Testicular cancer (TC) is a highly treatable malignancy that originates in the testicles, the male reproductive glands. Although relatively uncommon, TC is the most frequent cancer diagnosis among men in the young adult age range. Awareness of physical signs and early detection are the most effective tools for ensuring a successful prognosis. This guide offers information on identifying potential abnormalities and understanding the necessary medical steps.
Identifying the Visual Signs and Physical Changes
The most frequent indication of testicular cancer is a lump or swelling on one testicle. This mass is typically painless, though some may experience discomfort or a dull ache in the groin or lower abdomen. The lump often feels hard or firm, distinct from the surrounding tissue, and can vary in size.
Another physical change is a noticeable difference in the size or consistency of a testicle, making it larger or firmer than the other. This change may be accompanied by a sensation of heaviness within the scrotum. Fluid build-up or sudden swelling of the scrotal skin can also occur, though these are often symptoms of non-cancerous conditions.
Visual changes often manifest as subtle alterations in symmetry and texture. A solid, non-tender enlargement or a distinct hard spot requires professional medical attention, even if one testicle naturally hangs lower or is slightly larger than the other.
How to Perform a Testicular Self-Examination
Performing a Testicular Self-Examination (TSE) monthly familiarizes one with the normal feel of the testicles, making it easier to notice changes. The best time for the exam is during or immediately after a warm shower or bath, as the heat relaxes the scrotal skin.
Examine each testicle individually using both hands, gently rolling it between the thumbs and fingers. The goal is to feel the entire surface for any small, hard lumps, irregularities, or changes in size or shape. A smooth, firm, oval-shaped testicle is considered normal.
Behind the testicle, the epididymis, a soft, tube-like structure, can be felt. This is a normal part of the anatomy responsible for storing and carrying sperm. Familiarity with this structure prevents mistaking it for a suspicious mass.
Who is at Risk for Testicular Cancer?
Testicular cancer most commonly affects men between the ages of 15 and 35, although it can occur at any age. This age demographic accounts for the majority of diagnoses. A person’s risk profile is influenced by several specific factors unrelated to lifestyle choices.
A significant risk factor is a history of cryptorchidism, where one or both testicles failed to descend into the scrotum before birth. Even if surgically corrected, the risk of developing TC remains elevated, suggesting an underlying developmental abnormality. The risk is highest if the testicle remained in the abdomen.
Family history also plays a role; the risk increases if a brother or father has been diagnosed with TC. Having a personal history of TC in one testicle increases the probability of developing it in the other. Non-Hispanic white males also show a higher incidence rate.
Steps Following a Suspicious Finding
If a hard lump or swelling is discovered, the immediate action is to schedule an appointment with a general practitioner or a urologist. Prompt medical evaluation is necessary, as early detection significantly improves the prognosis. The initial visit includes a physical examination to assess the nature and location of the mass.
The next diagnostic step is usually a testicular ultrasound, which uses sound waves to create a detailed image of the testicle and scrotum. This non-invasive procedure determines if the lump is a solid tumor, which is more likely to be cancerous, or a fluid-filled cyst, which is typically benign. Solid masses found inside the testicle are highly suspicious for malignancy.
Blood tests are performed to measure specific proteins called tumor markers, which are often elevated in the presence of testicular cancer. Common markers checked include alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH). While elevated levels suggest cancer, the definitive diagnosis is confirmed after the surgical removal and pathological examination of the affected testicle.