A testicular self-exam takes about one minute and requires nothing but your hands. The goal is to get familiar with how your testicles normally feel so you can notice if something changes. Testicular cancer is most often diagnosed in men aged 20 to 34, and catching it early makes a significant difference in outcomes.
When and How Often to Check
The best time to do a self-exam is during or right after a warm shower or bath. Heat relaxes the scrotum, letting the testicles hang lower and making it much easier to feel their surface. Standing is the ideal position.
Many doctors recommend checking once a month. The American Cancer Society stops short of a universal recommendation because the research on whether routine self-exams reduce deaths is limited, but they do advise all men to be aware of testicular cancer and see a doctor immediately if they find a lump. If you have a higher risk, such as a history of an undescended testicle, a previous testicular tumor, or a family history, monthly exams are strongly encouraged.
Step-by-Step Self-Exam
Start by holding your penis out of the way and looking at your scrotum in a mirror. Check for any visible swelling, skin changes, or asymmetry. It’s normal for one testicle to hang slightly lower than the other or be a bit larger.
Next, examine one testicle at a time. Place your index and middle fingers underneath the testicle and your thumbs on top. Gently roll it between your fingers, feeling the entire surface. You’re checking for any hard lumps, smooth rounded bumps, or changes in size or firmness. A healthy testicle feels smooth, oval, and slightly firm, like a hard-boiled egg without the shell.
While you’re rolling, you’ll feel a soft, rope-like structure along the back and top of each testicle. This is the epididymis, a comma-shaped tube that stores and transports sperm. It’s completely normal, and it can feel a bit tender if you press on it. Don’t confuse it with a lump. It runs along the back, while cancerous lumps are typically found on the front or side of the testicle itself.
Repeat the entire process on your other testicle.
What Normal Feels Like
Both testicles should feel relatively smooth with a consistent firmness throughout. Minor differences in size between the left and right are common. The surface shouldn’t have any hard, pea-sized bumps or areas that feel noticeably different from the surrounding tissue. Getting to know your own baseline is the whole point. A change from your normal is what matters most.
What Should Get Your Attention
Not every lump is cancer. In fact, several benign conditions can cause lumps or swelling in the scrotum. A varicocele (enlarged veins) can make part of the scrotum feel like a bag of worms. A spermatocele is a fluid-filled cyst near the epididymis. A hydrocele is fluid buildup around the testicle that causes painless swelling. These are all non-cancerous, but they still warrant a doctor’s evaluation because you can’t tell the difference by touch alone.
Signs that should prompt a visit to your doctor include:
- A hard lump on or within the testicle
- A feeling of heaviness in the scrotum
- A dull ache in your lower abdomen or groin
- Sudden swelling in the scrotum
- Pain or discomfort in a testicle
- Enlargement or tenderness in breast tissue
- Unexplained back pain
Testicular cancer lumps are often painless, which is why waiting for pain is not a reliable strategy. A lump that doesn’t hurt still needs medical attention.
What Happens if You Find Something
If you notice a lump or any of the symptoms above, a doctor will typically start with a scrotal ultrasound. This painless imaging scan can distinguish between a solid mass inside the testicle and a fluid-filled cyst or other benign condition. Blood tests measuring specific protein markers also help clarify the picture.
If the ultrasound and blood work raise suspicion for cancer, the next step is surgical removal of the affected testicle. Unlike most cancers, a needle biopsy is not used here because puncturing the testicle can risk spreading cancer cells. The surgery itself serves as both diagnosis and treatment. Additional imaging of the chest, abdomen, and pelvis may be done to check whether anything has spread.
The outlook for testicular cancer is one of the best in oncology. About 0.4 percent of men will be diagnosed at some point in their lifetime, and the vast majority are cured, especially when it’s caught before it spreads beyond the testicle. That’s what makes a simple monthly check worthwhile: it costs you 60 seconds and catches something that’s highly treatable when found early.