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Movember 2020 | Testicular Cancer

Testicular cancer represents only about one percent to two percent of all cancers in males, but is one of the most common cancers in young men. It occurs predominantly in young males aged 20-40 years old.

Signs & Symptoms

Typically, patients present to their doctor with a painless lump in one or both testes. Occasionally, there may be a heavy or aching sensation in the testes. In advanced cancer, other symptoms may be present. For example, if cancer has spread to the lungs, there may be shortness of breath.


Common Causes

Males who have a history of undescended testes (testes that did not descend to lie in the scrotum during development) have a much higher chance of developing testicular cancer. Other risk factors include history of testicular cancer in the other testis and family history of testicular cancer.

Diagnosis

Ultrasound of the testes will locate and delineate the size of the testicular lump.

Blood tests are taken for tumour markers consisting of alpha-fetoprotein (AFP) and beta-human chorionic gonadotrophin (hCG), and lactate dehydrogenase (LDH). 

A computed tomography (CT) scan of the chest, abdomen, pelvis, and occasionally, the brain, is also performed to find out the extent of cancer.

Prevention:

There’s no known effective prevention for testicular cancer. However, regular testicle self examination may be useful.

Testicular Self-exam

So start a conversation with your friends and loved ones. Create awareness. Encourage those at risk to seek help. Together we can help to reduce disability and deaths among men from the above conditions.

How to Perform Testicular Self Exam

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 cancer is comparatively rare when putting side by side with other cancers, but testicular cancer is the most common cancer in males between the ages of 15 and 35.

How to Perform Testicular Self-exam

Step 1: Clean up, Warm-up


(Testicular Self-exam)
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.

Step 2: Roll it Gently between Your Fingers


(Testicular Self-exam)
You can examine yourself lying down or standing up. Most doctors will examine your standing up.
Hold your penis away. Hold your testicle one at a time between your thumb and fingers. Roll it gently between your fingers.

Step 3: Feel for any Lumps, Bumps or Fluid


(Testicular Self-exam)
Check for any lumps, bumps or unusual features. If you do examine your testicles regularly, you will eventually know what is normal for you and what is different.

Step 4: Feel for any change in the Size, Shape, or Consistency


(Testicular Self-exam)
Feel for any change in the size, shape, or consistency of your testicles. Seek medical attention if you notice any difference.

What is normal

  • One testis 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 are 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.

What is abnormal

  • 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.

Speak to our doctors for more information or professional advice on testicular cancer at our Men’s Health Clinic.

Happy Movember everyone!

Movember (Moustache + November)

Movember (Moustache + November) is a global movement by the Movember Foundation which puts the spotlight on men’s health, especially prostate cancer, testicular cancer, mental health and suicide prevention.
The Movember Foundation recognized that males of all ages may hide their pains and suffering and ultimately result in greater problems, including an untimely demise. Unlike females, males are unlikely to share their deeply personal pains and suffering with others, including loved ones or professionals. This is why it is important for fellow males to stand up for each other, and lift them up from the fog of suffering and silence.

Cancer and Suicide – Not a pretty picture

Prostate Cancer

Prostate cancer now makes up one in seven cancers in Singapore males and is the third most common cancer now. In the five years from 2011 to 2015, almost 20% of those diagnosed with prostate cancer died. What is worse is that prostate cancer in the early stages has no symptoms at all. The earlier the cancer is diagnosed, the more likely the treatment will be successful for patients and help them remain in remission.

Testicular Cancer

While testicular cancer only accounts for 1 to 2% of all cancers in males, it is the most common cancer in young males between ages 20 to 40 – at the prime of their lives. Like prostate cancer, the earlier testicular cancer is diagnosed, the more likely that a cure is achievable.
See:  How to Perform Testicular Self-Exam

Suicide Prevention

More than 70% of all suicides in Singapore for 2018 were males. This is not unique to Singapore. In Australia, males accounted for 75% of suicides. The number of male suicides in Singapore is twice that of women and the majority were aged 65 years old and above.
It is generally believed that many factors contributed to these statistics. Societal pressures for males to “Man Up” means that males may feel isolated and have nowhere to turn to for help.
In addition, many males may feel that if they seek the help they will lose status or identity and they fear that they may lose independence, competence, control, and autonomy, all of which are perceived norms expected of males.

Mental Health

Finally, a previous study by Oogachaga (a non-profit community-based organisation that works with LGBTQ individuals) in Singapore showed that 3 in 5 LGBT individuals who participated in the survey reported facing some form of discrimination as a result of their sexual orientation. This may be part of the reason why in 2015 a study in CDC found gay and bisexual youths in the U.S. are 4 times more likely to have attempted suicide than their straight peers.

What can you do?

Now, anyone, especially males, can step forward and support your buddies and families by:

  1. Growing a moustache or beard for the month of November.
  2. Pledge to walk 60 km for the month of November – for the 60 men that are lost every hour globally due to suicides.
  3. Spend time with your buddies – be it having a night out or playing a favourite sport or whatever activity you enjoy doing together.

For the whole month of November, Dr. Tan & Partners (DTAP) is proud to support the Movember 2019 initiative with a supportive and friendly environment throughout all its clinics for men of all ages to seek help for all men’s health issues.
Dr. Julian Ng

Dr Julian Ng has 10 years of medical practice experience. He currently serves as the Chief Medical Officer of the DTAP Group of clinics in Singapore and Malaysia. He is also a member of the Singapore Men’s Health Society. His special interests are in the field Andrology, especially sexual health. He is currently practising at Dr Tan and Partners (DTAP) clinic at Novena Medical Centre.