Testicular self-examination

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VOL 105 / NO 4 / APRIL 1999 / POSTGRADUATE MEDICINE

Unlike many types of cancer, testicular cancer most often affects young adults. In fact, it is the most common cancer in males between ages 15 and 35. The good news is that treatment is usually very successful. Examination for testicular cancer will probably be included in any physical examinations that you receive at a doctor's office, but you should examine yourself regularly as well.

Are certain males at risk for testicular cancer? A testis that has not fully descended into the scrotum (a condition called cryptorchidism, which means "hidden testis") is the single greatest risk factor. Males with a testis that is located completely within the abdomen (so it cannot be felt at all during palpation) are at especially high risk. An undescended testis increases the risk of cancer in the other testis as well, even if it is positioned normally.

Males who have had a groin hernia, a hydrocele (accumulation of fluid in the scrotum), or pain and swelling of the testes during an episode of mumps are also at higher risk, and so are patients with a family member who has had testicular cancer.

What are the signs of testicular cancer?
The first sign is usually a lump or nodule on a testis. Slight enlargement
or a change in consistency of a testis may also be early signs. Often, there is no pain, but some males with testicular cancer notice a dull ache in the groin area or heaviness in the scrotum.

How are testicular lumps usually found?
As with breast cancer, self-examination is very important in diagnosis of testicular cancer. Males should be as diligent in monthly self-examination as women are encouraged to be in breast self-examination. The technique is straightforward and easy, and the following are helpful tips:

• The scrotum is most relaxed, and the testes will be most easily palpated, after a warm bath or shower.
• Using both hands, gently roll each testis between the thumb and first two fingers.
• Feel for hard, fixed areas; lumps; and nodules. A normal testis is freely movable within the scrotum.
• Be consistent in your examination so that you will be most likely to notice any changes in size, shape, or firmness of the testis.
• See your doctor promptly if you notice anything that seems out of the ordinary. Radiology or ultrasound studies may be done to assist in diagnosis.

This information is not a substitute for medical treatment.

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