TESTICULAR CANCER: The Importance of doing a self examination

By Christopher Porter, MD

Introduction  

Testicular cancer is the most common cancer in young men and it is much more common in white American men than in African-American men; however the rates of testicular cancer in both black and white men have been rising steadily over the past two decades. It is important to know that testis cancer is a very curable disease and the chances of being cured are remarkably improved if the disease is found early. In fact, cure rates for men whose disease have not spread are in the range of 97-99%.

The testicles are the male sex glands which are held in the scrotum and are responsible for making sperm and the male sex hormone, testosterone. As a young man, you may be able to recognize some of the signs of testicular cancer, which include a lump or enlargement of one or both of your testicles, a heavy dull ache or sudden pain within the scrotum, or problems with breast enlargement.

Nobody yet really knows the causes of testicular cancer but we do know that some men are more at risk of developing the problem than others. Men who fit into an increased risk group are young men age 15-40, men whose testicles failed to drop down into the scrotum and men whose fathers or brothers have had the disease. There is also information suggesting that men with HIV infection and men whose mothers used DES during their pregnancies, are at an increased risk of getting testicular cancer.

Testicular cancer itself cannot be prevented, however, we do know that recognizing some of the early signs of testicular cancer and finding it early is very important. The main method finding cancer early is testicular self exam. The testicles are best examined right after a worm bath or shower as the tissue of the scrotum is the most relaxed at this time. While standing in front of a mirror, you use your fingers to carefully examine the testicle. By doing this and by gently rotating the testicle between your fingers and thumbs, any abnormal lumps, hardness or thickness can be found. Both testicles should be examined and you can compare the findings of one testicle to the other testicle during the exam. If you find a lump or abnormal hardness, you should see your physician as soon as possible. It should be noted that testicular self exam is recommended on a monthly basis but it is not a substitute for routine physical examinations by your family physician.

If you find an abnormality on the testicle and this is confirmed by your doctor, your doctor will carefully ask questions about your health history as well as performing a complete physical exam. Your doctor will very likely perform an ultrasound of the testicles to look for any abnormalities. This ultrasound examination does not hurt and is not invasive in any way. If a lump is seen in the testicle on the ultrasound examination your doctor will do special blood work to look for any signs of testicular cancer proteins in the blood. At this point your doctor will have you seen by a urologist who will confirm these findings and arrange for you to have surgery to remove the testicle containing the cancer.

The testicle will then be examined by a pathologist, an expert in looking at human tissues under a microscope, and will comment on the patterns that he/she sees during the microscopic examination. Essentially, testicular cancer can be classified by the way it looks under the microscope as a seminoma or as a non-seminoma.   Once testicular cancer has been confirmed by the pathologist, your doctor will probably send you for further discussions with a specialist physician. The first thing that your doctor will do is to find out if the cancer has spread. This is called staging. Staging is important because it can help your doctor decide the best way to treat you. To find out whether your cancer has spread, your doctor will probably perform more blood tests, a computerized tomography (also called CAT scan), and possibly a magnetic resonance imaging study (also called MRI). These studies will help your doctor stage the cancer. Briefly, stage I cancer is cancer that is limited to the testis. Stage II cancer is cancer that involves the testis and has spread to the lymph nodes in the lower abdomen. Stage III cancer is cancer that has spread to the lymph nodes outside the lower abdomen, to the lungs or to other organs.

Your doctor will then have staging information and when this is put together with the microscopic appearance your doctor will then have a blueprint for treating your testicular cancer.

We will not go into detail here about treatment options but it is important to know that most testis cancers are curable. It is also important to know that early treatment from doctors with a lot of knowledge about testicular cancer is very important. The most important step in curing testis cancer is finding it early. Your self exam can really help in finding it early and can help your chances of being completely cured from this disease.

 

For additional information on this release, please contact:

Debi Johnson Phone: (425) 971-5822 Fax: (360) 668-4053

Email: djmgmt@earthlink.net  

Source: Chris Porter, MD Virginia Mason Medical Center

 

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