In the United States, testicular cancer is a common type of cancer in men between ages 20-40. The most common presenting symptom is a painless lump in the testicle. Other possible presenting symptoms are testicular pain, dull ache in the scrotum, back pain, achy bones, cough and sometimes breast swelling. Early detection is extremely important to the success of testicular cancer treatment. Testicular self-examination is an important method of self-screening. Any changes in the size or lumps detected during the self-exam should be discussed with a doctor.