Testicular Self-Exams

Testicular cancer is very treatable when caught early. Often it is found by men doing self-exams. Learn about this exam.

Testicular cancer is the most common form of cancer in men between ages 15 and 34. Cancerous cells can form in one or both testicles. Each year, 8,000 men are diagnosed with this cancer and close to 400 die from it. It occurs more often in white men, especially those of Scandinavian descent, but the rate has begun to increase among African American men.

Most testicular cancers can be found early. A lump on the testicle is usually the first sign. Sometimes, though, there are no symptoms until the disease has advanced.

What to watch for
Doctors generally examine your testicles during routine physicals, but most lumps are found by men themselves. Men should see their doctor right away if they notice any of these symptoms:

  • A painless lump or swelling in a testicle
  • Pain or discomfort in testicle or scrotum
  • Enlargement of testicle or change in way it feels
  • Dull ache in lower abdomen, back, groin
  • Sudden fluid in the scrotum
  • Loss of size in a testicle
  • Enlargement or tenderness of the breasts

The American Cancer Society does not have specific guidelines for testicular self-exams. There has not been enough research yet to prove that these exams save lives. Yet some experts say that men should do monthly self-exams from age 14. Doing so will help you become familiar with your testicles - and may help detect any cancer early when it is often very curable. Testicular self-exam may also be advised if you are at increased risk for testicular cancer. This includes men with a personal or family history of testicular cancer, or who had an undescended testicle.

Doing a self-exam
A testicular self-exam is best done after a warm bath or shower. Heat relaxes the scrotum, which makes it easier to spot abnormalities. If possible, stand in front of a mirror.

  • Hold the penis out of the way.
  • Examine each testicle separately.
  • Hold a testicle between your thumbs and fingers with both hands.
    • The thumbs should be placed on top.
  • Roll it gently between the fingers.
    • There should be no pain.
  • Look and feel for any hard lumps, smooth rounded masses (nodules) or changes in testicle size, shape or makeup.

Cancerous lumps are found most often on the sides of the testicle, but they can show up in other areas, too. Lumps on or attached to the epididymis are usually not cancerous. But report any lumps that you find to your doctor right away. The epididymis is the soft, tube-like structure behind the testicle that collects and carries sperm.

One testicle may feel slightly larger than another, but that's normal. There may be other normal signs that can be mistaken for cancer, too. You may notice:

  • Blood vessels
  • Supporting tissues
  • The epididymis, which may feel like a small bump on outer side of a testicle
  • A pimple, ingrown hair or rash on the scrotum
  • Free-floating lumps in the scrotum, seemingly not attached to anything

See your doctor to sort out any of these lumps.

A testicle can get larger for many reasons. Fluid may gather around it to form a hydrocele. Veins in the testicle can stretch or enlarge to cause lumpiness. This is called a varicocele, and it may feel like a bag of worms. A doctor will need to examine you to make sure it's not a tumor, though.

If you find a lump or think you have other signs of testicular cancer, see your doctor right away.