The skill I am going to be covering is the Testicular self-exam. This is the most important skill as it is how you can determine if you may have Testicular Cancer and after the diagnosis to determine if the cancer has returned.
Before you begin:
The best time to perform a Testicular self-exam is during or immediately after a shower or bath. This is because the skin of the scrotum is relaxed and easier to notice any abnormal lumps.
Steps in a Testicular self-exam:
Hold your penis out of the way and check one testicle at a time.
Hold the testicle between your thumbs and fingers of both hands (as shown in the diagram above) and roll it gently between your fingers.
Look and feel for any hard lumps or smooth rounded bumps or any change in the size, shape, or consistency of the testicles.
It is important to know that the testicles contain blood vessels, supporting tissue, and an epididymis (a small, coiled tube). These may feel like lumps, but are completely normal. If you are unsure if it is normal or a lumps, you should contact your healthcare provider. The testicles may get larger or develop swelling or lumps for reasons other than cancer. Always make sure to check with your healthcare provider if you notice something abnormal.
After you have been diagnosed with Testicular Cancer, you may be very overwhelmed. You should have an open and honest discussion with your healthcare providers (which may include doctors, nurses, and social workers) about any possible questions you may have. I have provided a list of possible questions to ask your healthcare providers below.
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What kind of testicular cancer do I have?
There are 2 types of Testicular Cancer: Seminomas and Non-Seminomas. Seminomas grow and spread more slowly than Non-Seminomas. The treatment options also differ depending on what type of Testicular Cancer you have.
Has my cancer spread beyond the testicle?
This determines the type of treatment used and the likely outcome.
What is the stage of my cancer? What does this mean for me?
The stage of Testicular Cancer describes how far it has spread. Survival rates differ based on the stage. It is staged off the "TNM" system.
T- refers to how much the primary tumor has spread
N- Describes how much the cancer has spread to the lymph nodes
M- Describes whether the cancer has metastasized (spread) to other parts of the body
S- Indicates serum (blood) levels of tumor markers
Will I need other tests before we can decide on treatment?
Will I need to see other doctors?
You may need to see different types of doctors such as a Urologist (Specialist in treating diseases of the urinary system and male reproductive system), a Radiation Oncologist (Treats cancer with radiation therapy), and a Medical Oncologist (Treats cancer with medicine such as Chemotherapy).
How much experience do you have treating this type of cancer?
It is important to know the Doctor's experience because you have a better chance at a good outcome if your Doctor has had experience treating Testicular Cancer.
What are my treatment choices? What do you recommend? Why?
Typical treatment options may include Surgery, Radiation therapy, Chemotherapy, or High-dose Chemotherapy and stem cell transplant. A combination of these treatment options may be used depending on the type and stage of Testicular Cancer. You may also want to ask about Clinical trials or alternative therapies.
What should I do to be ready for treatment?
How long will treatment last? What will it be like? Where will it be done?
What risks or possible side effects can I expect from my treatment?
It is important to know the possible side effects of different treatment options so you can choose a treatment option that best fits your needs.
How long will it take me to recover from treatment?
How soon after treatment can I have sex?
What are the chances I will become infertile? Should I bank sperm?
Testicular cancer and its treatment may cause infertility (which would make you unable to have children). In some cases, if one testicle is left, fertility will return after treatment. However, the cancer and treatment may affect hormone levels and cause you to become infertile. If you may want to have children in the future, you may want to bank sperm. Make sure to discuss these options before you begin treatment.
What are the chances that my cancer will come back? What will we do if that happens?
For many people, treatment will destroy the cancer. However, if the treatment does come back, it will most likely happen in the first 2 years. Keeping up with follow-up appointments is important so you can catch the cancer early if it does come back and start treatment.
Does one type of treatment reduce the risk of recurrence (cancer coming back) more than another?
Should I get a second opinion before I start treatment, and when would a second opinion be helpful to me?
Getting a second opinion is a good idea so you can be comfortable with your treatment plan.
What type of follow-up will I need after treatment?
Follow-up care is extremely important because in the case that the cancer comes back, you will be able to find and treat it early. Follow up typically consists of labs tests and imagine tests (such as X-rays) to determine if the cancer has spread and if there are any side effects.
Make sure to ask any questions you may have no matter how small you think they are. The most important thing is to make sure to keep an open and honest conversation with your healthcare providers.
(Questions you may want to ask your Doctor)
For more information, please visit:http://www.cancer.org/cancer/testicularcancer/index
One of the risk factors of developing Testicular Cancer is being born with undescended testicles. Parents of these children should be taught the long-term effects of their child being born with undescended testicles, such as an increased risk of Testicular Cancer, and how they can correct the undescended testicles. Parents should inform their male children of their family history, so they are aware of their risk factors.
Most cases of Testicular Cancer are found by the men themselves. The next step for these men is to seek medical care to test for the different causes behind the lump found. However, most men are less likely to seek medical care despite their susceptibility to a disease. According to a study done on why men don't seek medical care, three commonalities were identified. The first was that men get most of their support for health concerns from their female partners. Therefore, female partners such as wives are very influential in getting the men to seek medical care for abnormalities found in their testicles. If the men are diagnosed, they are more likely to seek indirect support rather than straightforward support. Therefore, female partners need to be aware that men need support and provide the support without the men having to ask it. The second thing found was that men will seek help for a specific problem rather than general health concerns. Family should try to influence men to seek medical help. The third thing found were common barriers. These can include the belief that seeking help is unacceptable. Family members need to reinforce the ideas that seeking help is normal and encourage seeking medical care.
After men are diagnosed with Testicular Cancer, they may have any range of emotional reactions. Patients are usually better able to handle their feelings if they talk about their illness and share their feelings with family members and friends. The men need to bring up their feelings on their own and not be forced by family and friends.
Family members are vital in supporting those who have been diagnosed with Testicular Cancer
Recently diagnosed or having had the diagnosis for a while, you may still have some questions about Testicular Cancer. This post is about the daily management of Testicular Cancer, both physically and emotionally.
Physically, you need to do self exams monthly. Self testicular exams are important to become familiar with how your body normally is and to notice any changes in the testicles. This is important because most cases of testicular cancer are found by the man or their partner instead of a physician. These self exams are best to do after a warm shower or bath because the warmth relaxes the scrotum, making it easier to feel anything unusual.
How to perform a self-exam:
Use both hands to examine each testicle. Place your index and middle finders underneath the testicle and your thumbs on top.
Roll the testicle between your thumbs and fingers.
Feel for any lumps. The lumps can be pea-sized or larger and are typically painless.
As you feel the testicle, you might notice a cord-like structure on top and in back of the testicle. This is called the epididymis and is not a lump.
Note: The left and right testicle may be different sizes and one testicle may hang lower than the other. If you notice a lump or a change in the size of your testicles, contact your health care provider.
This is a picture of proper hand placement for the self-exam
How to perform a Testicular Self-Exam
Emotionally, the diagnosis of cancer can be very frightening. However, Testicular Cancer is one of the most treatable forms of cancer. You have to decide what form of treatment you want (based on the stage the cancer is in) and who to tell. Talking your emotions out with family members or even your Doctor or Nurses may be very helpful.
Testicular cancer is a disease where cells in one or both
testicles become malignant (cancerous).Although it is not known exactly what causes testicular cancer, there
are a few risk factors.These include having undescended testicles (cryptorchidism), congenital
abnormalities, history of testicular cancer, family history, age, and
race/ethnicity.
Diagram of Undescended Testicle
One of the major risk factors is having undescended testicles (where the testicles fail to move from the abdomen to the scrotum prior to birth).Congenital abnormalities include abnormalities in the testicles, penis, kidneys, or those with an inguinal (groin) hernia. Previously having testicular cancer in one testicle increases one's risk of getting testicular cancer again. This occurs in about 3-4% of those who have been cured. Although most men with testicular cancer do not have a family history, one may be at an increased risk if their brother or father had testicular cancer. The majority of men diagnosed with testicular cancer are between the ages of 20 and 34, however, men at any age can be affected. The risk of testicular cancer is highest among White, followed by Asian-American then African American men.
Normal Testicle on Left. Testicular Cancer on Right
Some of the signs and symptoms of those with this type of cancer include a lump or enlargement in one testicle, a feeling of heaviness in the scrotum, a dull ache in the abdomen or groin or back, a sudden collection of fluid in the scrotum, pain or discomfort in a testicle or the scrotum, enlargement or tenderness of the breasts. These symptoms can also be the result of other conditions, so it is important to get tested. Tests for testicular cancer include blood tests, an ultrasound, and a biopsy. Blood tests indicate the level of tumor markers in the blood. An ultrasound of the scrotum will show the presence and size of a mass in the testicle. If a biopsy is performed, the entire affected testicle will be removed through an incision in the groin.
If the biopsy has confirmed the presence of cancer, the next step is to determine what stage the cancer is. The stage is determined by the elevated tumor markers in the blood test and a CT scan of the abdominal lymph nodes. In stage 1, the cancer is limited to the testicle. Stage 2, cancer has spread to the lymph nodes in the abdomen. Stage 3, cancer has spread to other parts of the body (most likely the lungs, liver, bones, and brain). The treatment options are determined by the stage and type of cancer and can include surgery, radiation, and/or chemotherapy. It is important to know that 95% of cases can be cured.
Different Stages of Testicular Cancer and What is Affected
