TESTICULAR CANCER

As many of you know Lance Armstrong recently won the Tour de France. Arguably this is one of the hardest athletic events -- and the athletes that compete in it in the toughest -- in the world. Lance’s victory was indeed impressive, but when you consider his recent battle with advanced testicular cancer, the best description is, "miraculous".

In 1996, when he was diagnosed, Lance immediately became actively involved in promoting awareness, education, Survivorship (the patient’s life/experience after diagnosis), and research into testicular cancer. He coordinated the creation of the Lance Armstrong Foundation to further these goals. To honor the man, his mission, and his accomplishments, we will review some facts about testicular cancer, discuss how to perform testicular self-examination, and mention sources for further information.

In the U.S., new cases of testicular cancer are diagnosed in approximately 6 men per 100,000 per year. Even though it represents only 1% of all cancers in men, testicular cancer is the most common cancer in the 20 – 35 year old age group. Looking at all cases of testicular cancer, the peak age range is also found in 20 – 35 year olds. Thus, chances are that one of the male readers of this magazine has an undiagnosed testicular cancer. Recent advances in medicine have changed this disease into one of the most treatable of all cancers. In general, the earlier it is found the more that can be done. Testicular self-examination (TSE) is the best way to accomplish early recognition.

TSE is best done after a warm bath or shower, because this relaxes muscles within the scrotum and enables an easier and more thorough exam. Grasp the testicle (gently!) between the thumb and first two fingers. The testicle is roughly egg shaped, and one may be slightly larger than the other. At the top pole is a worm-like structure called the epididymis (see figure 1).To examine the testicle, slowly slide the thumb, on one side, and the fingers, on the other side, so that the entire surface is examined. The exam should not be painful. What you feel for is any swelling or hard lump in, or on, the testicle. Other warning signs include, change in size of one testicle, fluid accumulation in the scrotum, and pain in the testicle or scrotum.

Starting at age 15, TSE should be done monthly and any abnormal finding(s) should be investigated by a physician. It may seem strange when you first to do the exam, but over time you will get to know your testicles well and will be more likely to pick up any abnormality early. If you find something abnormal don’t panic; it doesn’t mean that you have testicular cancer. There are several benign conditions that may cause lumps or swelling. However, an abnormal finding DOES mean you need to see a doctor. Don’t mess around; just DO it.