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Testicular Self-Examination: Steps & When To See A Doctor

Dr. Sreelekha Daruvuri

2 Min Read

Cancer starts when cells grow out of control. Testicular cancer is the uncontrolled growth of cells in male reproductive organs- testes that are located inside the scrotum, a loose bag of skin underneath the penis. Considered as the second most common malignancy in young men, next to acute leukaemias, it has an incidence of 0.4-1.7% in the Asian population. Testicular tumours are rare, yet curable and can be easily treated in early stages and even if cancer spreads beyond the organ. Regular testicular self-examination can be helpful in detecting any early changes.

To understand cancer, it helps to know the normal structure and function of testicles.

Understanding the male reproductive system

Testicles or testes: Oval-shaped organs, smaller than the size of a golf ball
Scrotal sacs: Skin sac which holds the testes
Epididymis: Tube-like structure behind the testicles connecting to a cord-like structure called vas deferens

What is the function of testes?

To produce sperms
To produce testosterone, primary male sex hormones

Who is at risk of testicular cancer?

Positive family history
Undescended testes
Abnormal testicular development
HIV infection

How to perform testicular self-examination?

It is advised to start self-examination of testes during the teen years, once every month. The best time to do a testicular self-examination is after a warm bath or shower while standing in front of the mirror to see and feel at the same time when the scrotum is warm & relaxed and this takes less than a minute. Follow these steps:

Check each testicle: Gently but firmly roll each testicle between the thumb and forefingers and feel the whole surface. The firmness should be uniform all around.
Epididymis and vas deferens: These feel like soft tubes like structure above and behind the testicles. Just become familiar with how these structures feel like.
Check for lumps or swellings: Look for any lumps or swellings whether they are painful or not. Also observe the size, shape and texture.

How does a normal male reproductive system look?

Normal testicles have a firm and slightly spongy feel with the same firmness throughout.
Size of the testicles should also be about the same, though one may appear larger than the other.
It’s a common finding to have one testis hanging lower than the opposite
Epididymis should feel like a rubbery tube-like structure at the top of the testes and there should be no pain or discomfort while handling the testes gently.

Keep a check on these abnormal findings in testicular self-examination

Painless lump in the testis
Swelling of the testicle with/without pain or heaviness in the testicles
Change in shape or consistency of the testicles
Changes in the male breasts like enlargement or tenderness

Symptoms of testicular cancer

Painless swelling in the testicle is the most common symptom. Other symptoms include persistent ache in the testicle, lower abdominal pain or back pain. A few conditions which may mimic cancer symptoms:

Varicocele: Fluid accumulation in the scrotal sac
Hematocele- Painful enlargement of testicles that can be seen due to injury to the testes or scrotum
Cysts- Painless accumulation of fluid in the area
Torsion- Painful condition which is caused by twisting of the cord that attaches testis to the body and affecting the blood supply

If there are any of the above findings it’s important that you see a doctor immediately.

A lot of men do not reach out to doctors and delay for months which might lead to the spread of cancer. This is especially important if the symptom or sign is for more than two weeks.

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