Monday 11 November 2013

Testicular cancer: A guide to self examination

By DR MUKUHI NG’ANG’A

 

November is male cancer awareness month. Its dedicated mainly to prostrate and testicular cancers, the two which most affect men.
Its being popularised, globally, with an awareness campaign known as ‘Movember’. The spirit of Movember is to have men grow moustaches during the month as part of raising awareness about the cancers that affect men.
The awareness campaigns will end with a fundraiser event towards male cancer. Movember has yet to gain popularity in Kenya but it is well known in Europe, Australia, US and South Africa.
In the spirit of Movember we will tackle testicle and prostate cancer this month and what every man needs to know about these two male cancers.

TESTICULAR CANCER

What is normal? The testes should slide easily between your fingers. You shouldn’t feel any pain when doing the exam. One side of the scrotum hangs slightly lower than the other.
What is not normal? Pain in the testes or scrotum during the examination; One side of the scrotum appearing significantly larger than the other; Lumps on the testicle or epididymis (please note, not all of them are cancerous); An enlarged testicle; Once you get used to your normal size, any reduction in the size of one testicle is not normal (However, elderly men may notice a reduction in size of both testes – not one); Fluid collections in the scrotum; A heavy feeling in the scrotum; A dull ache in the groin or lower abdomen; and Enlargement or tenderness of the breasts.
Testicular cancer is more common in younger men, aged between 15 and 40 years, though it can occur at any age.
Risk factors:
  • Undescended testes: Men whose testes have not settled down in their scrotum have a higher chance of developing testicular cancer.
  • Family history: As with most cancers, if you have a family member with testicular cancer your chances of developing it are increased.
  • Previous testicular cancer: If you have had cancer in one testicle you have an increased chance of developing the same in the other testicle.
  • Abnormal testicle development: Boys born with testicular abnormalities have a higher chance of developing cancer.

TESTICULAR SELF-EXAM

All males above the age of 15 years should do a monthly testicular self-examination. This helps you get to know the normal structure of your body so that you can recognise changes that may signal a problem.
The self examination is best done after a warm bath or shower. This is because the heat relaxes the skin of the scrotum making it easier to handle.
Look: Stand in front of a mirror and look at your scrotum. Is one side larger than the other? Are there some unusual changes on the skin of the scrotum?
Look from the front and from the sides.
Feel: Place the index and middle fingers under the testicle and place the thumbs on top. Roll the testicle gently between the thumbs and fingers.
Examine one testicle at a time. Find the epididymis, a soft, tube-like structure behind the testicle that collects and carries sperm.
It can sometimes feel like a soft mass so get to know its normal texture.

WHAT IF YOU FIND SOMETHING AMISS?

Most men find it awkward and uncomfortable discussing their genital issues with their doctors but it is an essential part of the healthcare.
Ideally, all men should have their doctors examine their scrotum/testes at least once a year whether or not they have a problem, as part of routine physical examination.
However, if you do notice a problem during your self examination between annual check-ups go to your doctor for further care.

WHAT TO EXPECT ONCE YOU VISIT YOUR DOCTOR

Once the doctor finishes examining you, he or she may ask for some tests. These include scans and blood tests. These tests help determine whether or not you have an abnormality in your testes.
What is a biopsy?
If you have a suspicious lump in any part of your body the doctor may want to take a sample of it to take to the lab and examine under a microscope. This is known as a biopsy. This is taken using a special needle.
Are there hormonal changes?
Sometimes, you can get hormonal issues related to testicular cancer. This includes tenderness or pain in the breasts. They may also increase in size.

TREATMENT

Surgery: Usually most people have the affected testicle removed. Although most men find this a highly traumatic event – there is a positive side to this.
You can have a healthy sex life and sire children with only one testes.
Chemotherapy and Radiotherapy: This is medical treatment offered to men with testicular cancer in addition to the surgery.
Are all testicular abnormalities a sign of cancer?
No. Most testicular problems are not related to cancer. There may be infections, problems related to previous injury to the scrotum, hernias and non-cancerous fluid collections.
However, only your doctor can determine what your problem is. Testicular cancer has very good outcome with appropriate treatment and many men live a full life after dealing with it.

This article first appeared on Business Daily