How to self-examine for testicular cancer

Each year, more than 2,000 men are diagnosed with testicular cancer in the UK. Understanding the risk factors, symptoms, and available treatments is thus crucial for the early diagnosis and effective management of the condition.

Here, Dr Carla Perna, renowned clinical oncologist, offers a comprehensive insight into testicular cancer.

What are the risk factors for testicular cancer?

Approximately 2,300 cases of testicular cancer are diagnosed each year in the UK, with a higher incidence among younger men, particularly those aged 15 to 49.

Family history plays a significant role. Men whose fathers have had testicular cancer are four times more likely to develop testicular cancer as well, and men whose brothers have had testicular cancer are eight times more likely.

Additional risk factors for testicular cancer include:

• a history of an undescended testicle during childhood
• abnormalities in the penis or urethra
• past fertility issues
• a tall stature
• Caucasian ethnicity

Men who fall into these categories should be extra vigilant about their risk for testicular cancer.

What are the symptoms of testicular cancer?

The primary sign of testicular cancer is feeling a lump or observing a difference in the shape of the testicles.

Like penises, testicles are all different. No testicle is uniform; the testicles may be of equal size, or the right testicle might be slightly larger. Additionally, their hanging positions may differ, with the left testicle typically hanging lower than the other.

On average, the size of testicles is around 4x3x2 centimetres, with a weight ranging from 10g to 15g.

In addition to changes in size and shape, men should be attentive to a change in the feel of their testicles. This may manifest as a sense of heaviness and firmness in the scrotum, accompanied by discomfort, or potentially pain.

How to examine your testicles for cancer

1. Introduce a brief check into your regular routine, preferably during or just after a shower, as the warmth and water will relax the scrotal tissues, providing enhanced visibility and comfort.
2. Cup your testicles to assess their weight, ensuring an even distribution between both.
3. Gently roll each testicle between your thumb and forefinger, feeling for any hard lumps. Normally, testicles are oval-shaped with a soft, smooth texture - firm, but not excessively hard or wooden, with a slight fleshiness and no excessive give.
4. Try to locate your epididymis (the soft tube-like structure behind the testicle), and gently roll your finger along this area to check for any lumps.
5. If you discover a lump, avoid pressing too hard and try to remain calm. While some lumps or bumps are normal, a professional physical examination and an ultrasound are still required to rule out any serious issues.

Even if you detect a painless lump, it’s important to seek medical attention, as cancerous lumps are often painless. Persistent pain lasting more than a couple of days should prompt a visit to the doctor, as it could signify infection or inflammation, which is sometimes caused by cancer. Avoid self-diagnosis and consult a doctor for proper evaluation.

How is testicular cancer diagnosed?

Maintaining a normal life is feasible if testicular cancer is detected early, so it’s important to report any changes as soon as they are noticed.

During the initial clinical examination, the doctor will gently inspect each testicle for abnormalities. This will only take a few minutes, and is a pain-free process. In some cases, the doctor may request an ultrasound to locate the tumour. This is also a painless procedure.

Early diagnosis significantly improves the likelihood of curing testicular cancer. Statistically, 99% of patients survive a year or more after diagnosis, and 98% of patients survive for five years or more. Furthermore, the earlier the detection, the less hard-going the subsequent cancer treatment will likely be.

How is testicular cancer treated?

The treatment for testicular cancer generally involves the removal of the affected testicle, a procedure known as orchidectomy. Following this, subsequent treatment options will either be radiotherapy or chemotherapy, or regular monitoring.

While optional, some patients may have a prosthetic testicle implant placed at the same time as the real testicle is removed. These implants, made from silicone or saline, closely mimic the appearance and texture of a natural testicle.

To schedule an appointment with Dr Carla Perna, head on over to her Top Doctors profile today.