HIV is the leading healthcare issue addressed within our demographic. Our lives seem to be dictated by this single illness, either by how to avoid it or by our treatment if/when we test positive. The concern over sexually transmitted diseases is reasonable, but we must not forget that, as gay males, we are still human and male. This means we are susceptible to the same diseases and illnesses as the rest of the male human population, and this includes TESTICULAR CANCER.
This is a very rare cancer, but if you or someone you love is affected, ANY rate is too damn high. Because “rare “does not equal “never,” our goal with this article is to inform and educate you about the risks, preventive measures, and basic ways to self-diagnose yourself or your sexual partners, so that you may either entirely avoid it or seek out care and treatment quickly to avoid serious illness or even death.
Not much research has been collected relating specifically to gay males and cancer, but the information about males in general is pretty strong. It is essential to remember our maleness and gayness as risk factors for health concerns.
At this point, we all should know the basics about the significant cancers like lung and prostate, but we don’t hear much about rarer ones that are life-threatening and usually not caught early enough. One of the least talked about is testicular cancer. It primarily affects young men, but older men can also develop it. It should be relatively easy to detect and treat if you know your body and your testicles well. We gathered our information from cancer experts, such as the American Cancer Society (ACS). GMJ culled its data banks to answer your most prominent and pressing concerns about this illness. As usual, we provide links so you can learn more.
NOTE: Often, in porn or among our friends, it is common to hear about how large a guy’s balls are; bull balls, big as grapefruits, the size of apples..etc. These are just words and fantasy. In real life, these would be signs of serious illness. Don’t take things so literally.
Pro Tip: Masturbation is a great time to get off and learn more about your body and genitals. Don’t ignore anything unusual or out of place! Changes in your nuts, like hard or swollen knobs, are easily detected when jerking off or taking a bath/shower. Use your time wisely.
The American Cancer Society’s estimates for testicular cancer in the United States for 2026 are:
9,810, with an estimated 630 deaths.
The cancer is most frequently diagnosed among men aged 20 to 34.
The 5-year relative survival rate is above 95%,
and the risk of dying from this cancer is very low, about 1 in 5,000.
The incidence rate of testicular cancer has been increasing in the United States and many other countries for several decades. The increase is mostly in seminomas, and experts have not found a reason for it. Lately, the rate of growth has slowed.
The average age at the time of diagnosis of testicular cancer is about 33. This is largely a disease of young and middle-aged men, but about 7% of cases occur in children and teens, and about 7% occur in men over 55.
Because testicular cancer usually can be treated successfully, a man’s lifetime risk of dying from this cancer is very low: about 1 in 5,000. If you want to know more about survival statistics, see Testicular cancer survival rates.
Most testicular cancers can be found at an early stage. In some men, early testicular cancers cause symptoms that lead them to seek medical attention. Most of the time, a lump on the testicle is the first symptom, or the testicle might be swollen or larger than usual. However, some testicular cancers may not cause symptoms until they have advanced.
Testicular self-exam
The best time to examine your testicles is during or after a bath or shower, when the scrotal skin is relaxed.
- Hold your penis out of the way and examine each testicle separately.
- Hold your testicle between your thumbs and fingers with both hands and roll it gently between your fingers.
- Look and feel for any hard lumps or nodules (smooth, rounded masses) or any change in the size, shape, or consistency of your testicles.
It’s normal for one testicle to be slightly larger than the other and for one to hang lower than the other. Each normal testicle also has a small, coiled tube called the epididymis that can feel like a small bump on the upper or middle outer side of the testis. Normal testicles also contain blood vessels, supporting tissues, and tubes that carry sperm. Some men may initially mistake these for abnormal lumps. If you have any concerns, ask your doctor.
A testicle can get larger for many reasons other than cancer. For example, fluid can collect around the testicle to form a benign condition called a hydrocele. Or the veins in the scrotum can dilate, causing enlargement and lumpiness. This is called a varicocele. If your testicle seems larger, see a doctor to make sure it’s not a tumor. The doctor may order an ultrasound exam (see How is testicular cancer diagnosed?). This is an easy, painless way to find a tumor.
Scientists have found a few risk factors that make someone more likely to develop testicular cancer. Even if someone has one or more risk factors for this disease, it’s impossible to know for sure how much that risk factor contributes to developing cancer. Also, most boys and men with testicular cancer do not have any of the known risk factors. Risk factors for testicular cancer include:
- An undescended testicle
- Family history of testicular cancer
- HIV infection
- Carcinoma in situ of the testicle
- Having had testicular cancer before
- Being of a particular race/ethnicity
- Body size
- Some men with testicular cancer have no symptoms at all, and their cancer is found during medical testing for other conditions. Sometimes, imaging tests to find the cause of infertility can uncover a small testicular cancer.
- Lump or swelling in the testicle
Most often, the first symptom of testicular cancer is a lump on the testicle or the testicle becomes swollen or larger. (It’s normal for one testicle to be slightly larger than the other and for one to hang lower than the other.) Some testicular tumors might cause pain, but most of the time, they do not. Men with testicular cancer can also feel heaviness or aching in the lower abdomen or scrotum.
- Breast growth or soreness
In rare cases, germ cell tumors can make breasts grow or become sore. This occurs because certain germ cell tumors secrete high levels of a hormone called human chorionic gonadotropin (HCG), which stimulates breast development.
Some Leydig cell tumors can make estrogens (female sex hormones), which can cause breast growth or loss of sexual desire.
- Early puberty in boys
Some Leydig cell tumors can make androgens (male sex hormones). Androgen-producing tumors may not cause specific symptoms in men, but in boys, they can cause signs of puberty at an abnormally early age, such as a deepening voice and facial and body hair growth.
Symptoms of advanced testicular cancers
Even if testicular cancer has spread to other body parts, many men might not have symptoms immediately. But some men might have some of the following symptoms:
- Low back pain from cancer spreading to the lymph nodes (bean-sized collections of immune cells) in the back of the belly
- Shortness of breath, chest pain, or a cough (even coughing up blood) may develop from lung cancer.
- Belly pain, either from enlarged lymph nodes or because the cancer has spread to the liver.
- Headaches or confusion from cancer spread in the brain.
- Several non-cancerous conditions, such as testicle injury or inflammation, can cause symptoms similar to testicular cancer.
- Inflammation of the testicle (orchitis) and inflammation of the epididymis (epididymitis) can cause swelling and pain in the testicle. Both can also result from viral or bacterial infections.
Treatment
Depending on the type and stage of the cancer and other factors, treatment options for testicular cancer can include:
In some cases, doctors may use more than one type of treatment.
Depending on the stage of your cancer and your treatment options, you may have different types of doctors on your treatment team. These doctors may include:
- A urologist: a surgeon who specializes in treating diseases of the urinary system and male reproductive system
- A radiation oncologist: a doctor who treats cancer with radiation therapy
- A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy
Many other specialists might also be involved in your care, including physician assistants, nurse practitioners, nurses, physical therapists, social workers, and other health professionals. See Health Professionals Associated With Cancer Care for more on this.
What if one or both testicles need to be removed?
The surgeon makes a small cut in your scrotum (the sac that holds your testicles). After removing your testicles, your surgeon may put in fake testicles (prostheses) so that your scrotum looks and feels the same. You may be able to have a minor operation to remove only the inner part of your testes. This is a subcapsular orchidectomy; you don’t need a prosthesis after this operation.
You may have some discomfort after the operation. You will have a few stitches on your scrotum. Usually, these are absorbable. So, you don’t need to remove them. You may go home the same day or stay overnight.
- You can still successfully achieve an erection and ejaculate with one testicle.
- If both are removed, you will need hormone replacement therapy for the loss of testosterone.
- You can retain a normal sex life.
- Realistic testicular prostheses exist to replace the surgically removed ones.
Homosexual Male-focused support
If you are diagnosed with testicular cancer or any cancer, you may want to reach out to gay-specific organizations. Here are two that we found helpful.
Founded in 2005, the National LGBT Cancer Project and Out With Cancer are the first national LGBT cancer survivor support and nonprofit advocacy organizations in the United States.
Known collectively as the National LGBT Cancer Project, we provide cancer-related programs, services, and research focused on lesbian, gay, bisexual, transgender, and intersex people and other sexuality and gender-diverse people and communities.
The National LGBT Cancer Network works to improve the lives of LGBT cancer survivors and those at risk by:
- EDUCATING the LGBT community about our increased cancer risks and the importance of screening and early detection;
- TRAINING health care providers to offer more culturally competent, safe, and welcoming care; and
- ADVOCATING for LGBT survivors in mainstream cancer organizations, the media, and research.
Tags: American cancer society, ball cancer, testicular cancer
