Performing a testicular self-examination can help catch testicular cancer early and give you the best chance of having a good outlook.

According to the American Cancer Society (ACS), about 1 in 250 men will develop testicular cancer at some point in their lives. Unlike many cancers, it primarily affects young and middle-aged men. The average age at the time of diagnosis is about 33, per the ACS.

The chances of dying from testicular cancer are very low if it’s caught early. The ACS reports a 5-year relative survival rate of 99% if the cancer is contained to the testicles. However, the survival rate drops to 96% if the cancer spreads to surrounding tissues and 73% if it travels to distant parts of your body.

Performing a testicular self-examination can help catch testicular cancer early and give you the best chance of having a good outlook. The majority of testicular cancers are caught by men during a self-exam or by chance.

Keep reading to learn more about how to properly perform a testicular self-exam and why regular examination is important.

A note on terminology

In this article, we use the terms “male” and “men” to refer to someone’s sex as determined by their chromosomes, rather than to refer to their gender.

That language may seem pretty binary, but specificity is key when reporting on research participants and clinical findings. Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

The Testicular Cancer Society recommends performing a self-examination during or right after a warm shower or bath. The warm water relaxes the tissue around your testicles, called your scrotum, and makes the examination easier.

The best place to perform the exam is in front of a mirror, if possible, so you can easily see any noticeable swelling.

Here’s how you can do the exam:

  1. While standing, examine your scrotum for any visible swelling.
  2. Gently roll each of your testicles between the thumb and forefingers of both your hands to search for any hard lumps, bumps, or changes in size, shape, or consistency.
  3. Find the soft tube that carries sperm away from your testicles, called the epididymis.
  4. Feel for any lumps or irregularities on your epididymis.
  5. Continue to feel for any changes in the shape, size, or texture of your testicles. Your testicles should feel smooth and firm.

You should not feel any pain during your exam. Pain can be a sign of a complication that needs medical attention.

It’s typical for one testicle to be slightly larger or to hang lower. Some men confuse blood vessels or other supporting tissues inside the scrotum with a lump. It’s best to visit your doctor if you aren’t sure if something is a concern.

The age recommendations for testicular exams vary between medical organizations, but most doctors recommended starting around age 15. Some doctors recommend continuing monthly exams until age 35, while others recommend continuing until you’re 40 or even 55 years old.

It’s especially important to perform regular exams if you have a higher risk of testicular cancer. Risk factors include:

  • an undescended testicle
  • HIV
  • a family history of testicular cancer
  • previous testicular cancer or carcinoma in situ of the testicles

The risk of testicular cancer is about 4 to 5 times higher in Caucasian men than in African American or Asian American men. People of Native American heritage have a risk somewhere between these groups.

Doctors often recommend performing a testicular self-examination every month to screen for any changes.

No direct risks have been identified, according to 2018 research. However, it’s possible that self-exam could lead to unnecessary worry in some people if they find something that they think is cancer but isn’t.

According to the U.K. National Health Service, it’s important to visit a doctor as soon as possible if you notice:

  • a change in one of your testicles
  • a lump or bump
  • swelling in your scrotum
  • anything else concerning

According to the Testicular Cancer Awareness Foundation, testicular cancer is usually contained in one testicle.

Finding an atypical change in your testicle does not necessarily mean you have cancer. Other conditions that can cause changes in your testicles can include:

  • Epididymo-orchitis: Epididmo-orchitis is inflammation of your epididymis or testicles. It’s most commonly caused by a urinary tract or sexually transmitted infection.
  • Epididymal cyst: Epididymal cysts, also called spermatoceles, are lumps caused by a collection of fluid in the tube that leads away from your testicles. They’re common and usually painless, and they typically do not require treatment.
  • Hydroceles: A hydrocele is a collection of fluid between the testicle and the thin membrane that surrounds it. It may result from injury or inflammation to your scrotum, or it can happen without any obvious cause.
  • Varicocele: A varicocele is swelling of the veins inside your scrotum. The exact cause isn’t known but a malfunction inside the blood vessels may contribute.
  • Inguinal hernias: An inguinal hernia is when an internal tissue in your abdomen protrudes through a hole in your abdomen wall, called the inguinal canal. It can cause pain and swelling in your scrotum.

If your doctor suspects testicular cancer, they’ll likely order blood tests and a scrotal ultrasound.

If the results of these tests suggest cancer, your doctor will likely recommend the removal of your testicle. Cells in the testicle can be analyzed in a lab for cancer.

A pre-operation biopsy is usually not done because it may cause the tumor to spread to surrounding areas.

If you test positive for testicular cancer, your doctor can help you determine the best next steps. The sooner you begin treatment, the better the outlook typically is.

The three main treatment options are:

Only about 1 in 50 cases require the other testicle to be removed later. If your other testicle is removed, you’ll likely need testosterone replacement therapy.

A testicular self-examination can help you catch testicular cancer in the early stages before it spreads to other parts of your body. The outlook for testicular cancer is generally excellent when it’s caught early.

Most testicular cancers develop in young or middle-aged men. It’s a good idea to perform monthly examinations starting from about age 15. If you think you’ll have trouble remembering, you can register for the Testicular Cancer Society’s monthly reminder texts. To subscribe, text “selfexam” to 22999.