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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46959
Experience:  Board Certified Physician
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I would like to get an opinion. I recerntly noticed

Resolved Question:

Hello,
I would like to get an opinion. I recerntly noticed a very very small sort of dot/spot on my testicle. When I feel the testicle between my fingers I can feel a tiny dot which I did not notice before. It is smaller than a grain of rice, more or less the size of a grain of sand. i do not feel any pain or any other symptoms. When I move the testicle around it becomes more difficult to find this spot it does seem to be on the testicle although it hard to tell if this is the case. I regularly check my testicles after a hot shower and hot noticed this before. Does this sound like it could be testicular cancer?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
This is Dr. David

no, this doesn't sound like testicular cancer.

it sounds like you could be feeling a small benign cyst in your testicle.

you can see your doctor and get a testicular ultrasound scan

but I bet the ultrasound will be normal

let me know fi you have questions.
Customer: replied 2 years ago.

Could you please provide some more information on why you think this is infact a cyst? Also what makes me wonder is how come it just appeared,as I check regulary and didnt notice. It is infact very small but would normally be cause for concern in terms of testicular cancer?

Expert:  Dr. David replied 2 years ago.
cysts are very common in the testicle

they can be very very small.

what you are feeling the size of a grain of sand is not concerning for testicular cancer.
Customer: replied 2 years ago.

Do I need to have a scan done? It is very small infact depending on how I move the testicles it is not possible to feel it when the testicle is in certain positions. Also what about the fact that it just appeared and I didnt notice it before and also another question in what instances would one start to think about or be concerned about testicular cancer, what would be a tale tale sign? Also just to add this feels like it is under the skin on the testicle rather than on the scrotum because when i move the testicle around the spot does not stay in the same place, which would indicate it is not on the scrotum itself.
Would be greatful if you address all these questions. thanks again

Expert:  Dr. David replied 2 years ago.
no, you don't need a testicular ultrasound

but it seems with your anxiety and worry symptoms, you most likely will continue to worry about your testicles until you get a testicular ultrasound.

benign cyst can be new and pop up new and disappear all the time.

a solid nodule larger than 0.5cm attached to the testicle is worrisome for testicular cancer

you don't have this.

let me know if you have other questions.

if done for now, please leave positive rating below the chat box so I can get credit for helping you today

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you can always reach me with "a question for Dr. David" if you have any other questions

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Customer: replied 2 years ago.

I just have a couple of follow up questions. Can cysts appear all of a sudden and then disappear? Also can the cyst be on the actual testicle itself as it seems is the case here. Also in my case it is very very small but is quite hard. Can cysts be hard as well?

Expert:  Dr. David replied 2 years ago.
yes, cyst can appear suddenly and disappear suddently.

yes, cyst can be in the actual testicle itself.

yes, cyst can be hard as well.
Customer: replied 2 years ago.

What you advise that I should do at this point, also if this gets bigger should I then be concerned about testicular cancer, I mean it is really really small. You mentino that something firm and about 0.5cm can be worrisome but will it not typically start out smaller than that and grow?

Expert:  Dr. David replied 2 years ago.
if it gets bigger, it could still be a cyst getting bigger.

go get a scrotal ultrasound which will be normal. this will help calm down your anxiety about having testicular cancer.
Customer: replied 2 years ago.

but is not the case that in testicular cancer it starts off as a very small dot slash spot and then gets bigger?>

Expert:  Dr. David replied 2 years ago.
you are letting your anixety get out of control with worry here making up scenarios

you would not be able to distinguish a benign cyst from the start of testicular cancer by feeling your testicles

go get a scrotal ultrasound

I bet it will not show an early testicular cancer.
Customer: replied 2 years ago.

I still have a few follow up questions. You mentioned, that I dont have to have an ultrasound above but then you said I should get one. Also from what I described above what makes you sure that this is a small cyst or spot and not something else?

Expert:  Dr. David replied 2 years ago.
testicular cancer is a rare cancer

feeling a small grain of sand in the scrotum or testicule, chances are it is a benign cyst and not the start of a testicular cancer.

I never said you don't have to have an ultrasound.

from your questions you have a lot of anxiety and feel your testicles frequently for testicular cancer.

I said that having a scrotal ultrasound could help you worry less about having testicular cancer.
Customer: replied 2 years ago.

Are there any risk factors that would increase the risk? I also read it is common in the age group of 25-40 and I am 31, does this increase the risk?
From what I described above what would indicate if this was something to be concerned about, that is in what case should one be concerned?

Expert:  Dr. David replied 2 years ago.
if the nodule would continue to grow and be hard and fixed to the testicle, that would be a worrisome sign for testicular cancer.

but you don't describe that.

even in cases where the mass grows, in some cases, benign cysts can grow as well

it sounds like you are looking for more things to worry about without getting the scrotal ultrasound to help clear your anxiety.

you need to talk to your doctor about anxiety about having testicular cancer.

you might need treatment to help decrease some of your anxiety about this.
Customer: replied 2 years ago.

Yes i accept that I am a little bit anxious about this. The only thing that made me worry is the fact that I check the testicles regularly and had not noticed this until this week. Although this is very very small i just wonder how come it just appeared. I am going to see my doctor this week but, i think that if it is so small and they cant even feel it then they might not refer me for an ultrasound scan.

Expert:  Dr. David replied 2 years ago.
it is common for benign cysts to pop up in the testicle.

you don't need an ultrasound scan to check for cancer if it is too small to feel

you need an ultrasound scan to try to calm down your severe anxiety over this

you should talk to your doctor about yoru anxiety and worry about having testicular cancer.

he might order the ultrasound just to help you calm down your anxiety

you should also ask about treatment for anxiety

you might benefit from talking to a therapist about your anxiety

there are also medications which can help as well

please leave positive rating below the chat box so I can get credit for helping you today

Thanks for using JustAnswers.com
Customer: replied 2 years ago.

Its not that it is too small to feel as such. Its easier to feel when the testicle is in certain positions.

So that is another question I have the fact that it is so small like a grain of sand and I can only be felt more easily when the testicle is in certain position what does that indicate in this case?

Expert:  Dr. David replied 2 years ago.
it indicates that what you are feeling is not testicular cancer

testicular cancer you would be able to feel all the time

and what you are feeling most likely is benign, like a benign cyst
Customer: replied 2 years ago.

Okay I am seeing my doctor on friday. I just dont know if they are not able to feel it at all they might not ask me to have an ultrasound, I guess once they have a look they will decide if I need to have one or not.
I know I have already mentioned this but it is very very small could it also be like a spot that actually appeared and would go away? I mean like spots that you can get on other parts of the body can one get these types of spots on their testicle? It does move when i move the testicle indiciating that it is on the testicle itself and not on the scrotum.

Expert:  Dr. David replied 2 years ago.
small cyst can appear and go away

small early testicular cancer would not go away and would continue to grow.
Customer: replied 2 years ago.

does that mean that small spots on the testicle are refered to as cysts? I know i seem like i am anxious about this, but from everything i have described do you think this could turn out to be something else? Or should I be concerned?

Expert:  Dr. David replied 2 years ago.
you shouldn't be concern.

I am not concerned about testicular cancer

I am a cancer doctor.

your description of what you felt and now don't feel is not in line with testicular cancer.

I have told you this before

but you seem to keep asking these same questions

which makes me know that your anxiety symptoms are out of control with worry.
Customer: replied 2 years ago.

I dontt understand what you mean by what I felt and now dont feel. I have just had another look and it feels as though it is like a pimple on the testicle if such a thing is possible

Expert:  Dr. David replied 2 years ago.
you are feeling a cyst in your testicle.
Customer: replied 2 years ago.

Just a final question. I have read that testicular cancer that it can start as a small spot the size of a grain of sand and then can get bigger from there. How can I be sure that this is not the case for me? Because it could be a small dot that is potentially going to grow larger.

Expert:  Dr. David replied 2 years ago.
you should show the small spot to your doctor

and get a scrotal ultrasound

if it is indeed an early testicular cancer, the scrotal ultrasound will be able to tell
Customer: replied 2 years ago.

I thought you said that from the way I described it, it did not sound like early testicular cancer? So are you saying that it could actually be early testicular cancer?

Expert:  Dr. David replied 2 years ago.
it doesn't sound like early testicular cancer.

but your anxiety is severe with worry.

you keep worrying about an early testicular cancer.

one way to help calm down your anxiety is to get a scrotal ultrasound.

I would bet a million dollars that you don't have an early testicular cancer.
Customer: replied 2 years ago.

But if it is a small grain of sand sized spot then what does that mean i imagine all testicular cancer lumps would have been the size of a grain of sand at some point is that not how it would start?

Expert:  Dr. David replied 2 years ago.
your anxiety is doing this "imaginging"

your anxiety is making up scenarios

you are not detecting a super early testicular cancer

you are feeling a benign cyst

we have been through this already.

until you get a testicular ultrasound you will continue to worry

you are displaying severe anxiety over this

it doesn't sound like my replies are helping you.
Customer: replied 2 years ago.

Okay I am seeing the doctor but what can you please answer these two questions, do testicular cancer lumps not start out very small and grow? Also the second thing is do cysts just appear all of a sudden as this was not there before?

Expert:  Dr. David replied 2 years ago.
testicular cancers do start out very small and grow

but out of 10000 patients who fell small sand like nodules in the testicle 9999 of them will be benign cysts and 1 of them will be a testicular cancer.

yes, cyst do appear all of a sudden out of nowhere when none was there before
Customer: replied 2 years ago.

You say they dont start out small and grow but then how do they start does a pea sized lump just appear? Surely they would have to start out at a certain size and get bigger?

Expert:  Dr. David replied 2 years ago.
I do say they start off small

but the chance that your small sand like nodule in your testicle is a testicular cancer is 1 in 10000
Customer: replied 2 years ago.

I will provide you with a positive rating. I just have one further question in which case should I be really worried about testicular cancer, i mean what would be the tale tale sign?

Expert:  Dr. David replied 2 years ago.
I have told you this already

a fixed testicular mass of 0.5cm or larger to the testicle is a sign of possible testicular cancer

this still has to be confirmed by testicular ultrasound as well.

there is no 100% tell tale sign that tells you 100% you have testicular cancer without a scrotal ultrasound.
Customer: replied 2 years ago.

So what I describe does not sound like the early stages of testicular cancer? You said you are a cancer doctor have you seen cases of testicular cancer that started with a small spot/dot?

Expert:  Dr. David replied 2 years ago.
no, what you describe doesn't sound like the beginning stages of testicular cancer much more likely to be a testicular cyst. I have not seen any cases of testicular cancer which started with such a small spot or dot.
Customer: replied 2 years ago.

Okay please can you tell me the cases you have seen how did they start?

Expert:  Dr. David replied 2 years ago.
they started when a patient felt a 0.5 to 1cm lump in their testicle and then they went to get an ultasound which could see a mass in their testicle.

that is how their cases started.
Customer: replied 2 years ago.

Thats the only thing i dont understand that lump of 1cm would have been smaller at some point would it not?>

Expert:  Dr. David replied 2 years ago.
it probably was smaller at one point.

most people are not feeling their testicle and scrotoms as often as you are doing

but not every lump in the scrotum and testicle is a testicular cancer

most are not testicular cancer.
Customer: replied 2 years ago.

yes and so the fact that it was smaller at some point is what makes me worried that at this small point it could be the begining of something worrisome in my case.

Expert:  Dr. David replied 2 years ago.
your worry is quite severe

you seem fixed on this worry and unable to move forward with this anxiety of yours.
Customer: replied 2 years ago.

So what can I do at this stage. How can I help myself to be relaxed while waiting to be seen by a doctor because i cant stop thinking its the begining of something and i just happened to notice it early. I just had another look at it and its really really small, like a dot almost or feels like a small spot. I dont know what i can do to reassure myself its nothign serious until i see the doctor its i am struggling with fear to be honest.

Expert:  Dr. David replied 2 years ago.
you need treatment for your excessive anxiety about testicular cancer

you need to see a therapist and learn relaxation and deep breathing techniques

you need to learn mental visualization techniques to decrease anxiety

I have been trying to reassure you for the last 5 days on this question thread and you continue to worry.

you have not left positive feedback for me yet.
Customer: replied 2 years ago.

Yes I will leave positive feedback you have been very helpful. I just have one final question which you have probably already answered but I will ask anyway. How can I be so sure that it is not the begining of tesicular cancer without having an utrasound? I mean how do I know hat this is not how it starts as small spot. Thats the biggest concern for me how do I know this is not the start of something since it just appeared.

Expert:  Dr. David replied 2 years ago.
because of the statistics I have given you.

the chance of this small grain of sand you are feeling in your testicle being the start of testicular cancer would be one in 10,000 chance.
Customer: replied 2 years ago.

Sorry I know i said no more questions but I have one last one and i will provide an excellent rating for your service.
Does the fact that it has suddenly appreared and was not there a month ago indicate anyting?

Expert:  Dr. David replied 2 years ago.
no,

benign cysts can pop up and regress on their own frequently

suddenly popping up doesn't mean it is an early testicular cancer
Customer: replied 2 years ago.

It seems to have a very pointy head like how a spot/zit would be does that sound like a cyst can they be like that?

Expert:  Dr. David replied 2 years ago.
it sounds like a pimple on the skin or a cyst

it doesn't sound like an early testicular cancer.
Customer: replied 2 years ago.

But its on the testicle itslef, its not on the scrotum and thats why i am so worried its not on the scrotum/skin its on the testicle itself.

Expert:  Dr. David replied 2 years ago.
you can have cysts with a head on it on the testicle.
Customer: replied 2 years ago.

So you feel that the fact it just appeared all of a sudden is not an indication that it is early stage cancer? Also about two months ago I had a complete blood count done as part of an overall check up and this was fine. Would it have shown something even if the spot had not yet appeared?

Expert:  Dr. David replied 2 years ago.
blood testing doesn't help tell us about testicular cancer.

why are you now questioning what I have told you before?

sudden appearance does not mean early stage cancer.
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