Although it strikes just about 8,000 American men each year, testicular cancer is the most common malignancy in men ages 20 to 40. And incidence is on the rise, having doubled since the 1940s. Fortunately, testicular cancer is highly curable. But because some forms of the cancer are very aggressive, early detection is key to effective treatment. By performing monthly self–exams starting in their high school years, men can take a powerful role in their own protection.
The best time for a self–exam is during or right after a shower or bath, when the skin of the scrotum is relaxed. To search for any abnormalities, each testicle should be held between the thumb and fingers of both hands and gently rolled. It should take no more than one minute to examine a testicle thoroughly (examine testicles one at a time).
You should feel for any small, firm lump or swelling. (A small, firm area near the rear of the testicle is no cause for alarm; it is the epididymis—a long, coiled tube exiting from the back of the testicle.) Notice if the testicle looks or feels different from the last exam and check for overall hardening or enlargement. Report any suspicious area to a primary care doctor, who may do further tests, such as a CT scan, an MRI or a blood test, to find out more about the lump. Not all lumps are cancerous; they may be caused by a hernia or cyst or be nothing more than an enlarged blood vessel.
Men should not let embarrassment or fear prevent them from getting a lump checked out. Although the most effective and uncomplicated treatment requires removal of the affected testicle, the cancer rarely strikes both testicles—and the remaining testicle can produce enough hormones and semen to compensate for the loss. If appearance is a concern, reconstructive surgery can be performed.