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Testicular Self Examination
Testicular cancer is the most common form of cancer in young men in the UK and occurs mostly in those aged between 19 and 44. It is easily treated and if caught at an early stage testicular cancer is nearly always curable
A simple, regular self-check could help you to detect the early signs of the disease, but more than 50% of sufferers consult their doctors after the cancer has started to spread. This makes it more difficult to treat successfully and the treatment and its side-effects become more unpleasant
Men who were born with an undescended, or partly descended testicle, are five times more likely to develop testicular cancer. Other research has suggested that there may be a hereditary factor involved, and that if you have a father or a brother who has developed the disease you are at increased risk. A brother with testicular cancer means that you could be 10 times more likely to develop it
Symptoms
The first sign is usually a swelling of one of the testicles, or a pea-sized
hard lump on the front or side of a testicle. Occasionally there may be
a dull ache, or even more seldom, acute pain
What to do and when
From the time of puberty onwards you should do a simple, quick check of
yourself regularly. This will help you to know what is normal for you
(everyone is different) and you will be able to detect any changes early
on. A good place to do this is in, or immediately after, a bath or a shower,
when the muscle in the scrotal sac is more relaxed
Hold your scrotum in the palms of your hands, so that you can use the fingers and thumb on both hands to examine your testicles. Note the size and weight of the testicles. It is common to have one testicle slightly larger, or which hangs lower than the other, but any noticeable increase in size or weight may mean something is wrong
Gently feel each testicle individually. You should feel a soft tube at the top and back of the testicle. This is the epididymis which carries and stores sperm. It may feel slightly tender. Don't confuse it with an abnormal lump. You should be able to feel the firm, smooth tube of the spermatic cord which runs up from the epididymis. Feel the testicle itself. It should be smooth with no lumps or swellings. It is unusual to develop cancer in both testicles at the same time, so if you are wondering whether a testicle is feeling normal or not you can compare it with the other. If you notice any change (particularly a hardening lump or swelling, usually on the front or side of the testicle) you should discuss it with your doctor as soon as possible
Do not be nervous or embarrassed about consulting your doctor. Do not wait to see if the symptoms go away. Most lumps found by self-examination are benign, particularly those on the epididymis. But a few will be cancerous, particularly if they are on the testicle itself, and should be treated immediately. Only your doctor will be able to tell which should be investigated further. REMEMBER: 50% of patients consult their doctors after the cancer has started to spread when it is more difficult to treat
What if it's cancer?
If your doctor thinks it might be cancer, he or she will refer you to
hospital where doctors may do an ultrasound test to investigate further.
If this test shows that it is cancer, the affected testicle will be removed
and examined under a microscope to confirm the diagnosis. If the cancer
has not spread it may not be necessary for further treatment after surgery.
If it has spread, the patient is usually given chemotherapy (drug treatment),
though for a few patients radiotherapy is still used in the early stages
Sex life and fertility
Treatment for testicular cancer should not normally affect your sex life.
There is little risk of
fertility being damaged irreversibly by the treatment. A period
of 12 to 24 months of diminished fertility after treatment is usual, however.
It is rare to have the disease in both testicles, and if one testicle
has to be removed, the remaining testicle tends to make enough sperm to
compensate for the loss
Source: Imperial Cancer Research Fund / Department of Health
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