Testicular Self-Exam: What Every Young Man Should Know

Testicular cancer is the most common cancer in young men aged 15–40. The good news is that it is one of the most curable cancers when caught early — with a survival rate of over 95%. A simple monthly self-exam takes two minutes and could save your life.

Why do a testicular self-exam? Testicular cancer often has no symptoms other than a lump or change in the testicle. By examining yourself monthly, you learn what is normal for you. If something changes, you notice it early — when the cancer is easiest to cure.

When to do it?

• Once a month
• Best done during or after a warm shower, when the scrotal skin is relaxed
• Start at age 15 and continue through your 40s

Step-by-step guide:

1. Stand in front of a mirror. Look for any swelling or changes in the size or shape of your scrotum.

2. Examine each testicle with both hands. Place your index and middle fingers under the testicle and your thumbs on top. Gently roll the testicle between your thumbs and fingers.

3. Find the epididymis. This is a soft, tube-like structure at the back of each testicle. It collects and carries sperm. It is normal and should not be confused with a lump.

4. Feel for lumps. A healthy testicle is smooth, firm, and oval. Feel for any hard lumps, smooth or rounded bumps, or changes in size, shape, or consistency. One testicle is usually slightly larger or hangs lower than the other — this is normal.

What to look for:

• A hard lump (pea-sized or larger) on or inside the testicle
• A change in the size or shape of a testicle
• A feeling of heaviness in the scrotum
• A dull ache in the lower abdomen or groin
• A sudden collection of fluid in the scrotum
• Pain or discomfort in a testicle or the scrotum
• Enlargement or tenderness of the breasts (rarely, a sign of testicular cancer)

What is NOT concerning:

• The epididymis (soft tube at the back) — this is normal anatomy
• One testicle being slightly larger than the other
• One testicle hanging lower than the other
• Small, soft bumps on the scrotal skin (often sebaceous cysts)
• A varicocele (a collection of enlarged veins that feels like a "bag of worms" — common and usually harmless)

When to see a doctor:

• You find a hard lump on or inside a testicle
• A testicle has changed in size or shape
• You feel heaviness in the scrotum
• You have persistent pain in a testicle

Don't be embarrassed: In Pakistan, many young men are too embarrassed to discuss testicular problems or to see a doctor. This delay can be dangerous. Testicular cancer grows quickly — a lump you can barely feel today may be much larger in a few weeks. Don't let embarrassment put your life at risk. Doctors see these issues every day — it's routine for them.

What happens at the doctor?

• Physical examination of the testicles
• An ultrasound of the scrotum (quick, painless, and very accurate)
• Blood tests for tumour markers

If testicular cancer is found and treated early, the cure rate is over 95%. Even advanced cases have high survival rates with modern treatment.

Risk factors:

• Undescended testicle (a testicle that didn't move into the scrotum before birth)
• Family history of testicular cancer
• Previous testicular cancer
• Age 15–40

Key message: Testicular cancer is the most common cancer in young men, but it is one of the most curable — if caught early. Do a monthly self-exam. If you find a lump or notice any change, don't let embarrassment stop you — see a doctor immediately. Two minutes a month could save your life.