Risk Factors and Preventive Measures
The most significant risk factor for testicular can-
cer is undescended testicle (CRYPTORCHIDISM), even
after corrective treatment. Untreated crypt-
orchidism in which the testicle remains within
the abdomen presents a very high risk as well as
low potential for early detection of testicular can-
cer. Testicular atrophy, such as may occur after
INFECTIONwith the MUMPS VIRUS, bacterialORCHITIS,
or SEXUALLY TRANSMITTED DISEASES(STDS), and family
or personal history of testicular cancer also
increase a man’s risk for testicular cancer. Though
there are no measures to prevent testicular cancer,
monthly TSE is an effective means of early detec-
tion. Regular follow-up care, including blood tests
to measure tumor markers and imaging proce-
dures such as COMPUTED TOMOGRAPHY(CT) SCANor
POSITRON EMISSION TOMOGRAPHY(PET) SCAN, is impor-
tant.
See also BREAST CANCER; CANCER TREATMENT
OPTIONS AND DECISIONS; HORMONE-DRIVEN CANCERS;
PROSTATE CANCER; SEXUAL HEALTH; STAGING AND GRAD-
ING OF CANCER; SURGERY FOR CANCER.
testicular self-examination A technique by
which a man checks his TESTICLESfor lumps, PAIN,
and other abnormalities as a means of early detec-
tion of TESTICULAR CANCERand noncancerous condi-
tions that may affect the testicles and a man’s
fertility, such as VARICOCELE and HYDROCELE. The
primary purpose of TSE is to familiarize a man
with the characteristics and anatomy of his testi-
cles so he can detect changes that occur because it
is these changes that may signal health conditions
that require medical treatment. Though the main
intent of TSE is early detection of testicular cancer,
as mentioned, the technique also detects non-
cancerous conditions such as SPERMATOCELE, which
can reduce fertility.
Health experts recommend TSE monthly, such
as on the first day of every month, and suggest
doing TSE in the shower when the SCROTUMis
relaxed and lowered and the hands are soapy. TSE
takes only a few minutes, following these steps:
- Cup the testicles in one hand to support them.
- Gently roll one testicle between the fingers,
feeling for small lumps or unusual tenderness.
The testicle should feel firm and smooth.
3. Use the fingers to feel the cordlike structure
that runs from top to bottom, along the back of
the testicle, the epididymis, exploring for hard
lumps or areas of unusual tenderness. The epi-
didymis is a tightly coiled structure that should
feel somewhat lumpy or ropelike.
4. Use the fingers to feel the tubelike structure
that runs from bottom to top along the side of
the testicle, the VAS DEFERENS, checking for
lumps or areas of unusual tenderness. The vas
deferens should feel smooth and firm, and
should move easily within the scrotum. - Repeat for the other testicle.
A doctor should promptly evaluate any changes
or unusual findings such as lumps. It is normal for
the testicles to be somewhat different in size and
for one to hang lower than the other within the
scrotum. Factors that increase a man’s risk for
developing testicular cancer include undescended
testicle (CRYPTORCHISM), even after treatment to
correct it, and family or personal history of testic-
ular cancer. Testicular cancer is most common in
men between the ages of 20 and 40, though can
occur at any age. With early detection and treat-
ment testicular cancer is highly treatable or cur-
able, which is what makes TSE so important.
See also BREAST SELF-EXAMINATION (BSE); PROSTATE
HEALTH; ROUTINE MEDICAL EXAMINATION; SEXUAL
HEALTH.testicular torsion A condition in which the sper-
matic cord twists within the SCROTUM, turning the
testicle and jeopardizing its BLOODsupply. Testicu-
lar torsion is very painful and can result in loss of
the testicle due to strangulation (cutting off the
flow of blood to the testicle). Testicular torsion
may occur as a result of injury or may occur spon-
taneously (without apparent cause) and is most
common in boys between the ages of 8 and 14.
Normally connective tissues firmly attach the epi-
didymis to the SCROTUM; in testicular torsion this
attachment either did not exist (congenital) or
broke free with exertion or a blow to the TESTICLES.Testicular torsion is a medical emer-
gency that requires urgent treatment
from a doctor.346 The Reproductive System