Testicular self-exam: How and why to do it

(MayoClinic.com) Testicular cancer is most common in men ages 20 to 35 — but it can occur at any age. A simple testicular self-examination can improve your chances of finding a tumor early. Beginning at age 15, it's a good idea to do a monthly testicular self-exam. Regular testicular self-exams are an important way to identify changes that can be a sign of cancer. Early diagnosis is important because testicular cancer is highly treatable when found early. Lumps or other changes found during a testicular self-exam aren't always a sign of cancer, but still need to be checked by a doctor.

It's a good idea to examine your testicles once a month, after a warm bath or shower. The heat from the water relaxes your scrotum, making it easier for you to check for anything unusual. To do a testicular self-exam, follow these steps:

• Stand in front of a mirror. Look for any swelling on the skin of the scrotum.
• Examine each testicle with both hands. Place the index and middle fingers under the testicle while placing your thumbs on the top.
• Gently roll the testicle between the thumbs and fingers. Feel for lumps and bumps. Remember that the testicles are usually smooth, oval shaped and somewhat firm.
• If you find a lump, call your doctor as soon as possible. Signs and symptoms of cancer include lumps, swelling, a heavy-feeling testicle and pain. Don't be embarrassed about calling your doctor if you find a lump or other problem. Early diagnosis is important — over time, testicular cancer can spread and it becomes more dangerous and difficult to treat.

You may notice a few things about your testicles that seem unusual — but aren't signs of cancer:

• One of your testicles is larger than the other. It's normal for one testicle to be slightly larger — it's only a cause for concern if there's a change in the size of one of your testicles.
• You have bumps on the skin of your scrotum. This can be caused by ingrown hairs, a rash or other skin problems.
• You feel a soft, ropy cord leading upward from the top of the back part of each testicle. This is a normal part of the scrotum called the epididymis. It may be tender when you press on it.

Lumps, swelling, testicular pain or other changes can be caused by something other than cancer — such as inflammation, enlargement of scrotal veins (varicocele), fluid around the testicle (hydrocele), or a hernia. But unusual signs or symptoms still need to be checked out by a doctor to be sure they aren't caused by cancer. Even if symptoms are caused by something other than testicular cancer, you may still need treatment.

If you have a retractile testicle, a condition in which your testicle doesn't descend from the groin into the scrotum, tell your doctor. You may need to see a urologist for treatment or a more specialized exam. Having a retractile testicle (also called an undescended testicle) increases your risk of testicular cancer. Surgical correction of an undescended testicle can reduce your risk.

By regularly doing a testicular self-exam, you'll recognize what's normal — and what's not — with your testicles and will be aware of any changes that might be of concern. This increases your chance of identifying testicular cancer early, while it's relatively easy to treat. A regular testicular self-exam is an important health habit. But it can't substitute for a doctor's examination. Many doctors do this as a normal part of a physical exam. If you aren't sure whether something is normal or not, don't hesitate to ask your doctor. It may be uncomfortable to ask your doctor to check your testicles — but it's a good idea to have this done whenever you have a physical exam or if you notice something unusual.

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