Testicular cancer is most common among men ages 15-35. In fact, it is the most common type of cancer for men in this age range. Men can play an important role in detecting testicular cancer through self-examination. Despite the ease and benefit of performing a self-exam, not many men know how to check for testicular cancer, or how to talk to a doctor about sensitive men’s health issues. To help start the conversation, Washington University urologist Zachary Smith, MD, answers some of the most frequently asked questions about performing a testicular self-exam.
Testicular Cancer: Frequently Asked Questions
Testicular cancer (TC) is—just as it sounds—cancer that forms in the testicle itself. This does not include any tumors or cancer of the other scrotal contents or penis. It is a relatively rare cancer, with only about 9,000-10,000 cases per year in the United States. Fortunately, it is very curable in most situations, even if advanced, and there are only approximately 400 deaths per year in the U.S.
The goal of testicular self-examination is to find TC early. Compared to other tumors, it has a more rapid growth rate. Early detection decreases a man’s likelihood of the disease spreading and requiring more extensive treatment. While the data is mixed on the absolute benefit of self-examination, since TC is a very treatable disease for most men, it is generally felt that this is an easy and low-risk test to detect tumors early and potentially help men avoid more aggressive treatment.
The examination is best performed in a warm environment, so the scrotum and muscles can relax and hang free. It is often recommended to be done in the shower.
- Check each testicle one at a time.
- Gently roll each testicle between the thumb and the other fingers
- Palpate the entire surface of the testicle, checking for any hard lumps, bumps, or irregularities
Note that the testicle itself (the oval shaped body) is the portion we are generally concerned about. The epididymis (the tube-like structure on the back of the testicle), is a normal part of the anatomy and may often have some asymmetry. Similarly, the spermatic cord (the blood vessels and tubes that the testicle hangs from) may feel different from person to person and is of low risk for cancer. Any change in shape, contour or firmness of the testicle itself should be noted and raise concern.
If you feel anything concerning, you should reach out and make an appointment to see your doctor as soon as possible. It is important to make sure that the office knows the reason for your visit. Do not leave the reason for your visit nondescript. That way, the appointment may be scheduled in a time-sensitive fashion. Abnormalities in the testicles are often something for which men delay medical evaluation for a number of reasons. However, there is no reason to be embarrassed, as this is very routine for doctors. This is what we are here for. Early evaluation could make a profound impact on the extent of treatment required if the abnormality turned out to be TC.
It is generally recommended to perform self-examination monthly. Monthly exams help to reduce the chance of missing a tumor. Routine examination also allows a man to be more familiar with what “normal” feels like. This makes it more likely you will be able to detect something “abnormal.” It is easiest to remember to do this monthly if you choose the same day each month (like doing the exam in the shower on the first day or the last day of the month).
It is important to know that most cancerous tumors are not painful. So just because you “feel fine” or it “doesn’t hurt” doesn’t mean that a lump is fine. If there is any question, seek evaluation. Also, while it is generally easiest to be seen by your primary care physician, since you have an established relationship with them, you can also always reach out to a urology office, where you would generally be seen very soon for any testicular lump. Here at Washington University and Siteman Cancer Center, we specialize in treatment of TC and have the experience and knowledge to walk you through the diagnosis from start to finish.
To make an appointment with a Washington University urologist, please call 314-862-8200 or fill out the online appointment form.
To learn more about testicular cancer treatment at Siteman Cancer Center, please call 1-855-273-4915 or visit the Siteman Cancer Center website.