When, how, and how often you should perform a testicular self-examination

Posted on 5 July 2018

With regular self-examinations, testicular cancer can be caught early and effective treatment is possible.

Testicular cancer is most prevalent in young males between the ages of 15 and 35 years. It’s also very rare, accounting for approximately 1% of cancers in males, says the Cancer Association of South Africa (CANSA).

The good news is this disease responds well to treatment, with a 99% five-year survival rate of patients diagnosed with localised testicular cancer. Even if the cancer has spread to other parts of the body, what’s known as a distant spread, the five-year rate is 77%.

‘Testicular cancer is highly chemo-sensitive,’ says urologist Dr Kgomotso Mathabe. ‘This is one of the cancers for which the outcomes [of treatment] are very good with high response rates.’ However, catching the disease early is critical to successful treatment, which is why doctors recommend monthly testicular self-examinations (TSE). ‘The idea is to catch it while it’s still localised in the testis, which makes treatment that much easier,’ Dr Mathabe adds.


  • Examine your testes straight after a hot shower when the skin around the scrotum is relaxed and abnormalities will be easier to feel.
  • Feel one testicle at a time by gently rolling the testicle between the fingers of both hands.
  • Place your thumbs over the top of the testicle, with the index and middle fingers of each hand behind the testis.

Dr Mathabe says it’s not so much about a specific method of examining the testes as it is about knowing what is normal for your body. This becomes apparent with continuous monthly self-examinations. ‘Any lump, whatever consistency, whether it’s hard or soft, should be checked out’ she says. If you feel anything untoward, consult your doctor who may schedule an ultrasound.

Don’t worry!

A lump in the testes is not a sure sign of cancer. In South Africa, we have a high exposure to tuberculosis (TB), and although we may not show symptoms of TB, it can be present in the testes, says Dr Mathabe. Furthermore, patients who have weakened immune systems, such as diabetics, may present with lumps in their testes due to infections. Remember that one testicle, usually on the right, is naturally larger than the other. Also, the lump-like epididymis is a sperm-carrying tube at the top of each testicle and is entirely normal


Following an examination by your GP, an ultrasound is usually the next step to define the lump. If necessary, blood tests will reveal which type of cancer it is. If cancer is diagnosed, the affected testicle will be surgically removed. Dr Mathabe stresses that males can live a healthy life regarding fertility and sexual function with one testicle. Follow-up appointments are very important, Dr Mathabe adds. This is when the healthy testicle will be screened for any signs of cancer.


Published in Cancer

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