Understanding Testicular Cancer: The Importance of Self-Exams and Early Detection

In this video, urologist Dr. Bob Baruchem discusses the importance of early detection in treating testicular cancer. He emphasizes the need for regular self-exams, especially for men between the ages of 20 and 40 who are at higher risk. Dr. Baruchem advises checking for lumps or abnormal textures during a self-exam, and seeking medical advice if anything unusual is found. He also mentions other warning signs, such as persistent pain or heaviness, that should be addressed with a healthcare professional. If diagnosed, treatment options can include surgery, radiation therapy, and chemotherapy, depending on the stage of cancer. Dr. Baruchem assures that testicular cancer has high survival and cure rates when detected early.

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Key Insights:

  • Testicular cancer can be highly treatable with early detection being key.
  • Testicular self-exams should be considered starting in teenage years.
  • An abnormal finding is usually a lump that feels harder or like a knuckle.
  • Other warning signs include a dull aching or pain in the testicle that doesn’t go away.
  • Seek medical advice if experiencing unusual pain or a sense of heaviness in the testicle.
  • Urinary pain is not typically associated with detecting testicular cancer.
  • Diagnosis involves a physical examination and imaging tests like ultrasound.
  • Surgery to remove the testicle is often necessary for both diagnosis and treatment.
  • Evidence of a mass on an ultrasound prompts surgery to prevent rapid growth and spreading.
  • Remaining testicle can compensate for hormone and sperm production in most cases.
  • Treatment options after diagnosis may include observation, radiation therapy, chemotherapy, or lymph node removal.
  • Survival rates and cure rates for testicular cancer are among the highest of any cancers.
  • Regular self-exams and speaking up if something is felt are important.


Hello there, I’m here with urologist Dr. Bob Baruchem to talk through what you guys need to know when it comes to testicular cancer. I know this is a difficult topic, but the good news is testicular cancer can be highly treatable, and for the guys, it all starts with an at-home self-exam, right? Talk to me.

Absolutely. The main place that we’re actually finding these tumors is in people who are examining themselves, and so early detection is really key. The unfortunate thing about testicular cancer is that it has a much younger age distribution than other cancers that we think about, so usually it’s men in the ages of 20 to 40 who are presenting with this. I tell most people that they should be considering doing testicular self-exams in their teenage years.

So what is considered abnormal?

It’s usually a lump. What I tell most people to do is, when they’re in the shower, to do an examination of themselves. And usually, the best way to figure out if there’s something wrong is if you take the hand and you hold the thumb together with the remainder of the hand. If you feel in this part of the hand over here, it’s got a soft consistency that you can usually push down on. If you feel anything that’s harder, feels like a knuckle or like a lump that doesn’t belong, you should usually seek a doctor and kind of see what they have to say about it.

Now, outside of feeling a lump, what are other warning signs men need to pay attention to?

There have been a few patients who we’ve seen who come in and they’ve had kind of like a dull aching or a pain in their testicle that they can’t explain, that hasn’t gone away after a few days. And so what I tell most guys is if you’re having a pain that isn’t usually there or you’re feeling a heaviness that doesn’t quite belong, speak to your primary doctor. And if there is something a little bit further of more importance, they will usually refer you along to a specialist to look at it. So, there isn’t any urinary pain or anything like that to detect it further, usually not. By the time that people will present way with other symptoms, they will have a rather advanced testicular cancer, which thankfully is very rare. So usually, it’s based on either a sensation of discomfort in that area and the presence of a lump.

I’ve seen many patients over my career where the guy has said this felt unusual and it felt kind of firm, and I thought it was going to go away. And then three months have passed, and then he’s coming in, and the entire picture is very different. And so just seek the information, just go get advice. Hopefully, it’s absolutely nothing, and if it’s something, then we’re ready, and we can respond to it, right?

There’s absolutely nothing wrong with being diligent about your health and your overall health. Yeah, the most natural man is the one who’s alive. There you go.

So if someone comes to see you, what steps do you take to actually diagnose the condition?

We have some very pointed questions, trying to figure out exactly what has this patient been feeling. And then the physical examination really paints a lot of the picture. So if I’m feeling a lump, usually I’ll send them for an ultrasound to kind of prove, is there something there or not? If we’re feeling something and it’s being proven on the sonogram, we’ll usually do some blood tests to kind of look to see if there are any markers that would suggest that this is a specific type of tumor. But the mainstay of diagnosis, and something that’s been proven on an ultrasound to be a mass within the testicle, is actually to remove the testicle. That is the way that we come to a diagnosis. Very often, that is both diagnostic and therapeutic, meaning removing it will very often treat and cure the cancer, but it’ll also help us to figure out exactly what it is that we’re dealing with. The other thing for men to understand is that there are many things that will come up that will feel like a mass that are completely benign, that will leave alone. But if we have a proven mass on an ultrasound, we will take them for surgery usually quite quickly because these do have a tendency to grow and to spread in a more rapid manner. So we want to act on these rather fast, so any event that you do have to have to, absolutely.

So, we have many men who soon after this kind of earth-shattering diagnosis for them, their partners will conceive, and everything will look rosy again. All you really require is the one testicle to make up your hormone production and to make up for the sperm production. So this is not something to delay. If somebody has something that they’re feeling, you need to come in, you need to be evaluated.

Now, if you are diagnosed with testicular cancer, what can you expect next?

Right after that surgery, usually within a week or so, we’ll get tissue back that will confirm, yes, this was this type of tumor versus a different type of tumor, and thereafter, we then look at the treatment options. And some men, that treatment is to just simply monitor. We’ll do observation, we’ll follow them for a few years, and if everything is proving to be negative, then they’ll be fine moving forward. And some men will consider doing radiation therapy. Other men will get chemotherapy. And in other men, there’s a surgery that’s done in the abdomen to remove some of the lymph nodes that may have been affected. So it really depends on the stage and the type of cancer that they have. Stage one is cancer that’s confined to the testicle, which is the most common place where we’re diagnosing men. Stage two is when it has spread but to the lymph nodes of the abdomen, and stage three is where there’s been a more distant spread.

These all sound horrible, and nobody should ever have to deal with this, but the important thing to understand is that survival rates and cure rates with testicular cancer are among the highest of any cancers. And so this is something that’s readily cured. Thank you is to do self-exams each month, and if you feel something, say something. Don’t hesitate to speak up.