Download the Self Exam Poster

How is testicular cancer diagnosed?
Most testicular cancers are found by men themselves. Also, doctors should examine the testicles during routine physical exams. Between regular checkups, if a man notices anything unusual about his testicles, he should talk with his doctor.

Symptoms
The earliest symptom of testicular cancer is, most often, pain, swelling, or hardness in the testis, or some combination of these symptoms. Less often, the first symptom a patient will notice is a small, painless lump on the testicle. A man with testicular cancer might also feel heaviness in the scrotum, an ache in the lower abdomen or groin area, an accumulation of blood or fluid in the scrotum, or a change in the way a testicle feels. More rarely, there is tenderness in the man's breast area usually caused by high levels of a hormone called human chronic gonadotropin (HCG). If the cancer has spread, symptoms may include severe, unrelenting back pain, shortness of breath, or hemoptysis (coughing up blood).

Often, a person with testicular cancer will not feel sick. In fact, there may not be any warning signs present. But remember, only a doctor can make a positive diagnosis of cancer.

Most testicular cancers are found by men themselves. Also, doctors should examine the testicles during routine physical exams. Between regular checkups, if a man notices anything unusual about his testicles, he should talk with his doctor.

The Importance of Self-Examination
The vast majority of testicular tumors are discovered by men themselves, either by accident or by performing the self-examination procedure. In fact, one research report found that only 4% of all testicular tumors are discovered by physicians, usually when they are performing an exam for other reasons. As a result, regular self-examination is essential.

The Exam
The testicular self-examination, or TSE, is a quick, simple, painless, exam that men can perform on themselves in the privacy of their own home. All men should perform the exam once a month. The exam takes only about three minutes to properly perform. By performing it regularly, you will become familiar with your anatomy and better able to recognize changes.

The best time to perform the TSE is during or immediately after a warm shower or bath. The warm water relaxes the skin on the scrotum, making it easier to perform the TSE. Also, your fingers will more easily glide over soapy skin, making it easier to concentrate on the texture underneath and increasing the likelihood that you will feel any lumps or nodules on your testicles.

Performing the Exam

• Gently examine each testicle one at a time with both hands.
• Place your index and middle fingers under the testicle and your thumbs on top.
• Gently roll the testicle between your thumbs and fingers.
• Feel for any small, hard lumps on the testicle.
• Repeat the process with the other testicle.

Look and feel for any hard lumps or nodules (smooth rounded masses) or any change in the size, shape, or consistency of the testes. You should not feel any pain when performing the TSE. It is normal for one testicle to be a little larger than the other, and for one testicle to hang down a little lower. The testicles should be smooth and firm to the touch. You should be aware that each normal testis has an epididymis, which appears as a small "bump" on the upper or middle outer side of the testis. Normal testicles also contain blood vessels, supporting tissues, and tubes that conduct sperm. Some men may confuse these with cancer. If you have any doubts, ask your doctor. Sometimes, the testicle can be enlarged because fluid has collected around it. This is called a hydrocele. Other times, the veins in the testicle can dilate and cause enlargement and lumpiness around the testicle. This is called a varicocele. To be sure you have one of these conditions and not a tumor, you need to have a doctor examine you.

What if I find a lump?
If you find a lump on your testicle, see a doctor immediately. The lump may not be cancer, but if it is, the chances are very good that it can be treated. Testicular cancer has a 95% survival rate, but it is extremely important to catch the cancer early. If you have any concerns about what you find during self-examination, see your doctor. Do not dismiss your concern or hope it will go away. Many men let fear or embarrassment keep them from seeking medical help. Concerns about masculinity or sexuality often present significant barriers for men faced with the need for medical attention. But testicular tumors are some of the fastest growing of all human cancers. The longer you wait to seek help, the worse your situation may be when you finally see a doctor. There is nothing to be embarrassed about when it comes to cancer. See your doctor as soon as possible.