Detection of Testicular Cancer

Only 4% of testicular cancer cases are found by a physician during a routine examination, with the rest being self-reported. Most often the patient notices the warning signs of testicular cancer during a testicular self-examination. Occasionally the cancer is discovered by a sexual partner, after an injury, or while diagnosing infertility.

The warning signs of testicular cancer include:

  • A lump in a testicle.
  • Enlargement of a testicle.
  • Testicle feels harder than normal.
  • A growth external to the testicle (testicular mass).
  • A dull ache or sense of pressure in the groin or lower abdomen.
  • A feeling of heaviness or fullness in the scrotum.
  • Pain or discomfort in the scrotum or testicle.
  • Enlargement or tenderness of the breasts.

In most cases early testicular cancer presents itself in a completely painless manner.

Advanced testicular cancer can be accompanied by:

  • Back pain.
  • Chest pain, coughing or difficulty breathing.
  • Significant weight loss.
  • Enlargement of the lymph nodes in your abdomen or neck.

The most common method of early detection is through a testicular self-exam. Testicular self-exams should be conducted at least once a month and preferably every time you shower. (The heat from the bath will cause the skin of your scrotum to relax.) All men age 15 and up should conduct testicular self-exams.

The purpose of a testicular self-exam is to familiarize yourself with the size, shape and texture of your testicles. This will allow you to notice changes in subsequent exams.

Since testicular cancer is usually isolated to a single testicle, comparison of your testicles with each other can often be helpful. (Note: It is normal for one testicle to be slightly larger than the other. Your focus should be on noting changes from one exam to the next, since a testicular cancer tumor can double in size in less than 30 days.)

To conduct a testicular self-exam, do the following:

Place your thumb on top of the testicle, and your index finger and middle finger underneath. Gently roll the testicle between your fingers. Look for any lumps, swelling, or change in size, shape or texture. A normal testicle feels smooth and firm, and is shaped like an egg. Also feel the epididymis, a tube-like structure attached to the top and back of the testicle. Note if there is any change in the epididymis.

If you notice any anomalies or changes, it is imperative that you see your doctor or a urologist immediately. (Most family doctors will encounter testicular cancer only once every ten years. A urologist will have more experience with testicular cancer, encountering a few cases a year.) If your doctor cannot see you immediately or you are experiencing testicular pain, go to the nearest emergency room.

Insist on your doctor ordering a testicular ultrasound immediately. If you futz around with antibiotics for weeks or months, you're only giving the cancer time to grow and spread. An ultrasound is the only sure way to verify or rule out a testicular cancer diagnosis.

There are many good web sites that describe how to do a testicular self-exam. A few of the better ones include:

A good illustrated article that describes various testicular masses can be found on the American Academy of Family Physicians web site.

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