Testicular Cancer & Self-Examination
It is November this month, which is also the month of Movember! Movember is an annual event which to most people, involves the growing of moustaches and beards. But the true meaning behind Movember is to raise awareness of men’s health issues, such as prostate cancer, testicular cancer, and men’s suicide.
In the same vein, today we will be talking more about testicular cancer and self-examination. Testicular cancer is the most common cancer in men aged 15 to 34 years.
The testicles are the sex organs located inside the scrotum. They produce the male sex hormones and sperm for reproduction. Testicular cancer is a cancer that arises from the cells that make up the testicle. Testicular cancer is comparatively rare when put side by side with other cancers, but testicular cancer is the most common cancer in males between the ages of 15 and 35.
Signs & Symptoms Of Testicular Cancer
- A lump or enlargement of the testicle (cancer usually affects one testicle in most cases)
- A feeling of discomfort, pain or heaviness in the testicle or scrotum
- A dull ache in the lower abdomen or groin
- Fluid in the scrotum
- Groin lymph node swellings
- Breast swelling or tenderness
Know Your Risk!
Are you between 15-35 years old, of certain ethnicity, have an undescended testicle or a personal or family history of testicular cancer? Consider a testicular cancer screening.
The chances of a cure and full recovery increases when the cancer is detected EARLY.
The vast majority of testicular cancers are from germ cells (the cells that produce immature sperm). They can be either a seminoma or nonseminoma tumour. What causes germ cells to become abnormal and develop into cancer isn’t known, but factors that may increase your risk of testicular cancer include:
- An undescended testicle
- Personal history of testicular cancer (e.g. in other testicle)
- Abnormal testicle development
- Syndromes such as Klinefelter syndrome
- Family history of testicular cancer
- Being ages 15-35, however, testicular cancer can occur at any age too
However, many men with testicular cancer have no known risk factors
Cancer can also arise from the stromal (connective) tissues. These are often benign but sometimes can be malignant. These grow in the tissues that produce hormones inside the testicles. Testicular cancers can also be secondary (spread to the testicles from other organs), or lymphomas.
Treatment For Testicular Cancer
Testicular cancer is highly treatable as they are very sensitive to chemotherapy, even when the cancer has spread outside of the testicle. Cure rates can reach as high as 90%-95%. However, patients cured of testicular cancer have about a 2% risk of developing a cancer in the contralateral testicle.
If testicular cancer is found early when it is small and has not spread, the chances of a cure is much higher. Early testicular cancers may cause symptoms listed above that lead men to seek medical attention. The most common presenting symptom is a lump on the testicle. Having said that, testicular cancers in other people may not cause symptoms until the later stages.
There are doctors that recommend all men examine their testicles monthly after puberty, but because testicular self-exams have not been studied enough to know if they reduce the death rates from testicular cancer, no clear guidelines exist on whether or not they should be recommended to everyone. Each man has to decide for himself if he wants to examine himself. This might be more important if you have any of the risk factors listed above. Seek medical attention immediately if you do find a lump. Your doctor will advise as appropriate.
Testicular Self-Exam (TSE)
The testicles are easiest to examine when the skin of the scrotum is relaxed. The skin is usually relaxed when you are relaxed, or after a warm shower or bath. You can examine yourself lying down or standing up. Most doctors will examine you standing up.
- Hold your penis away.
- Hold your testicle one at a time between your thumb and fingers.
- Roll it gently between your fingers.
- Feel for any lumps, bumps or fluid.
- If you do examine your testicles regularly, you will eventually know what is normal for you and what is different. Feel for any change in the size, shape, or consistency of your testicles. Seek medical attention if you notice any difference.
- One testes may be slightly larger than the other
- One side may hang lower than the other
- Part of the testicle is known as the epididymis where sperm is stored. This may be felt as a bump at the posterior upper or posterior middle aspect of the testicles
- Above the testicles you may feel a cord like structure – this is the spermatic cord where sperm is carried.
- An abnormally large testes compared to the other side
- A hard lump
- Fluid around the testicle
- Dilated veins above the testicles which may feel like worms
- Tender lumps
Not all the above abnormalities are related to cancer. But if you do find such abnormalities, please visit your doctor for a consultation. One of the easiest ways to characterize a lump is with an ultrasound, which is completely painless.
Happy Movember everyone!
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