The most reliable way to check for testicular cancer at home is a monthly self-exam, ideally performed during or right after a warm shower when the scrotal skin is relaxed. The entire process takes about two minutes per testicle and requires nothing but your hands. Starting around age 15, this simple habit helps you learn what’s normal for your body so you can spot changes early, when testicular cancer is most treatable.
How to Do a Testicular Self-Exam
Stand up, as it’s easier to examine yourself in this position. Lift your penis out of the way and visually inspect your scrotum first, looking for any swelling or changes in skin appearance. Then gently grip the top of your scrotum and locate one testicle.
Using both hands, gently roll the testicle between your fingers and thumb. You’re feeling for any hard lumps, smooth rounded bumps, or changes in size or shape. A healthy testicle feels smooth and firm but not hard, somewhat like a peeled hard-boiled egg. The two testicles don’t need to be exactly the same size; slight asymmetry is common and normal.
While you’re there, feel for the spermatic cord, which connects to the top of the testicle and supplies blood. It feels like a piece of rope. Then find the epididymis, a soft, comma-shaped tube that sits along the top and back of the testicle. This structure stores and transports sperm, and it often feels slightly tender or sensitive to the touch. Knowing where these normal structures are helps you avoid mistaking them for something abnormal. Repeat the entire process with your other testicle.
What You’re Looking For
The most common sign of testicular cancer is a painless lump or area of hardness on the testicle itself. Lumps found inside the testicle are more concerning than those outside it. Many people expect cancer to hurt, but testicular lumps often cause no pain at all, which is exactly why a hands-on check matters.
Beyond lumps, other symptoms to watch for include:
- A feeling of heaviness in the scrotum, even without a visible lump
- A dull ache in the lower belly or groin
- Sudden swelling in the scrotum
- Pain or discomfort in a testicle or the scrotum
- Breast tissue changes, including enlargement or tenderness
- Back pain that doesn’t have another clear explanation
Any of these can show up with or without a noticeable lump. A change in one testicle compared to the other, or compared to how it felt last month, is what you’re trying to catch.
What’s Normal vs. What’s Not
Not every lump in the scrotum is cancer. Several common, harmless conditions can cause bumps or swelling in the area. Fluid-filled cysts near the epididymis, swollen veins (which feel like a “bag of worms” above the testicle), and fluid collections around the testicle are all relatively common and benign. These tend to be soft, separate from the testicle itself, and located above or behind it rather than on its surface.
A cancerous lump, by contrast, is typically attached to or embedded within the testicle. It feels hard or firm rather than squishy. The key distinction is location: lumps inside the testicle raise more concern than those sitting outside it in the surrounding structures. You can’t diagnose the difference at home, but knowing what to describe to a doctor helps move things along faster.
What Happens at the Doctor’s Office
If you find something unusual, the first step is usually a scrotal ultrasound. This painless imaging test uses sound waves to create a picture of the inside of the scrotum, and it can show whether a lump is inside or outside the testicle. It also helps distinguish between solid masses and fluid-filled cysts.
Blood tests may be ordered alongside the ultrasound. These check for specific proteins that certain testicular cancers release into the bloodstream. Elevated levels don’t automatically mean cancer, but they give doctors another data point. If imaging and blood work suggest cancer, the standard next step is surgical removal of the affected testicle. The removed tissue is then examined under a microscope to confirm the diagnosis and determine the type of cancer. Doctors don’t typically biopsy a testicle while it’s still in the body, because of the risk of spreading cancer cells.
Who’s Most at Risk
Testicular cancer is most frequently diagnosed in men between ages 20 and 34, making it one of the most common cancers in younger men. Overall, about 0.4 percent of men will be diagnosed with it at some point in their lifetime. While that number is relatively low, the fact that it peaks during an age when many people aren’t thinking about cancer screening makes self-exams especially valuable.
Other factors that increase risk include an undescended testicle (even if it was surgically corrected), a family history of testicular cancer, and a previous diagnosis in the other testicle.
Why Early Detection Matters
Testicular cancer has one of the highest survival rates of any cancer, particularly when caught early. Based on data from 2015 to 2021, the five-year survival rate for localized testicular cancer (still confined to the testicle) is 99 percent. Even when it has spread to nearby lymph nodes, the rate is 96 percent. For cancer that has spread to distant parts of the body, survival drops to 72 percent, which is still relatively high compared to many other cancers but a meaningful difference from the near-perfect rate at earlier stages.
That gap between 99 percent and 72 percent is the entire argument for spending two minutes in the shower once a month. The earlier you notice a change, the more likely treatment will be straightforward and the outcome will be excellent.