Diagnosis & Treatment

All men, whether 16 or 60, should know how to perform a testicular self-exam. 

“In general, the best way to detect testis cancer is to feel it,” says Dr. Peter Black, an urologist active in the Men's Health Initiative of BC. “You just check the testicle maybe once a month by feeling it between your fingers.”

Testis cancer is highly treatable and curable if found early. It develops in one or both of the testicles, which are located in the scrotum, the sac of skin that hangs beneath the penis. The testicles manufacture male hormones, mainly testosterone, and produce sperm.

The most common symptom of testis cancer is a hard, painless lump on the testicle. While it's normal for one testicle to be larger than the other, you should schedule an appointment with your physician if you notice unusual swelling or changes in your testes.

It can be helpful to take a bath or shower before you do a testicular self-exam, as the warm water helps relax the skin of the scrotum.

You can do a testicular self-exam by:

• Placing your right leg on an elevated surface while standing up.
• Cupping your scrotum with one hand to see if it feels any different than normal.
• Placing your index and middle fingers under the testicle, with the thumb on top.
• Rolling the testicle between your thumb and fingers, checking for lumps in and on the side of the testicles.

For those of you who are more visually oriented, there are illustrated instructions in the Canadian Cancer Society's Nutcheck Brochure. Also check out Rachel Stevens' very convincing self-check video.

“Then, if you notice a change over time, if you notice a new lump come up, then you go to your family doctor and they will examine it as well,” says Dr. Black. “If there's any concern at all then your doctor will send you for an ultrasound, which is a painless test that will tell you if there's a tumour there or not.”

Many men are uncomfortable at first with performing a testicular self-exam, but it can be a lifesaving test. Checking for testis cancer symptoms by performing a testicular self-exam and seeing your doctor regularly is essential, as early detection of testicular cancer may mean the difference between life and death.

Diagnosis:

Your doctor will perform a physical exam and ask some questions about your family history.  If your doctor suspects you have testicular cancer you may need some of the following tests:

• ultrasound
• blood tests
• other imaging test (e.g. x-rays, CT scans, MRIs or bone scans)

Treatment:

The main treatment for testicular cancer is surgery to remove the affected testicle.  This surgery is called an orchiectomy or orchidectomy.  In some cases, lymph nodes may be removed as well.  During surgery, a prosthetic testicle can be inserted if desired to present the appearance of having two testicles.  Men who undergo this type of surgery continue to have active, healthy sex lives; they can get and maintain erections, and can produce sperm.

Sometimes surgery may be the only treatment needed, but in some cases it may be necessary to undergo chemotherapy and/or radiation treatment. Since some of these treatments can cause infertility, be sure to talk to your doctor about fertility and family planning options – like banking your sperm – beforehand.