Understanding Testicular Cancer - Treatment

How Do I Know If I Have Testicular Cancer?

If found early, testicular cancer is highly curable. For this reason, every man should have his doctor explain the steps of testicular self-examination, a procedure that is simple but very important. Men should be sure to examine their testicles once a month for signs of changes. The basics are listed below, but be sure to discuss it with your doctor to be sure this test is performed correctly.

Testicular Self-Exam

Do the exam during or after a warm shower or bath. The warmth relaxes the skin of the scrotum, making it easier to feel for anything unusual.

• Stand undressed in front of a mirror, and check the scrotum for any skin swelling. It's normal for one testicle to be slightly larger than the other. By performing a self-exam monthly, you will become familiar with what is normal for you and recognize any changes.
• With both hands, examine each testicle one at a time. Place your index and middle fingers behind the scrotum and your thumb on top. Roll the testicle gently between your fingers.
• As you feel the testicle, you may notice a cord-like structure on top and in back of the testicle. This is the epididymis (a structure used to transport the sperm from the testicle). It is about an inch long and is sensitive but should not be painful to examine. Do not mistake this for a lump.
• Feel for hard, tender, or painless lumps. Lumps can be pea-sized or larger. If you notice a lump or irregularity, contact your doctor.
• Repeat the exam on the other testicle.
• If you detect abnormal swelling or a lump, contact your doctor. Remember, not all lumps are cancer. Some may be due to an infection that is treatable with antibiotics. Your doctor may prescribe a course of antibiotics to see if the mass disappears.

Doctor’s exam and tests. If your doctor suspects testicular cancer, he or she will probably order tests to find out what is happening. These tests and procedures may include the following:

• Ultrasound imaging, using sound waves and a computer to create images of the suspicious area
• Urine and blood tests
• Surgical removal and biopsy of the testicle, analyzing the tissue to determine if a cancer is present and if so, the type of testicular cancer

If cancer is diagnosed, other tests such as a CAT scan will determine whether it has spread.

Note that removal of the second testicle is not standard practice because in most cases, it remains cancer-free. Removing one testicle usually does not cause infertility, but because further treatment may (such as techniques using radiation or chemotherapy), patients are advised of the importance of sperm banking before treatment proceeds. A single sperm specimen is all that is needed, so there should be no delays in treatment.