Know your testes: testicular cancer, self-awareness and Movember
Movember is a good time to talk openly about men’s health. Testicular cancer is uncommon overall, but it matters because it often affects teenagers and younger adults, and a new lump can be easy to dismiss or feel awkward to discuss. Knowing what is usual for your body can help you notice a change and seek advice.
How common is testicular cancer in Australia?
Cancer Australia estimates that 1,040 people will be diagnosed with testicular cancer in Australia in 2025. The estimated lifetime risk for males is about 1 in 188 by age 85. The rate is highest in men aged 30–34, although it can occur at other ages. Testicular cancer is one of the more common cancers in younger men. [1,2]
The outlook is generally very good. For Australians diagnosed from 2017 to 2021, five-year relative survival was 98%. This is a population estimate: an individual’s outlook depends on the cancer type, stage, tumour markers, health and response to treatment. Many testicular cancers, including some that have spread, can be cured with modern treatment. [1,2]
What does “regular self-examination” mean?
There is no national screening program or recommended screening interval for testicular cancer. Research has not shown that scheduled self-examination of people without symptoms reduces deaths, and a Cochrane review found no randomised trials that tested whether screening by self-examination or a clinician prevents testicular-cancer deaths. Cancer Council Australia therefore does not recommend population screening. [3,4]
That is different from being familiar with your own body. Movember’s “Know Thy Nuts” campaign encourages men to learn what feels normal and to get changes checked. A practical approach is to check in with yourself from time to time, such as in the shower, without treating it as a test that can rule cancer in or out. If you have a higher-risk history, discuss an individual plan with your GP or urologist. [3,5]
A simple way to get familiar with what is normal
- Warm water can relax the scrotal skin, making it easier to feel the testicles.
- Examine one testicle at a time. Gently roll it between your thumb and fingers; do not squeeze hard.
- Notice its usual size, shape and feel. It is common for one testicle to hang lower or be slightly larger than the other.
- The epididymis, a soft, slightly ridged tube along the back of each testicle, is normal anatomy. It can be mistaken for a lump when you are not familiar with it.
- Pay attention to a new firm lump on the testicle, a change in size or shape, new swelling, a feeling of heaviness, or a persistent ache.
There is no need to follow a rigid monthly schedule. The useful point is to know what is usual for you and to arrange a medical review if something changes. Self-checking cannot diagnose cancer, and a normal-feeling testicle does not replace assessment of symptoms.
When should you see a doctor?
Arrange a prompt appointment with your GP if you find a new lump or notice persistent swelling, a change in size or shape, heaviness, or an ache in the testicle, scrotum or lower abdomen. Most scrotal changes are not cancer, but they deserve assessment rather than guesswork. A sudden, severe testicular pain needs urgent emergency assessment because conditions such as testicular torsion can threaten the testicle and require rapid treatment. [2,6]
Movember notes that a GP can ask about symptoms, examine the testicles and arrange an ultrasound or blood tests when needed. It is reasonable to ask when and how you will receive results, and to follow up if you have not heard back. [5]
What types of testicular cancer are there?
Most testicular cancers start in germ cells, the cells that develop into sperm. They are grouped into two main categories: [2,7]
- Seminoma: Often grows and spreads more slowly than non-seminoma. It is most often diagnosed in adults roughly 25–45 years old, but can occur outside this range. A rare spermatocytic type tends to occur in older men.
- Non-seminoma: More common in younger men, often from the late teens to early 30s. The main cell types are embryonal carcinoma, yolk-sac tumour, choriocarcinoma and teratoma. A tumour may contain more than one type; mixed tumours are generally managed as non-seminoma.
- Stromal tumours: These arise from hormone-producing or supporting cells, such as Leydig or Sertoli cells. Many are benign, but specialist assessment is needed to determine what a mass is.
- Germ-cell neoplasia in situ (GCNIS): Abnormal germ cells that have not invaded surrounding tissue. It is a precursor condition, rather than an invasive cancer, and is usually found on tissue examination.
The type matters because seminoma and non-seminoma can behave differently and may need different follow-up or treatment.
How is a testicular mass investigated?
A doctor will ask about the change and examine the scrotum and surrounding areas. Scrotal ultrasound is the key imaging test to distinguish a solid testicular mass from other causes of swelling. Blood tests may measure alpha-fetoprotein (AFP), beta-human chorionic gonadotrophin (β-hCG) and lactate dehydrogenase (LDH). These markers help with diagnosis, staging and monitoring, but normal results do not exclude testicular cancer. If cancer is suspected, further imaging—often CT scans—is used to assess whether it has spread. [6,8]
A needle biopsy through the scrotum is generally avoided when a germ-cell cancer is suspected. Diagnosis is usually confirmed by removing the affected testicle through an incision in the groin (radical inguinal orchidectomy) and examining it under a microscope. This operation is also the first treatment for most testicular cancers. [6]
Treatment options
Treatment depends on the tumour type, stage, blood-marker results, risk of recurrence, general health and the person’s priorities. Care is planned by a multidisciplinary team, usually including a urologist, medical oncologist, radiation oncologist and cancer-care nurses. Options can include: [6,9]
- Orchidectomy: Removal of the affected testicle. For some cancers confined to the testicle, this may be the only treatment needed.
- Active surveillance: Regular appointments, blood tests and imaging after surgery to detect any recurrence early. This is a structured treatment option, not being left without follow-up.
- Chemotherapy: Often cisplatin-based combinations, such as BEP, for selected cancers with a higher recurrence risk or disease that has spread.
- Radiotherapy: Used in selected seminoma cases; its role is more limited than in the past because surveillance and chemotherapy are alternatives, and long-term effects are considered.
- Retroperitoneal lymph-node surgery: Removal of selected lymph nodes in the abdomen in particular non-seminoma situations, often when cancer remains after chemotherapy or when surgery is preferred in carefully selected cases.
The choice after orchidectomy is not the same for everyone. For early seminoma, surveillance is commonly offered; some people may consider a single dose of carboplatin. For early non-seminoma, surveillance, one cycle of chemotherapy, or (in selected cases) lymph-node surgery may be discussed. The aim is to cure the cancer while avoiding treatment that is not necessary. [6]
Fertility, hormones and life after treatment
If there is time before chemotherapy or radiotherapy, ask about sperm banking, even if you are unsure about future plans. Cancer and its treatment can affect fertility, and it is easier to discuss preservation before treatment begins. Many men retain adequate testosterone and fertility with one healthy testicle, but this is not guaranteed; hormone levels, semen quality and sexual wellbeing can be discussed with the treatment team. A testicular prosthesis can be considered before or after surgery. Follow-up also matters because recurrence and some late effects can occur after treatment. [6,9]
A Movember reminder
Movember’s message is straightforward: get to know what is normal for you, speak up if something changes, and make an appointment rather than carrying the worry alone. Testicular cancer is highly treatable, and getting a new lump assessed is a sensible step—not a reason to assume the worst. [1,5]
This article is for general education and does not replace an individual assessment by a doctor.
References
- Cancer Australia. Testicular cancer in Australia: statistics. Incidence estimates, age patterns, mortality and relative survival. Accessed 4 November 2026.
- Cancer Council Australia. Testicular cancer: causes, symptoms and treatments. Australian overview of incidence, symptoms, types, diagnosis, treatment and screening position. Accessed 4 November 2026.
- Ilic D, Misso ML. Screening for testicular cancer. Cochrane Database Syst Rev. 2011;(2). doi:10.1002/14651858.CD007853.pub2.
- Cancer Council Australia. Early detection policy: testicular cancer. Position statement on population screening and testicular self-awareness. Accessed 4 November 2026.
- Movember Australia. Seeing a doctor about testicles and testicular cancer; and Know Thy Nuts. Campaign information on noticing changes and seeking medical review. Accessed 4 November 2026.
- European Association of Urology. EAU Guidelines on Testicular Cancer (2026), including chapters on diagnostic evaluation and disease management. Accessed 4 November 2026.
- Cancer Australia. Types of testicular cancer. Accessed 4 November 2026.
- Cancer Australia. How is testicular cancer diagnosed?. Accessed 4 November 2026.
- Cancer Australia. Treatment options. Accessed 4 November 2026.
- Baade PD, Carrière P, Fritschi L. Trends in testicular germ cell cancer incidence in Australia. Cancer Causes Control. 2008;19(10):1043–1049. doi:10.1007/s10552-008-9168-z.
