TESTICULAR EXAMINATION
Did you know that testicular cancer is the most common form of cancer
in young men in the UK and it occurs mostly in those aged between
19 and 44. The risk of developing it has doubled in the past 20 years.
It is easily treated and if caught at an early stage testicular cancer
is nearly always curable. A simple, regular self-check could help
you to detect the early signs of the disease. Only three per cent
of young men regularly check their testicles according to an Imperial
Cancer Research Fund study. Most are unaware of this simple method
of early detection of cancer. More than 50% of sufferers consult
their doctors after the cancer has started to spread. This makes
it more difficult to treat successfully and the treatment and its
side-effects become more unpleasant. The message is simple: BE AWARE!
If you know the way your testicles feel normally, you are more likely
to detect changes which could be the early signs of developing cancer
Causes
Testicular cancer is still quite rare, with just over 1,420 new cases
a year in the UK. However, it is one of the most curable cancers
with 90% making a complete recovery. We don't know what causes it
yet, but we do know that men who were born with an undescended, or
partly descended testicle, are five times more likely to develop
testicular cancer. Other research has suggested that there may be
a hereditary factor involved, and that if you have a father or a
brother who has developed the disease you are at increased risk.
A brother with testicular cancer means that you could be 10 times
more likely to develop it
Prevention
Not enough is known at the moment about the causes to suggest effective
ways of preventing it. However, recent work by ourselves and the
CRC has shown that if undescended testicles are corrected before
a boy is 10 years old, his risk of developing testicular cancer drops
back to the average level of one in 450 before the age of 50. The
research also suggests that regular exercise could help to reduce
the risk
Symptoms
The first sign is usually a swelling of one of the testicles, or a
pea-sized hard lump on the front or side of a testicle. Occasionally
there may be a dull ache, or even more seldom, acute pain
What to do and when
From the time of puberty onwards you should do a simple, quick check
of yourself regularly. This will help you to know what is normal
for you (everyone is different) and you will be able to detect any
changes early on. A good place to do this is in, or immediately after,
a bath or a shower, when the muscle in the scrotal sac is more relaxed.
You could ask your partner to help. Hold your scrotum in the palms
of your hands, so that you can use the fingers and thumb on both
hands to examine your testicles. Note the size and weight of the
testicles. It is common to have one testicle slightly larger, or
which hangs lower than the other, but any noticeable increase in
size or weight may mean something is wrong
Gently
feel each testicle individually. You should feel a soft tube at the
top and back of the testicle. This is the epididymis which carries
and stores sperm. It may feel slightly tender. Don't confuse it with
an abnormal lump. You should be able to feel the firm, smooth tube
of the spermatic cord which runs up from the epididymis. Feel the testicle
itself. It should be smooth with no lumps or swellings. It is unusual
to develop cancer in both testicles at the same time, so if you are
wondering whether a testicle is feeling normal or not you can compare
it with the other. If you notice any change (particularly a hardening
lump or swelling, usually on the front or side of the testicle) you
should discuss it with your doctor as soon as possible. Do not be nervous
or embarrassed about consulting your doctor. Do not wait to see if
the symptoms go away. Most lumps found by self-examination are benign,
particularly those on the epididymis. But a few will be cancerous,
particularly if they are on the testicle itself, and should be treated
immediately. Only your doctor will be able to tell which should be
investigated further. REMEMBER: 50% of patients consult their doctors
after the cancer has started to spread, when it is more difficult to
treat
What if it's cancer?
If your doctor thinks it might be cancer, he or she will refer you
to hospital where doctors may do an ultrasound test to investigate
further. If this test shows that it is cancer, the affected testicle
will be removed and examined under a microscope to confirm the diagnosis.
If the cancer has not spread it may not be necessary for further
treatment after surgery. If it has spread, the patient is usually
given chemotherapy (drug treatment), though for a few patients radiotherapy
is still used in the early stages
Sex life and fertility
Treatment for testicular cancer should not normally affect your sex
life. The occasional patient may have problems with infertility before
diagnosis of testicular cancer. For those who are fertile there is
little risk of their fertility being damaged irreversibly by the
treatment. A period of 12 to 24 months of diminished fertility after
treatment is usual, however. It is rare to have the disease in both
testicles, and if one testicle has to be removed, the remaining testicle
tends to make enough sperm to compensate for the loss. Several hundred
children have been fathered over the last decade by patients treated
for testicular cancer and there is no evidence of any genetic risks
to your offspring from the treatment
Source: Imperial Cancer Research Fund / Department of Health
NHS
Direct 0845 46 47 www.nhsdirect.nhs.uk
