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How Do I Know If I Have It?

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 healthcare provider.
• Repeat the exam on the other testicle.

If you detect abnormal swelling or a lump, contact your doctor. Remember, not all lumps are cancer. Often, many are due to an infection that is treatable with antibiotics.

To rule out other possibilities, a doctor may prescribe a course of antibiotics to see if the mass disappears. If it doesn't, your doctor will probably order tests to find out what is happening.

Ultrasound imaging uses sound waves and a computer to create images of the suspicious area. The urine and blood also are tested in a laboratory. If cancer is suspected, the testicle is surgically removed and a biopsy is analyzed to determine if a cancer is present and type of testicular cancer. If cancer is diagnosed, other tests such as a CAT scan will determine whether it has spread. 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.

What Are the Treatments?

Conventional Medicine
Because it is required for diagnosis, surgical removal of a testicle is unavoidable. If cancer is found, a second operation to remove abdominal lymph nodes may be performed, and these two operations are often enough to cure limited testicular cancer. In addition to surgery, advanced cases are treated with chemotherapy and/or sometimes radiation. Nearly all testicular cancer patients achieve life long cure, but they are urged to have frequent follow-up examinations. If cancer recurs, additional treatment frequently produces another remission. If testicular cancer is not cured by conventional chemotherapy, doctors may advise a bone-marrow transplant to allow higher-dose chemotherapy. All men with testicular cancer must be monitored for the rest of their lives.

Supportive Therapies
Although conventional medicine is remarkably successful at curing testicular cancer, simply learning that you have cancer can cause severe emotional distress. Many patients find psychological counseling or support-group therapy helpful in dealing with the emotional consequences.

How Can I Prevent It?

It is essentially impossible to prevent testicular cancer. Because it is so highly curable in early stages, regular testicular self-examination is the most effective way to prevent complications or death from testicular cancer.

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