You may have read somewhere, or been told by your doctor, that you should examine your testicles every so often. A good place to do this is in a warm bath or shower, so the skin around your testicles will be relaxed. You're looking for any lumps, swellings or changes in the size of your testicles. However, it's normal to feel a soft cord or tube at the back of each testicle. It may feel a bit tender. This isn't a lump. The cord stores sperm and carries them from your testicles to your penis. It's nothing to worry about.

One testicle usually hangs slightly lower than the other. But apart from this, most men's testicles are pretty much the same. So, if you're not sure whether something's wrong, you can always compare one of your testicles with the other.

Occasionally, men notice other problems which can be a sign of testicular cancer. For more information, see What are the symptoms of testicular cancer?

There hasn't been much research on examining yourself regularly.

 

 

 

 

 

Source:
Scottish Intercollegiate Guidelines Network.
Management of adult testicular germ cell tumours.
September 1998. Available at http://www.sign.ac.uk/pdf/sign28.pdf (accessed on 18 April 2008).

 

 

 

 

 

¹

 

 

 

 

 

Source:
U.S. Preventive Services Task Force.
Screening for testicular cancer: recommendation statement.
Available at http://www.guideline.gov/summary/summary.aspx?doc_id=4777 (accessed on 18 April 2008).

 

 

 

 

 

² We don't know if it makes a difference to how soon you'll notice a lump, so don't feel too bad if you haven't been doing it. The important thing to know is that there's a chance that a lump could be cancer. So, if you do find a lump, see a doctor as soon as you can.

Your doctor will examine your lump to see whether it could be cancer. Some men don't like to see a doctor if they think their problem might not be serious. You may think it's a waste of time. Or you may feel embarrassed. Men sometimes wait and hope that their lump will go away on its own. But cancer is a disease that can spread through your body over time. Don't wait for your symptoms to get worse. It's important to get any sort of lump checked, and the sooner the better.

Your doctor will examine you. He or she may shine a light on your scrotum to see if light passes through your lump. If the lump is cancer, light won't pass through it. Your doctor will ask you some questions, such as when you first noticed the lump. You'll also be asked about your health in general.

If your doctor thinks there's a chance your lump could be cancer, he or she will refer you to a specialist for more tests.

You'll have several tests, including blood tests and

 

 

 

 

 

radiation therapy
This treatment uses high-energy X-rays to kill cancer cells. It's most often used for tumors that are hard to treat with surgery alone. You won't feel any pain during this treatment, but you may get some side effects afterward.

 

 

 

 

 

X-rays. These are used to help find out whether your lump is cancer or not. If your lump is cancer, tests can tell you how far it has spread. This is called the stage of your cancer. For more information, see Staging testicular cancer. The stage of your cancer will affect the treatment you need.

If you have testicular cancer, you may have higher-than-normal amounts of several chemicals in your blood. These are called tumor markers. The chemicals are:

 

 

 

 

 

Source:
Bosl GJ, Sheinfeld J, Bajorin DF, et al.
Chaper 35: cancer of the testis.
In: DeVita VT, Hellman S, Rosenberg SA (editors). Cancer: principles and practice of oncology. 6th edition. Lippincott Williams and Wilkins, Philadelphia, U.S.A.; 2001.

 

 

 

 

 

³

Tests for these chemicals can help your doctor find out what type of testicular cancer you have: seminoma or non-seminoma. For example, if you have seminoma, you'll have normal levels of AFP. If you have a non-seminoma, such as teratoma, you may have raised levels of AFP.

However, a blood test on its own isn't enough for your doctor to say for sure you have cancer. Not all men with testicular cancer have high levels of these chemicals. And it's possible to have increased levels of tumor markers in your blood without having testicular cancer.

 

 

 

 

 

Source:
Bosl GJ, Sheinfeld J, Bajorin DF, et al.
Chaper 35: cancer of the testis.
In: DeVita VT, Hellman S, Rosenberg SA (editors). Cancer: principles and practice of oncology. 6th edition. Lippincott Williams and Wilkins, Philadelphia, U.S.A.; 2001.

 

 

 

 

 

³

You'll have more blood tests as you go on with your treatment. If the level of these chemicals in your blood drops, it's a sign that your treatment is working.

An ultrasound uses soundwaves to look inside your body. You'll have a gel put on your groin and scrotum. A handheld sensor will be put against your scrotum, and a screen will show an image of the inside of your body. An ultrasound can be useful if it's difficult to tell from a physical exam whether your lump is cancer or another kind of swelling.

 

 

 

 

 

Source:
Husband J.
Advances in tumor imaging.
In: Horwich A (editor). Testicular cancer: investigation and management. 2nd edition. Chapman and Hall, London, UK; 1996.

 

 

 

 

 

⁴

Occasionally, an ultrasound will be used to look inside your abdomen.

 

 

 

 

 

Source:
Husband J.
Advances in tumor imaging.
In: Horwich A (editor). Testicular cancer: investigation and management. 2nd edition. Chapman and Hall, London, UK; 1996.

 

 

 

 

 

⁴ If you're quite thin, an ultrasound may get a better picture than a CT scan.

A computed tomography, or CT, scan is a very detailed X-ray. It uses X-rays taken from several different angles to build a picture of your body. A CT scan can be used to look for swollen

 

 

 

 

 

lymph nodes
Lymph nodes (also called glands) are small, bean-shaped lumps that you cannot usually see or easily feel. They are located in various parts of the body, such as the neck, armpit and groin. Lymph nodes filter the lymph fluid and remove unusual things, such as bacteria and cancer cells.

 

 

 

 

 

lymph nodes in your abdomen. If your cancer had spread outside your testicle, these nodes are usually the first place it spreads to. A CT scan can find out whether you'll need treatment to kill any cancer cells in these nodes.

 

 

 

 

 

Source:
Husband J.
Advances in tumor imaging.
In: Horwich A (editor). Testicular cancer: investigation and management. 2nd edition. Chapman and Hall, London, UK; 1996.

 

 

 

 

 

⁴

For more information, see What is my lymphatic system?

It's possible for testicular cancer to spread to your lungs. This is more likely if you have a kind of testicular cancer called teratoma.

 

 

 

 

 

Source:
National Institute for Health and Clinical Excellence.
Guidance on cancer services: improving outcomes in urological cancers, the manual.
September 2002. Cancer service guidance. Available at http://www.nice.org.uk (accessed on 18 April 2008).

 

 

 

 

 

⁵ (For more information about the types of testicular cancer, see What is testicular cancer?) You'll have an X-ray or CT scan of your lungs to check for this. Most doctors now think that a CT scan gives a better picture than an regular X-ray.

 

 

 

 

 

Source:
Husband J.
Advances in tumor imaging.
In: Horwich A (editor). Testicular cancer: investigation and management. 2nd edition. Chapman and Hall, London, UK; 1996.

 

 

 

 

 

⁴

If your doctor thinks your cancer may have spread to your brain, you'll have an MRI scan.

 

 

 

 

 

Source:
Horwich A.
Testicular germ cell tumors: an introductory overview.
In: Testicular cancer: investigation and management. 2nd edition. Chapman and Hall, London, UK; 1996.

 

 

 

 

 

⁶ MRI stands for magnetic resonance imaging. You are put inside a machine that uses a magnetic field to make a detailed scan of your brain.

You may also have an MRI scan if an X-ray or CT scan doesn't give a clear picture.

If you do have testicular cancer, you'll need an operation to remove the affected testicle. For more information, see Surgery to remove the affected testicle. Strictly speaking, this operation is also part of having your cancer diagnosed.

Your doctor can't be totally sure you have testicular cancer until you have surgery. But your doctor won't recommend an operation unless he or she is convinced that you need it.

When your testicle has been removed, it will be examined under a microscope. This will show the kind of testicular cancer you have. For example, it will show whether the cancer cells are a kind called seminoma or not. This affects the treatment you'll need. For more information, see What is testicular cancer?

You may have heard of a test for cancer called a biopsy. This takes away a few cells so they can be checked for cancer. Doctors don't usually like to do a biopsy on the main lump (tumor) in your testicle. There's a risk that it could break off some cancer cells. These could then spread around your body.

Doctors sometimes recommend a biopsy of your other testicle (the one without the tumor).

 

 

 

 

 

Source:
Scottish Intercollegiate Guidelines Network.
Management of adult testicular germ cell tumours.
September 1998. Available at http://www.sign.ac.uk/pdf/sign28.pdf (accessed on 18 April 2008).

 

 

 

 

 

¹ Your doctor may suggest a biopsy if he or she thinks there's a risk of cancer in your other testicle. But it's rare to get cancer in both testicles.

If you have a biopsy, you'll be given a

 

 

 

 

 

local anesthetic
Local anesthetic is a painkiller for one area of your body. You usually get it as a shot. It makes that area numb. An example is the novocaine you get when your dentist fills a cavity.

 

 

 

 

 

local anesthetic to numb the area around your testicles. There are two main ways of doing a biopsy. A doctor can use a needle to take some cells from your testicle. Or you can have it done through a small cut in your scrotum. A small part of your testicle is taken away. The cut in your scrotum can then be closed with a single stitch.

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