- What are the risk factors for Testicular Cancer?
- What is the Testicular Self-Examination (TSE) and why should men do it?
- When and how often should I do my TSE?
- How can I do my TSE and what do I look for?
- What does it mean if I palpate any induration or lump?
Testicular cancer is the most common cancer in men aged 15-35 years old. There is no prevention for testicular cancer but it can be diagnosed in an early stage. Many Urologists recommend men to do the Testicular Self-Examination (TSE), in the very same way as breast self-examination is recommended to women for breast cancer prevention. The reason for this is that testes are superficial organs and therefore their examination/palpation is easy; testicular cancer always manifests some palpable induration in the testes. Other symptoms are sensation of testicular heaviness or mild pain and increase of testicular size.
It has been shown that the risk for testicular cancer is higher in men whose testes do not descend normally down to their proper position in the scrotum. Cryptorchidism is defined as the condition of undescended testes that remain outside the scrotum. Retractile testes are testes that do come down into their normal position in the scrotum but then immediately retract upwards and out of the scrotum. This means that, when a boy grows up, his testes do not descend from the lower abdomen to the scrotum. Such cases require surgery to fixate testes to the scrotum and restore the problem. It has not been proven that surgery protects such an operated testis from developing cancer but it surely faciliates testicular self-examination. Other risk factors for testicular cancer are:
- Family history
- Occupational risk factors (radiation, high testicular temperature)
- Cancer in fellow testis
- Testicular injury
- HIV Infection/ AIDS
Besides clinical testicular examination performed by the physician, every man can check his own testes on a regular basis. During self-examination, the man palpates his testes to identify any changes in the testicular shape, color or texture, which might potentially be symptoms of cancer. Once a man decides to get into the habit of self-examining his testes, this should be done once a month during his life after puberty.
Testicular self-examination should be done once a month preferrably after a hot bath or shower. In this way, you get familiar with the morphology of your testes and you are able to identify early any change in testicular shape, color and morphology. After a hot bath, the scrotal skin 'is relaxed' thanks to the heat and it is thus easier to detect anything unusual upon palpation. The process is very simple and takes only a few minutes.
- First, stand in front of a mirror and visually check your scrotum for any potential swelling, change in shape or color.
- Use both hands to palpate your testes. With one hand retain the scrotum and with the other one palpate each testis separately. Place your index finger (pointer) and middle finger below the testis and your thumb above. Start palpating with slow and gentle movements, without rubbing the testes.
- There may be some difference in the size or height at which the testes are located within the scrotum. This should not worry you, as long as it has not occured suddenly.
- Examine the entire scrotal surface; normally it should feel soft and smooth without any indurations (hard points).
- Behind the testis you will palpate the epididymis, which is like a soft tube.
Should you palpate any induration in the testis, you must visit your physician without any delay.
Palpating any induration or lump in the testes does not necessarily mean it is cancer. There are also benign diseases than could give similar findings during self-examination, such as simple cysts, inflammation and fluid collection in the scrotum. In case you have any kind of doubt or suspicion, do not hesitate to visit your physician.