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Understanding Testicular Cancer -- Diagnosis and Treatment

How Do I Know If I Have Testicular Cancer?

Testicular cancer is highly curable. For this reason, every man should have his doctor explain the steps of a testicular self-exam, something that is simple but very important. Starting in their teens, men should examine their testicles once a month for signs of changes. It is easy to learn and safe to perform. The basics are listed below, but be sure to discuss it with your doctor to be sure this test is done 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 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 be able to 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. 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, call your doctor.
  • Repeat the exam on the other testicle.
  • If you find swelling, a lump, or any change, see your doctor. Most lumps are not cancer. Cysts or nodules are common, but it is never safe to assume a lump can be ignored. If very tender, it may be due to an infection that is treatable with antibiotics.

Doctor's Exam and Tests

If your doctor suspects testicular cancer, he or she will order tests to find out more information. These tests may include the following:

Ultrasound imaging, which uses sound waves and a computer to create images of inside the testicle. This test can tell if the mass is something suspicious, but it cannot distinguish between a cancerous and a non-cancerous tumor.

Blood tests, specifically alpha-feto-protein (AFP), beta-human chorionic gonadotropin (B-hCG), and lactate dehydrogenase (LDH).

Surgical removal of the testicle is needed if there is a suspicious lump. The lump will be tested for cancer. A biopsy without surgical removal of the testicle should never be performed as this can cause the spread of cancer.

If cancer is diagnosed, other tests such as a CT scan of the chest, abdomen, and pelvis will show whether it has spread to lymph nodes or other organs.

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 radiation or chemotherapy), patients think about sperm banking before more treatment proceeds. A single sperm specimen is all that is needed, so there should be no delays in treatment.

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