Self-Screening Exam - Testicular Cancer

Recommendation: Monthly self-assessments for Males

What is Testicular Cancer?

Testicular Cancer is a type of cancer in males that is fortunately highly treatable and can normally affect only one testicle if caught early.  Testicular cancer can occur at any age in males but most commonly affects those that are between 15-35 years of age.  We don't know exactly what causes it but there is increased risk with patients who have a family history, a history of undescended testicles, and of Caucasian race.  We currently know of no way to outright prevent the development of testicular cancer but more research is happening all the time. 
 

How to recognize testicular cancer

Testicular cancer itself will typically cause localized symptoms once it has grown large enough.  Oftentimes patients will be able to feel a lump or mass on the testicle itself directly, however sometimes it creates affects tissues surrounding it - this includes fluid collection in the scrotum, non-specific pain in the scrotum, or an unusual heaviness.  The scrotum and testicles are full of nerves and vessels, so occasionally problems with the testicles can cause referred pain traveling along these nerves and result in aches in the abdomen, groin, or even back.  On rare occasions, testicular cancer can affect the hormones in the body and can start to result in tenderness and swelling of male breasts. 
 

Anatomy of a testicle

Testicular anatomy has several main parts.  First is the testis themselves, there is an epididymis which is a palpable cord that wraps around the top of the testicle itself.  Then several nerves and vessels travel up and away in the spermatic cord.  Palpable lumps and nodules can be found on the testis itself, in the epididymis, in the spermatic cord, or even in the surrounding tissues. These are usually benign but not always.  The most concerning for testicular cancer would be if one were to find a lump on the testicle itself.  Any lumps located, however, should be addressed at least once by a healthcare provider to make sure there is no cause for concern.

The Self-Testicular Exam

The following recommendations and graphics are from the Testicular Cancer Awareness Foundation.   Please visit their website if needed for additional information


The self-testicular exam is a short and quick exam that should take less than 2 minutes to perform completely.  It is easily performed in the shower and should be done once per month.  The important thing here is that you do not need to be able to diagnose what you are feeling.  With a basic understanding of the anatomy of the testicle - Testicle, epididymis, and spermatic cord you can properly evaluate the testicle for any lumps, bumps, or abnormalities.  The goal here is to do the exam regularly each month so that you know what your normal is.  If you should ever do it and notice something new that was not there before or that has changed that would prompt an evaluation with a healthcare provider. 


Tips to Performing

The testicular exam is not complicated, but it can be easy to miss things.  It is important to remember that the testicle is a 3-dimensional structure shaped like an egg.  When palpating for nodules you must check all sides of the testicle, front, back, left, right, top, and bottom. it is normal to feel the epididymis on top of the testis and one can often feel small cysts inside the epididymis.  If you feel these be sure to have them evaluated by a professional.


What to do if you have suspicious findings

Testicular Cancer, like any cancer, can be fatal.  However, cancer is not the only thing that can be found on the testicle and there are a variety of benign problems that can also occur.  If you find something suspicious contact your healthcare provider immediately for an evaluation.  Be prepared to get an ultrasound procedure done to evaluate it further.