Knowing how to self-examine for testicular cancer only takes around two minutes, and no equipment is necessary. Most people who check find nothing. Some find a harmless lump. A few find a change that needs a doctor, and noticing it early means it gets looked at sooner.
Dr Carla Perna is a consultant clinical oncologist and treats patients with testicular cancer. This guide shows you how to check your own testicles for cancer, what you are feeling for, and when to see a doctor. It is for anyone with testicles, including trans women, non-binary people, and teenagers. For prostate symptoms, start with my prostate cancer page or read about the urological cancers men should pay attention to.
How to examine yourself for testicular cancer in six steps
Learning how to check for testicular cancer is simple. Heat relaxes the scrotum (the skin bag that holds your testicles), so checking during a warm shower is ideal. This is how to do the check at home.
Follow these steps in order:
- Pick your moment. Check during or just after a warm shower or bath. Cold skin tightens and feels firmer than it is.
- Look first. Stand in front of a mirror. Look for swelling, a change in skin colour, or a testicle that looks bigger or differently shaped than before.
- Cup both testicles. Hold your scrotum in one palm and notice the weight of each testicle. A slight difference is normal.
- Roll one at a time. Using your thumb and fingers with gentle pressure, feel the front, sides, and top of each one. A testicle should feel smooth and firm, but not hard.
- Find the epididymis. This soft, coiled tube at the back of each testicle can feel slightly lumpy or tender. Learn where it sits so you do not mistake it for a lump.
- Repeat on the other side and compare. You are comparing with your own normal, not a textbook.
A light touch is the main skill necessary to check your testicles. A check should not hurt, and pressing hard can make normal structures feel suspicious.
Testicles are not identical, and one, usually the left, often hangs lower. Only a change from your own normal is a worry.
What a cancerous lump feels like, and other signs
A lump is the most common sign, but it’s not the only one.
A lump, swelling or heaviness
A cancerous lump usually feels firm or hard and can be as small as a pea. It tends to sit on the testicle itself rather than behind it, and it is often painless. Other changes to watch for include:
- a testicle that becomes larger or swollen
- a scrotum that feels heavy, firm or hard
- a dull ache in the testicle, groin or lower tummy
- tender or swollen breasts.
Pain and testicular cancer
Testicular cancer does not always hurt, so a painless lump still needs checking. Infection, injury and cysts are more likely to cause pain. Never use a lack of pain to decide not to get checked.
The first signs can occasionally appear elsewhere, such as backache, a cough or breathlessness. Alongside a testicular change, these need prompt assessment.
Testicular torsion: sudden pain is an emergency
Torsion is not cancer, but waiting a few hours to get help could cost you the testicle. It happens when the cord that supports a testicle twists and cuts off its blood supply. It is most common in teenagers and young men, but it can happen at any age, even in your sleep.
Look out for sudden, severe pain, a swollen red scrotum, a testicle that sits higher than normal, and nausea or tummy pain.
Timing decides the outcome. Treated within 4 to 6 hours of the start of pain, 90% of people keep the testicle. After 12 hours, the chance falls to 50%, and after 24 hours to 10%. Go to A&E or call 999 straight away.
Other causes of a testicular lump
Most scrotal lumps are not cancer, but you can’t tell by touch alone. Some need treatment. These are the common causes:
- Epididymal cyst. A fluid-filled sac that is common and usually harmless.
- Hydrocele. Fluid around a testicle. It can cause painless swelling.
- Varicocele. Swollen veins above the testicle. Most are harmless.
- Epididymitis or orchitis. Inflammation. Often from an infection and may cause pain and tenderness.
- Inguinal hernia. A groin or scrotal lump that appears when you strain.
A doctor can tell these apart with an examination and usually a scrotal ultrasound. This painless scan shows whether a lump is solid or filled with fluid.
How often to check, and what the evidence says
There is no clear agreement on how often you should self-examine for testicular cancer. The NHS suggests checking about once a month from around the age of 12.
Cancer Research UK is more cautious. It says there is no UK screening programme for testicular cancer, and not enough evidence for checking at set times. The US Preventive Services Task Force recommends against screening in adolescent and adult men. Mayo Clinic says there is no research showing that self-examination reduces the risk of dying from testicular cancer.
Testicular cancer is uncommon and often treatable, even when found late. Regular self-examination has not been shown to save lives, and false alarms can lead to worry and unnecessary tests.
My advice is to make it a habit, not a rule. If you miss a month, you’ve lost nothing. What counts is acting on a change instead of waiting to see whether it goes away.
How to self-examine for testicular cancer at every age
The method for how to check for testicular cancer is the same at 14 as it is at 44.
Checking for testicular cancer as a teenager
Puberty is when checking can begin. It’s when torsion is most common. If you are a teenager, self-examining for testicular cancer is no different from the steps above. If you find a lump or have any lasting pain, tell an adult you trust and ask to see a GP. Sudden, severe pain means going to A&E.
Parents, a calm chat usually works better than a lecture. Reassure your child that most findings are harmless, and that they should never hide sudden pain out of embarrassment.
How about if you are trans or non-binary?
Testicular cancer can affect anyone with testicles, including transgender women and non-binary people. The advice on how to self-examine for testicular cancer is the same. Learn what is normal for you and have any change checked. If you can’t face your own GP, a sexual health clinic is another route. If you attend a gender identity clinic, they can also help.
If you are at higher risk
An undescended testicle, a brother or father with testicular cancer, a previous testicular cancer, hypospadias, HIV and a white British background can all make your risk higher. Most people with these risk factors never develop it. If you’re in a higher-risk group, it’s worth asking your GP how to spot a problem early, how to self-examine for testicular cancer, and how often to do it.
What to do if you find a change
If your testicular self-exam finds something new, that is a reason to get checked. It is not a diagnosis. I recommend:
- Stay calm. Most lumps are not cancer.
- Leave it alone. Repeated poking cannot tell you what it is.
- Book a GP appointment soon. Say clearly that you have found a lump or change in your testicle.
- Use the easiest route. A sexual health clinic can assess you too, and you can ask for a male clinician.
GPs follow NICE guidance. This covers a suspected cancer pathway referral for a painless change in the size, shape or texture of a testicle, and a direct-access ultrasound for unexplained or persistent symptoms.
Your doctor will examine each testicle and arrange a scrotal ultrasound. They may take blood to measure tumour markers called AFP, hCG and LDH. If the results suggest cancer, surgery to remove the testicle is the usual next step. A CT scan can then check whether it has spread.
Specialist advice after finding a change
If you have found a lump, see your GP or a urologist first, even if you have only just learned how to self-examine for testicular cancer. If you have been diagnosed or are under investigation, you can request a consultation with Dr Carla Perna, including for a second opinion on treatment.
If it is testicular cancer: treatment and outlook
Testicular cancer is the most common cancer in men aged 15 to 44, and the five-year survival rate is 95%. That figure is an average, so it cannot predict one person’s outcome.
Treatment depends on the type and stage. Many people have surgery to remove the testicle (an orchidectomy) followed by monitoring. Others need chemotherapy or, for some seminomas, external beam radiotherapy. I use both when they are appropriate. You can ask about a silicone prosthesis, and about storing sperm before chemotherapy because it can affect fertility.
Seeing a specialist privately
NHS urgent pathways are built to see people with suspected testicular cancer quickly, so do not delay your GP visit. Some people prefer private care for speed, choice of consultant or continuity, and some insurers need a referral first.
Frequently asked questions
How do you check your testicles for cancer?
Checking your testicles for cancer is best done during, or just after, a warm shower. A testicular self-exam usually takes about 2 minutes. Look for swelling, then roll each testicle gently between your thumb and fingers. Find the soft tube behind each testicle and note any lump or change in size or firmness.
How often should I check my testicles?
The NHS suggests about once a month from puberty. Other trusted bodies say evidence for a fixed routine is lacking. Any change needs checking whenever you find it.
What does a testicular cancer lump feel like?
It is usually firm or hard, pea-sized or bigger, on the testicle itself and often painless. Cysts can feel similar, so every new lump needs a doctor.
Does testicular cancer hurt?
Often not, but a painless lump still needs checking. Pain is more common with infection, injury, or a cyst. If you notice a change, get it checked, pain or no pain.
Is there NHS screening for testicular cancer?
No. The UK has no screening programme because there’s no reliable test to find it early in people without symptoms. Checking for changes is different from screening.
When is testicular pain an emergency?
Sudden, severe pain in one testicle, especially with swelling, nausea or tummy pain, may be torsion. Go to A&E or call 999 straight away.
