Testicular self-examination: information for people affected by acute lymphoblastic leukaemia

This is a step-by-step guide on how to examine your testicles. It explains what you need to do and why it’s important. If you have any questions about the self-exam or information on this page, speak to your nurse or doctor. 

Why is self-examination important?

Leukaemia cells can sometimes hide in the testicles either during or after chemotherapy treatment. This is because there is a barrier between the blood and the testicles (known 
as the blood–testes barrier) which limits how much chemotherapy reaches the testicles. 

A testicular self-exam (TSE) is an easy way for boys and men to check their own testicles 
to make sure there aren’t any unusual lumps or bumps. We ask all our male patients to check their testicles regularly during and after treatment and report any lumps to us as soon as possible, regardless of size.

Self-examination: five steps

Step 1

Try to do a TSE every week so you become familiar with the size and shape of your testicles. This makes it easier to spot if something feels different or abnormal down there.

Step 2

The best time to do a TSE is during or after a warm shower or bath. This is because the skin that covers the testicles (the scrotum) is most relaxed and it will be easier to feel for lumps. Examine one testicle at a time.

Step 3

Start by holding the top of the scrotum gently. Place your index and middle fingers under 
the testicle and your thumb on top. Pinch gently so that the testicle stays put and doesn’t move during the exam. Between your fingers, you should feel the spermatic cord. This connects the testicle to the rest of your body.

Step 4

With your free hand, gently roll your thumb and fingers along both sides of the testicle, 
from top to bottom. Feel for any lumps or bumps. Then, glide your fingers over the front and back of the testicle. On the back of your testicle, near the top, you should feel the epididymis, a tube that carries sperm. This is a normal lump and may feel tender to the touch.

Step 5

Please tell us if you notice any:

• swelling    
• painless or painful lumps of any size (lumps may be as small as a grain of rice or a pea)    
• changes in the size or color of a testicle  
• pain or achy areas in your groin. 

The images on this page were produced by Nemours Kids Health and are used with permission.