Testicular cancer is a malignancy that develops in the testicles, the organs in the scrotum that produce sperm and testosterone. It is one of the most common cancers in young men, especially those between ages 15 and 44, with the highest rates in the 20s and 30s, according to the Urology Care Foundation. While it can occur at any age, including in teenagers and older adults, the good news is that testicular cancer is highly curable—especially when it is found early. Regular self-exams help men recognize changes sooner and get prompt medical attention when needed.
Common symptoms include a painless lump or swelling in one testicle, a feeling of heaviness in the scrotum, or a dull ache in the groin or lower abdomen. Some men notice a change in how a testicle feels—becoming harder or irregular—or sudden fluid accumulation in the scrotum. Less common symptoms can include breast tenderness or enlargement (gynecomastia), back pain or shortness of breath from advanced disease, or a feeling of fullness in the lower belly if lymph nodes become involved. Any new, persistent change should be evaluated by a clinician.
How to perform a testicular self-exam
A testicular self-exam (TSE) is a simple, quick check you can do once a month to become familiar with what is normal for you and to notice any new lumps or changes early.
When to do it:
Perform the exam during or right after a warm bath or shower. Warmth relaxes the scrotal skin, making it easier to feel the testicles and surrounding structures.
Step 1: Get into position
Stand in front of a mirror and look at your scrotum. Check for any visible swelling, changes in size, or differences between the two sides that are new for you. It is normal for one testicle to hang slightly lower or be slightly larger than the other; what matters is noticing new changes over time.
Step 2: Examine one testicle at a time
Use both hands. Place your index and middle fingers underneath the testicle and your thumb on top. Gently roll the testicle between your fingers and thumb, feeling the entire surface. You want to note the size, shape, and consistency. A normal testicle feels smooth and firm but not rock-hard, without any distinct lumps.
Step 3: Identify the epididymis
At the back and top of each testicle, you will feel a soft, tube-like structure—this is the epididymis, where sperm matures and is stored. It may feel a bit tender and can be mistaken for an abnormal lump the first time you examine yourself. Take time to recognize it so you can distinguish normal anatomy from something new.
Step 4: Feel for any changes
You are specifically checking for:
- A hard, pea-sized lump or nodule on the testicle itself
- A change in size (larger or smaller) or firmness of one testicle
- Areas that feel unusually heavy, swollen, or irregular
If you notice a lump that is attached to the testicle, persistent swelling, or a consistent change that does not go away after a few days, contact a healthcare professional. Mild discomfort or brief changes can occur for many reasons, but a true lump on the testicle should always be evaluated.
Step 5: Repeat on the other side
Perform the same steps on the other testicle. Over time, these monthly exams will help you understand what is normal for you, making it easier to recognize a problem early.
Regular self-exams take only a few minutes each month and can play a key role in early detection, according to the . If you notice any changes, contact urologic specialists at WashU Medicine to get answers and care as soon as possible. Early detection saves lives.
When to seek medical care urgently
While most testicular lumps are not cancer, some require immediate attention. Sudden, severe testicular pain, a testicle that becomes very tender or rides high, or rapid swelling may indicate testicular torsion (a twisted testicle), which is a surgical emergency. Any of these symptoms should prompt immediate evaluation in an emergency department.
WashU Medicine provide expert testicular cancer care.
If you feel a lump or notice a change during a self-exam, or if you are unsure about what you are feeling, it is important to seek professional evaluation promptly. Urologists at WashU Medicine offer comprehensive care for testicular conditions.
Our collaborative team includes fellowship-trained urologic oncologists, radiologists, pathologists, medical and radiation oncologists, fertility specialists, and supportive care providers who work together to deliver personalized, evidence-based care. We offer state-of-the-art diagnostic imaging, testicular-sparing and cancer surgeries, access to clinical trials through Siteman Cancer Center, and guidance on fertility preservation and survivorship.
To schedule an appointment or learn more: 314-362-8200.
Our specialists can help you understand your risk, interpret concerning findings, and design a treatment or surveillance plan tailored to your needs.