practitioner feel for it and one said I was feeling something that was supposed to be there and the other said he couldn't feel anything abnormal, this was before the ultrasound. I can clearly feel something there on the left one that isn't there on the right one. It feels like it is right next to the tube work on my testicle. It is not really what I would describe as a frozen pea, and is sometimes easier to feel than other times. Since yesterday my chest has been hurting somewhat and my breathing feels.. weird, so of course now I think I've waited too long and it's spread to my lungs in addition to my lymph nodes which is causing my earlier described pain. I mean surely after months of it staying the same and other than the place, my testicle feeling normal, and a clear ultrasound, that pretty much rules out TC, right? Surely after that many months it would have changed and gotten much worse. Also, if the place is big enough for me to feel, the ultrasound wouldn't of missed it, right? I am already in hundreds of dollars in debt to the doctors from previous tests and can't afford more, but I feel like I am essentially dooming myself by not doing anything. Also would the pain of something spreading to the lymph nodes be one sided like I have, or my whole lower back?

ANSWER: Can you be more specific in where the "place" is located and what it feels like?

Is it on the front, side or back of the testicle? If it is on the back, it is not really on the testicle at all - it is on the epididymis and the lump is probably a spermatocele or other kind of benign cyst. Based on the location and the negative ultrasound, I am guessing this is what you've got.

Is it a lump or a section that feels harder than the rest? Testicular cancer is typically going to feel like a BB or half a pea sticking out the side or front of the testicle. The whole testicle could feel harder or heavier than the other testicle. It probably wont hurt. If it is a lump, it is not the sort of thing that is going to come and go. It will always be there. A cyst, on the other hand, could come and go.

I can't tell you if it would or wouldn't spread in this amount of time. It might or it might not. I'm not actually going to tell you where it might hurt if it spread because I dont want to feed your brain any suggestions. That said, it seems pretty improbable that your lungs or lymph nodes would hurt. In fact, none of the places that are hurting are the places that would likely hurt if you had metastatic testicular cancer.

Does this help?

---------- FOLLOW-UP ----------

QUESTION: Hi, thanks for your fast response. I'm not familiar with how to differentiate the sides versus the back of the testicle. I can say that when I am laying down feeling it it is facing the front of my body ( same way I'm facing ). It feels like it is right next to where the tube work connects to the testicle, which I think is the epididymis. It feels pretty close to the epididymis, but feels to me like it's on the testicle, I could be wrong though. I feel it sometimes on the left, and sometimes on the right, but I think that is because the testicle moves around, so it's on the same side just moving around. I've tried to pinch it away from the testicle but with it being so small and my skin being lose, it's hard to get a grip on it, so it's hard to tell 100% if it's connected or not. It feels like a lump/bump or something I guess. It comes up off the testicle a bit but feels connected. I am able to wiggle it around with my finger almost like you could a nipple or something with it still being connected. ( bad comparison ). One thing I've noticed is when I squeeze my testicle a bit, it makes it easier to feel like it makes it bigger or just stick out more. Other than that spot though the testicle feels normal sized and normal not too soft but not too hard.

Answer
Take a look at the picture on this page: http://tcrc.acor.org/testicle.html

The back is the part where the tubes are connected. To be honest, it might not feel quite as straight forward as it looks i the picture. I tried to figure it out for myself, but as I had cancer and only have one testicle, the extra room makes it a lot easier for the testicle to move and finding the front is a challenge.

That said, the lump should always be in the same place. if not, then it is probably on a tube and is not a concern. (I assume it is not on the scrotum itself, right?). If it was cancer, it could not be separated or lifted from the testicle. Again, I dont think this is cancer.  

Oncology (General Cancer)

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Doug Bank

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I know a great deal about all aspect of testicular cancer. I am a testicular cancer survivor, and have run a testicular cancer website since 1996. If I do not know the answer to a question, I have access to a number of my own world-class experts to get the correct answer. Please note that I am not an expert when it comes to other cancers. If your question involves something other than testicular cancer or a cancer of that general region, please ask another expert.

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I am a survivor of Stage I nonseminoma, diagnosed in 1992. I have been helping testicular cancer patients online ever since. I also run the non-profit Testicular Cancer Resource Center

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BS from MIT, MBA from Northwestern

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