How to Do a Testicular Self-Exam

Testicular cancer is relatively rare compared to breast cancer, but according to the Mayo Clinic, it is "the most common cancer in American males between the ages of 15 and 34." ^[1] As noted by CNN.com, testicular cancer is highly treatable if caught early ^[2] and regular, self-administered examinations can be the key to an early diagnosis. ^[3]

Step 1: Consider Subtle Symptoms

Comedian Tom Green (of MTV fame) was diagnosed with testicular cancer in March, 2000, and subsequently had his right testicle removed. (Creative Commons photo by Randi Hogsden)
An abnormal lump can be the only indication of testicular cancer, but according to the Testicular Cancer Resource Center, there can be subtler symptoms. Before your physical examination, consider the following. If you have any of these symptoms, a trip to the doctor is warranted.

Pain
- According to the American Cancer Society, if you feel an ache in either testicle, the scrotum, the groin area or lower abdomen, see a doctor [1] immediately.
Heaviness in scrotum
- According to WebMD, "a sensation of heaviness in the scrotum" can indicate testicular cancer [2].
Breast tissue
- According to a study funded by the National Cancer Institute, swelling, tenderness or enlargement on either side of the chest could result from testicular cancer. [3]
Size and consistency.
- As noted in the Medline Plus Medical Encyclopedia, it is normal for one to be a little larger than the other [4]—and in terms of consistency, testicles should be firm, but not "rock hard" [5]. However, according to the American Cancer Society if either has changed in size or consistency [6], you should see a doctor.
Fluid
- According to the Testicular Cancer Resource Center, if your scrotum has suddenly filled with fluid, it may be a symptom of a tumor [7].
Swelling
- If there is swelling on the scrotal skin, it may something as simple as heat rash, but the American Academy of Family Physicians notes that it could be a symptom of Testicular cancer [8].
- In either case, you'll want to see a doctor.

Step 2: Take Exam

A hot shower can make the self-exam easier to perform. (Creative Commons photo by Jun Acullador)

Start with a warm bath or shower.
- American Cancer Society offers this tip to loosen the scrotum [1] and make the testicles easier to palpitate. When the scrotum is cold, it contracts and thickens.
After drying off, according to the Mayo Clinic, you should check in the mirror for swelling on the skin of the scrotum [2].
Now, lift one knee and place your foot on the edge of the bathtub or toilet.
- This way, you'll have a better angle to feel around down there.
The Mayo Clinic recommends that you gently roll one of your testicles between your fingers, with index and middle fingers beneath, thumbs on the top [3].
Locate the epididymis, the tube that transports sperm from the testicle.
- Where the epididymis and testicle are connected, you may notice some soft lumpy tissue: this is normal [4], according to the the Testicular Cancer Resource Center.
Now, run your fingers thoroughly over the entire surface of the testicle, gently rolling the testicle between your fingers.
According to WebMD, if a "small, hard lump (often about the size of a pea) is felt on the surface of the testicle, or the testicle is swollen or enlarged," you should see a doctor immediately [5].
- WebMD additionally recommends that the following symptoms may indicate harmful conditions beside testicular cancer and are cause for immediate medical attention [6]:
  1. a "soft collection of thin tubes... above or behind the testicle." [7]
  2. any "sudden (acute) pain" pain resulting from the exam [8].
  3. absence of a testicle in the scrotum [9].

Tom Green's musical tribute to testicular examination.

Step 3: Assess Risk Factors

Any man can be susceptible to testicular cancer at any point in his life, but if you fit any of the following profiles, you may be at higher risk.
Race: According to Memorial Sloan Kettering Cancer Center, testicular cancer is "much more common in Caucasian men than in men of other ethnic groups." ^[1]
Age: The Mayo Clinic says that this form of cancer is most common among men age 15 to 34 ^[1].
Family history: Men with relatives who've had testicular cancer are at higher risk ^[1], according to WebMD.

Prior Conditions

The following conditions are suspected to predispose men to testicular cancer. If your medical history includes any of them, be vigilant.
Previous Testicular Cancer: The National Cancer Institute notes that men who have had cancer in one testicle have a higher risk of developing it in the other ^[1].
Undescended testicle: According to WebMD, men with a personal history of an undescended testicle have an increased incidence of testicular cancer ^[1].
Congenital defect/Hernia: According to the National Cancer Institute, "Men born with abnormalities of the testicles, penis, or kidneys, as well as those with inguinal hernia (hernia in the groin area, where the thigh meets the abdomen), may also be at increased risk." ^[1]
Gynecomastia: A study punlished in the BioMed Central Cancer journal suggests that men with extra breast tissue diagnosed as gynecomastia are at increased risk for malignant tumors, including testicular cancer ^[1].
Chromosomal disorder: Men known to have the genetic anomaly of an extra X chromosome (with a corresponding genetic profile of XXY), are at higher risk ^[1], according to Yahoo! Health.

Conclusion

Testicular cancer is less common than breast cancer, but that's no excuse to become complacent. According to the Mayo Clinic it's not only common, but the most common cancer developed by men between ages 15 and 34 ^[1]. A regular self-exam, or doctor-administered exam, may save one or both of your testicles—and even your life.