Key Terms: Epididymis, Scrotum, Testes.
Definition
A testicular self-examination (TSE) is the procedure by which a man checks the appearance and consistency of his testes.
Purpose
Most testicular cancers are first noticed by the man himself, many times after a blow or other injury to the scrotum. Men should perform a TSE every month to find out if the testes contain any suspicious lumps or other irregularities, which could be signs of cancer or infection.
It is particularly important for adult male survivors of childhood cancers to perform TSE on a regular basis. A group of researchers at the University of Minnesota reported in 2004 that only 17% of male survivors of childhood cancer examine their own testes as a form of cancer screening. The researchers urged primary care physicians to teach cancer survivors about the importance of regular self-examination in adult life.
Precautions
None.
Description
A TSE should take place during a warm shower or bath, when the skin is warm, wet, and soapy. The man needs to step out of the tub so that he is in front of a mirror. The heat from the tub or shower will relax the scrotum (sac containing the testes) and the skin will be softer and thinner, making it easier to feel a lump. It is important that the exam be done very gently.
The man should stand facing his mirror and look for swelling on the scrotum. Using both hands, the scrotum should be gently lifted so that the area underneath can be checked.
The next step is the exam by hand. The index and middle fingers should be placed under each testicle, with the thumbs on top. The testes should be examined one at a time. The man should roll each testicle between his fingers and thumbs. He should feel for lumps of any size (even as small as a pea) particularly on the front or side of each testicle. He should also look for soreness or irregularities. Next, the epididymis and vas deferens, located on the top and back of the testes, should be felt. This area feels like a cord, and should not be tender.
Normal Results
It is normal for one testicle to be larger than the other, and for them to hang at different levels; but the size should stay the same from one month to the next. The testes should be free from lumps, pain, irregularities and swelling.
Abnormal Results
A TSE is considered abnormal if any swelling, tenderness, lumps, or irregularities are found. Hard, unmoving lumps are abnormal, even if they are painless. A lump could be a sign of an infection or a cancerous tumor. A change in testicle size from one month to the next is also abnormal. A feeling of heaviness in the scrotum is another abnormal sign. If any abnormality is found, a man is encouraged to check with his doctor as soon as possible because testicular cancer is highly curable if found early.
Questions to Ask the Doctor
- How long should a testicular self-examination take?
- What should be done if the presence of a lump is uncertain during a TSE?
- What action should be taken if a lump or abnormality is definitely found during TSE?
- What medical tests are done to confirm testicular cancer?
- How often is a testicular examination performed as part of a physical examination?
- What are the other signs of testicular cancer?
Resources
Books
Beers, Mark H., MD, and Robert Berkow, MD, editors. "Overview of Cancer." Section 11, Chapter 142 In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2002.
Hainsworth, John D., and F. Anthony Greco. "Testis." In Cancer Treatment, edited by Charles M. Haskell, 5th ed. Philadelphia: W.B. Saunders, 2001.
Seidel, Henry M., et al. Mosby's Guide to Physical Examination. 4th ed. St. Louis: Mosby, Inc., 1999.
Periodicals
Yeazel, M. W., K. C. Oeffinger, J. G. Gurney, et al. "The Cancer Screening Practices of Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study." Cancer 100 (February 1, 2004): 631–640.
Other
"Questions and Answers About Testicular Cancer." Feb. 2000 National Cancer Institute.
—Rhonda Cloos, RN; Rebecca J. Frey, PhD
Gale Encyclopedia of Cancer. Copyright © 2006 by The Gale Group, Inc. All rights reserved.
