Most of the time a lump on the testicle is the first symptom, or the testicle might be swollen or larger than normal. But some testicular cancers might not cause symptoms until they’ve reached an advanced stage. Many times cancers can be found at an early stage, when they’re small and haven’t spread. In some men, early testicular cancers cause symptoms that lead them to seek medical attention.
Some doctors agree that examining a man’s testicles should be part of a general physical exam during a routine check-up and most doctors recommend that all men examine their testicles monthly after puberty. Each man has to decide for himself whether or not to do this, so instructions for testicular exams are included in this section. If you have certain risk factors that increase your chance of developing testicular cancer (such as an undescended testicle, previous germ cell tumor in one testicle, or a family history), you should seriously consider monthly self-exams and talk about it with your doctor.
The American Cancer Society advises men to be aware of testicular cancer and to see a doctor right away if they find a lump in a testicle. Because regular testicular self-exams have not been studied enough to know if they reduce the death rate from this cancer, the ACS does not have a recommendation on regular testicular self-exams for all men.
The best time for you to examine your testicles is during or after a bath or shower, when the skin of the scrotum is relaxed.
Hold your penis out of the way and examine each testicle separately. Hold your testicle between your thumbs and fingers with both hands and roll it gently between your fingers. Look and feel for any hard lumps or nodules (smooth rounded masses) or any change in the size, shape, or consistency of your testicles.
It’s normal for one testicle to be slightly larger than the other, and for one to hang lower than the other. You should also be aware that each normal testicle has a small, coiled tube called the epididymis that can feel like a small bump on the upper or middle outer side of the testis. Normal testicles also contain blood vessels, supporting tissues, and tubes that carry sperm. Some men may confuse these with abnormal lumps at first. If you have any concerns, ask your doctor.
A testicle can get larger for many reasons other than cancer. For example, fluid can collect around the testicle to form a hydrocele. Or the veins in the testicle can dilate and cause enlargement and lumpiness around the testicle. This is called a varicocele. If your testicle seems larger, have a doctor examine you to be sure you have one of these conditions and not a tumor. The doctor may order an ultrasound exam (see Tests for Testicular Cancer). This is an easy and painless way of finding a tumor.
If you choose to examine your testicles regularly, you will get to know what’s normal and what’s different. Always report any changes to your doctor without delay.