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Barbara Zoltick, RN

Barbara Zoltick, RN, is an onocolgy nurse practitioner at the Abramson Cancer Center. Barbara has more than 30 years experience caring for patients with urologic cancers including testicular cancer. She has authored peer-reviewed journal articles, book chapter and educational webinars. In this article, she discusses testicular cancer and self-exams for testicular cancer. 



Testicular cancer is the most common cancer in men between 15 and 35 years of age.

Though it can occur in older men, testicular cancer generally occurs in young men, at the time of life when they are completing their education, finding new jobs, and creating families.

The American Cancer Society estimates that in 2013, 7,920 men in the United States will be diagnosed with testicular cancer, and 370 of those diagnosed will die.

Who is at Risk for Testicular Cancer?

The incidence of testicular cancer has been increasing over the past 40 years for reasons which remain unclear. Testicular cancer is more prevalent in white men than in black, Asian, or other nonwhite ethnic groups. Historically, the incidence has been found to be greater in men of any ethnicity with higher socioeconomic status and more education, though more recent studies have found this difference has diminished.

The risk factors associated with the development of testicular cancer are not well established. However, cryptorchidism, or an undescended testicle, is currently the most recognized risk factor. Cryptorchidism increases the risk of developing testicular cancer by ten-fold, though only about 5% of testicular cancers can be attributed to this condition. Additional risk factors include prenatal exposure to estrogen; other testicular abnormalities, such as underdeveloped testicles; and genetic disorders that affect sexual development, such as Kleinfelter’s Syndrome.

Fortunately, testicular cancer is one of the most curable cancers. Men diagnosed and treated when the disease is still in an early stage have a 97 to 100 percent chance of being cured. Therefore, early detection is critical.

What Testicular Cancer Looks Like

The most common sign of testicular cancer is a lump, or swelling or enlargement of a testicle. This may be accompanied by tenderness, pain or a feeling of heaviness. Unfortunately, after noticing a change in a testicle, men may wait several months before seeking a medical evaluation. The disease is then more advanced upon diagnosis, possibly requiring more intensive treatment and potentially decreasing the chance of a cure. Monthly testicular self-examinations can help a man become familiar with how his testicles normally feel. He can then recognize any changes and seek medical attention at an early, more curable stage.

It is also important to note that not every change or discomfort indicates cancer; seeking medical evaluation can provide reassurance that cancer is not the cause.

How to Perform a Testicular Self-Exam

• Check for any swelling on the scrotum. You may need to do this in front of a mirror.
• Examine one testicle at a time using both hands. Put your index and middle fingers under the testicle with thumbs on top. Roll the testicle gently between your fingers. It can be normal for one testicle to be slightly larger than the other.
• You will notice a soft, tube-like area behind the testicles. This is the epididymis where sperm is stored.
• Any testicular changes, pain, swelling, lump or tender area should be evaluated by a health care professional, preferably a urologist as soon as possible. It may not be cancer, but needs to be evaluated to be sure.