Men’s health awareness: prostate and testicular health

How to perform a testicular self-examination

Calling all men! When was the last time you gave your health an MOT? Men’s Health Week runs from 13-19 June and is the best opportunity to check your prostate and testicular health. One man in five dies before the age of 65 but together we can change that.

Visit the Men’s Health Forum website to access resources designed specifically for checking your physical and mental health.

Did you know that early-stage cancer diagnoses fell by a third in the first lockdown? Unfortunately, this decrease has continued, for example, prostate cancer diagnoses were down by 29% between 2019 and 2020. The main reason for this is that men were not contacting their GPs to get their health concerns checked. Read on to learn what the signs, symptoms, causes and outlook is for testicular and prostate cancer.

Testicular cancer

Just as it’s recommended that women check their breasts on a monthly basis, men should also be performing a self-examination of their testicles (balls) on a regular basis. Checks can help you become familiar with your body and recognise any changes sooner. If you’ve never ‘checked your chaps’, it’s not too late to start, learn how to perform a five-minute testicular check.

Check your testicles in these three simple steps

To perform the exam, stand nude in front of a mirror after a warm bath or shower.

  1. Check for swelling: hold the penis out of the way and look at the skin of the scrotum. You may see bumps which seem unusual, but these are not necessarily a sign of cancer. Bumps can be caused by ingrown hairs, rashes or other skin-related problems
  2. Roll each testicle: using your thumb and forefingers, gently roll each testicle in turn, looking and feeling for any changes. These include lumps, bumps or changes in shape or size
  3. Check again: make sure you ‘check your chaps’ on a regular basis. Add a monthly reminder in your diary, phone or calendar to give you a nudge

At the back of your testicles you may also feel a softer, bumpier tissue which feels different to the testicle it’s attached to. These tubes are called the epididymis and are a normal part of the male reproductive system. They can easily be mistaken for an unusual mass if you’re unfamiliar with them.

What should my testicles feel and look like? 

The vast majority of men’s testicles are about the same size, though it's common for one to be a bit larger than the other, as well as one hanging lower than the other.

Your testicles should feel fairly smooth, without noticeable lumps or bumps. They should be relatively firm but not hard. Around the back of your testicles, you can feel a soft tube which is called the epididymis.

The best place to notice any changes to your testicles is during a hot shower, as the heat causes the testicles to hang lower, making them easier to examine. 

What causes swelling or lumps in the testicles?

There are a few different causes of testicular swelling or lumps;

  • Epididymal cyst– lump(s) caused by a collection of fluid in the epididymis
  • Varicocele– enlarged veins in the testicles.
  • Testicular torsion – a sudden and painful swelling that occurs when a testicle is twisted, requiring medical attention as soon as possible
  • Hydrocele– swelling caused by fluid
  • Epididymitis – Chlamydia infection located in the epididymis which can cause inflammation. This often leads to swelling, tenderness and redness on the scrotum (ball sack)
  • Testicular cancer – an estimated 4 in 100 testicular lumps are cancer, so this is an uncommon cause of lumps. However, it is the most severe and - should you identify a lump on your testicle - you should contact your GP

Types of testicular cancer

The different types of testicular cancer are classified by the type of cells the cancer begins in.

According to NHS UK (2021), the most common form of testicular cancer (95% of all cases) is germ cell testicular cancer. Germ cells are a type of cell that the body uses to create sperm. This form of testicular cancer has two ‘subtypes’ which both respond well to chemotherapy, they are:

  • Seminomas – 40 to 45% of all testicular cancers
  • Non-seminomas – 55 to 60% of all testicular cancers

Other, less common types of testicular cancer include: Leydig cell tumours and Sertoli cell tumours.

What are the different signs of testicular cancer?

Testicular cancer is luckily easy to identify, it’s important that you get checked out by a doctor if you notice any of these changes, so look out for one or more of the following signs:

  • Swelling or unusual enlargement, or a change in shape of a testicle
  • A hard lump on the front or side
  • An unusual and noticeable difference between one testicle and the other
  • Increased firmness of the testicle

Prostate cancer

Symptoms of prostate cancer

You may not notice symptoms in the early stages, as they usually appear when the prostate enlarges. Our Consultant Urological Surgeon, Mr Steve Garnett explains:

“Men can start to worry about prostate cancer if they have an increased need to urinate, if they strain while urinating or feel that their bladder hasn't fully emptied after each visit to the toilet. These symptoms should not be ignored, but they don't mean that someone definitely has prostate cancer. It's more likely that they are caused by something else, such as benign prostate enlargement (Benign Prostatic Hyperplasia) which can be treated with a UroLift® procedure"

What causes prostate cancer?

The causes of prostate cancer are mainly unknown, however the chances of developing prostate cancer can increase if you:

  • Are over 50 years old
  • Are of African-Caribbean or African descent
  • Have a father or brother that have been affected by prostate cancer
  • Are considered obese

How is prostate cancer diagnosed?

There are various types of tests for prostate cancer, these have different benefits and risks which your doctor can discuss further. The most commonly used tests for prostate cancer are:

A PSA (prostate-specific antigen) test measures the level of PSA and can detect early prostate cancer. Men over 50 can ask for a PSA test from their GP.

How is prostate cancer treated?

Treatment may not be necessary, your doctor may advise for this to be monitored until this spreads to avoid any risks and side effects. The best option depends on your age and overall health.

Some may be offered treatment if prostate cancer is found in the early stages and carry their own risks and side effects, these include:

  • Surgically removing the prostate
  • Radiotherapy – either on its own or alongside hormone therapy
  • High-intensity focused ultrasound (HIFU)
  • Cryotherapy

Get yourself checked

Prostate and testicular cancer is far easier to treat in the early stages, so it’s essential to check on a regular basis to ensure that no changes go unnoticed. Usually these symptoms may relate to other conditions, which we offer a range of urology treatments for a range of problems with the male reproductive organs (penis, testes, scrotum and prostate).

If you are experiencing prostate cancer symptoms or any unusual changes in the way your testicles look or feel, book a GP appointment.

Get in touch by completing our online enquiry form or by contacting our Private Patient Team on 01580 363158.

Published on 15 June 2022