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How to perform a testicular self-exam

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on June 8, 2022.

It’s important to be aware of testicular cancer, as it’s the most commonly diagnosed cancer in men age 15 to 34. The American Cancer Society (ACS) estimates that about 9,760 new cases will be diagnosed in 2024.

Testicular cancer occurs in germ cells, which are cells in the testicles that make sperm. Located inside the scrotum, the testicles play an important role in the male reproductive system, also producing male hormones.

Testicular cancer may usually be treated successfully and has a high survival rate. The five-year relative survival rate for all types of testicular cancer is 95 percent, while localized cancer (meaning it hasn’t spread outside the testicles) has a 99 percent survival rate, according to the ACS.

You may have heard about self-exams as a way to diagnose testicular cancer. Below find what you need to know about performing a self-exam.

Should I regularly do testicular self-exams?

Monthly self-exams may help you get to know your body and what feels normal, so that you may notice any changes. The ACS recommends that men visit their doctor if they find a lump.

However, not enough research has been done to conclusively link self-exams with a lower death rate from testicular cancer. Check first with a doctor to see if it’s right for you.

Are you at higher risk for testicular cancer?

The most common testicular cancer risk factors include:

  • Undescended testicle—Also known as cryptorchidism, this is when one or both testicles don’t move from the abdomen into the scrotum before birth.
  • Family history—Having a brother or father previously diagnosed with testicular cancer may increase risk. A family history of Klinefelter syndrome, an inherited disease, is also linked to an increased risk.
  • HIV infection—Some evidence shows that men with HIV have an increased risk of testicular cancer, especially those with AIDS.
  • Race and ethnicity—Caucasian men have a five times greater risk of developing testicular cancer than black men, and a three times greater risk compared with Asian-American or American Indian men. Hispanic/Latino men have a lower risk than Caucasian men but a higher risk than Asian-American men.
  • Previous testicular cancer—About 3 to 4 percent of men who have had testicular cancer go on to develop cancer in the other testicle.
  • Age—Men ages 20 to 34 have the highest risk, although testicular cancer may develop at any age. 
     

How to perform a self-exam

The ideal time to perform a self-exam is after a bath or shower, as the skin of the scrotum is more relaxed. It’s also fine to do while in the shower, as it only takes a few minutes.

Scheduling it for once a month may be a good idea—consider picking the same date each month, so you’re less likely to forget.

Below are the steps for performing a self-exam.

Hold penis away or to the side: First, gently lift your penis, so it’s out of the way while you’re doing your self-exam. Examine each testicle separately.

Hold each testicle and gently roll it through your fingers: Softly hold your testicle between your thumb and fingers. Then, slowly roll it back and forth a few times to feel it.

Look and feel for lumps or changes: While massaging each testicle back and forth, try to feel for changes. These may include hard lumps; smooth, rounded masses known as nodules; or changes to the size, shape or appearance. A testicle that feels sore or heavier than usual may be an indication that something is wrong. However, your testicles contain something called the epididymis, which is a coiled tube that helps move sperm. If you feel it during the self-exam, be aware that it’s a normal part of your body.

It’s also common for one testicle to be slightly larger or hang lower than the other. After several self-exams, you’ll get to know what feels normal for your body.

What if something feels abnormal during my exam?

If you feel something new or different, the best thing to do is to make an appointment with your doctor.

Often, testicular lumps aren’t cancerous. They may be caused by factors such as a hydrocele, which is when fluid collects around the testicle, or a varicocele, which is when veins in the scrotum dilate, causing lumpiness.

Your doctor may perform a physical examination. More tests, such as an ultrasound, may be recommended.

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