During ultrasound examinations of the testicles, countless times I have heard from the mouth of a 40-year-old man the words ” I figured that at this age I should already get myself examined”.

What surprise is painted on the patient’s face when he hears that he was actually very lucky, because the peak age for testicular cancer is behind him.

Most cases of testicular cancer are recorded in men between the ages of 15 and 40, and it is they who should pay special attention to prevention and early detection of testicular disease.

Does this mean that after the age of 40 the topic no longer concerns me?

Absolutely not! At the same time, I always say that the potential risk of disease is as long as the patient has testicles. Therefore, prevention should not be abandoned throughout life.

Testicular cancer is the most common cancer among young men, and according to the data, every year 8 out of 100,000 Polish men receive such a diagnosis.

 

Is testicular cancer curable?

Yes. Testicular cancer, if diagnosed early, is one of the better prognostic types of malignant tumors, and in such cases we can achieve a 5-year survival rate from the time of diagnosis, of 95-100%.

 

How to diagnose testicular cancer?

As with breast cancer in women, self-examination and the ability to self-examine the testicles play a very important role in this case. Every man from his teenage years onward, should regularly evaluate his testicles and skillfully check them for abnormalities.

Every man should perform a self-examination of the testicles and the contents of the scrotal sac at least once a month. This is best performed after or during a bath, when the skin of the scrotal sac is relaxed and the testicles are accessible to examination to the maximum extent possible. Remember to examine each testicle separately, checking the entire surface of the testicle with your fingers, assessing whether the outline of the organ is smooth, whether nodules or bumps have appeared, whether the testicle has not become enlarged, whether it has not become painful, and whether its mass has not changed and does not differ significantly from the other testicle. If any abnormalities or deviations are found, you should see your doctor and usually perform a follow-up ultrasound.

 

Is there any point in doing an ultrasound of the testicles?

As much as possible, yes. As studies report, it is frighteningly common that the first perceptible symptoms appear and are already related to the stage of metastasis of the cancer to other organs – a situation that affects up to 14% of patients. Even in 75% of patients, the diagnosis was made only thanks to ultrasound examination and was not associated with the onset of symptoms.

The ultrasound examination allows the detection of even very small pathologies that correspond to the earliest stages, thus dramatically increasing the chance of a complete cure.

 

Does an ultrasound of the testicles hurt?

Testicular ultrasound is a brief and non-invasive examination, and painless. The superficial location of the testicles in the scrotal sac makes them well accessible to examination and the procedure itself is not too complicated. The most common barrier is a sense of embarrassment on the part of the examinee, but it should be remembered that the examination is performed by doctors for whom the human body has no secrets and nudity and dealing with the patient’s intimacy is no different from other examinations, such as auscultation of the lungs or examination of the throat.

The ultrasound examination is completed with the issuance of a description by the examining physician and allows rapid follow-up, if necessary.

 

How often to perform an ultrasound examination?

In preventive terms, such an examination should be performed every 12 months or more often if there are any worrisome symptoms or changes.

 

Is it possible to live normally with one testicle?

A diagnosis of testicular cancer is usually associated with surgical treatment and may take the form of an orchidectomy, or removal of the testicle with the lesion. Many patients are concerned about functioning after removal of the testicle, but it should be noted here that having one functioning testicle is in the vast majority of cases perfectly sufficient for normal functioning and does not result in clinically significant hormonal disturbances, and does not even have a negative impact on the ability to have offspring. In terms of aesthetics, there are also options for implanting a testicular prosthesis, so that visually it is very difficult to notice the difference with the state before surgery.

 

Is an ultrasound of the testicles harmful?

Ultrasound, or ultrasonography, is a test that uses ultrasound and does not use harmful forms of radiation, so the test is safe even if it involves such sensitive structures as the testicle.

 

Does ultrasound only detect cancer?

No. Ultrasound is used for early detection of cancer, but it also allows assessment of potential post-traumatic changes, blood supply to the testicle and vascular structures such as the choroid plexus – dilatation of the choroid plexus vessels, called varicocele, if not properly treated can have a negative impact on testicular function, including male fertility.  During the examination, the entire contents of the scrotum and possibly the structures are also evaluated adjacent structures, which allows, among other things, to diagnose certain hernias.

Remember! Regular self-examination of the testicles and regular prophylactic ultrasound examination allows early diagnosis of cancer and possibly other pathologies, the appropriate treatment of which carries the chance of complete recovery.

 

“Do I already have a prostate?”

This is one of the common questions I hear from patients. At first I see the anxiety on their faces when I firmly answer, yes you definitely have a prostate!

The prostate, or prostate gland, is a part of every man’s body in normal anatomy. It plays an extremely important role in sexual and reproductive functions, and its secretions are an extremely important component of male semen.

Unfortunately, it also has its drawbacks. A common condition affecting up to one in two men over the age of 55, its benign prostatic hyperplasia can result in urinary problems, frequent urination, a tendency to urinary tract infections and even, in extreme cases, complete stoppage of urine outflow from the bladder, requiring urgent urinary catheter insertion or surgical methods.

Equally alarming is the increase in the incidence of malignant prostate cancer, which is particularly dangerous in young men. Cases of advanced prostate cancer have been reported as early as in men in their 3rd decade of life.

 

How to examine the prostate?

An important aspect is to observe one’s own body and, in case of alarming symptoms, to see a urologist or family doctor early.

Examination of the prostate gland is usually done through what is known as a per rectum examination, when the doctor palpates the structure, size and cohesiveness of the prostate with his finger, from access through the rectum. The examination, although considered embarrassing by many, is a common procedure that is short and usually completely painless. The patient may only experience brief discomfort during the examination due to the need to insert the finger into the rectum.

Another test, usually performed by urologists, is a transrectal ultrasound, which is performed with a special probe and allows an accurate assessment of the structure of the gland.

If necessary, the doctor may recommend supplementing with an MRI or CT scan.

The prostate gland, with proper patient preparation, is usually available for ultrasound imaging during a standard abdominal ultrasound, performed through the abdominal layers. This examination is not very accurate, but usually allows a preliminary assessment of the size of the prostate and any visible pathology.

PSA test. PSA has nothing to do with veterinary It is a test of the level of specific steroidal antigen ( PSA), which allows assessment of prostate function and is a very good tool for screening, early detection of pathologies such as hypertrophy or even malignancy.

Such a determination is performed from venous blood, which is obtained by a standard collection method as with many other laboratory tests, such as peripheral blood count. 

 

Can the prostate be treated?

Treatment of prostate disease depends on the type of condition and includes pharmacological and surgical methods. As in many other cases, early recognition of the pathology makes it possible to reduce the invasiveness of therapy and facilitate treatment management.

 

How often to get examined?

A preventive examination should be performed at least once a year, or more often if there are worrisome conditions or medical recommendations.

Remember! Take care of the condition of your prostate to enjoy a healthy and happy life.

 

 

Bibliography:

Rębiałkowska-Stankiewicz, Małgorzata, Magdalena Gajewska, and Jacek Mianowski. “Prevention activities targeting testicular cancer in men aged 15-40. Promotion of the campaign “Brave wins”-the Toronto experience.” Pomeranian Journal of Life Sciences 65.1 (2019).

 Brzozowska, Joanna, et al. “Demand for education on testicular cancer prevention in a group of young men-preliminary research.” Journal of Education, Health and Sport 5.7 (2015).

Scientific, Committee. “Metastasis as the first symptom in patients with testicular cancer Article published in Urologia Polska 1993/46/4.”