By Jody L. Hancock, MAEd, RDMS, RVT, RT(R)
October was Breast Cancer Awareness month. Hopefully with that, the idea that awareness is not only for the consideration of detection and treatment options, but also to inspire women to take preventative measures to reduce their risks and to take responsibility in using early detection mechanisms.
Though breast cancer is detected in great numbers (one in about every eight women), men also need to take personal responsibility for their own early detection measures, by paying close attention to those cancers with greater risk factors as they age. Once men approach their fifth decade of life, prostate cancer is of increased concern. Did you realize that many men on our campus, sometimes earlier than the age of 18, have increased risk factors for testicular cancer? As a sonographer, I’ve been involved with many such cases in men of all ages. This is one diagnosis in which young men, particularly, should not feel invincible by being quick to dismiss risk factors, warning signs or by feeling self-conscious about conducting their own monthly self-examinations. Snicker if you must – then read on.
Because of the activity level of younger males, there are often other scrotal masses and responses that are not cancer; however, many of these should not be ignored either. If you have any discomfort or pain, swelling, or unfamiliar knots in your scrotal area, do not delay in seeking medical attention as some issues could cause the loss of a testicle or could become a precursor to testicular cancer in the future. Beyond a physical exam, the first-line method of diagnosis is generally an ultrasound study, which is relatively simple, quick, and non-invasive.
One of the most common findings is epididymitis, or an inflamed epididymis, often caused by some sort of infection. Generally, a hydrocele (abnormal fluid collection) will build up within the scrotum. The scrotum will usually appear enlarged and the skin thickened because of the fluid and infection within it. It may be painful, and you may feel a knot. Generally, antibiotics are needed for treatment, but it is also wise to make sure you don’t have a mass or torsion of the testicle.
Torsion (turning of the testicle) most often occurs due to trauma (often sports-or fight-related), but can occur simply because of epididymitis or just because of how your testicle was attached when you developed as a fetus. Whatever the cause, the testicle is able to turn and gets “tangled,” shutting off its blood supply (which is really going to hurt). Ultrasound can check for blood flow to see if torsion has taken place. This next part is very important; If your testicle is torsed (turned), you have about 24-48 hours to take care of this problem before the loss of blood flow could cause permanent damage – meaning the loss of your testicle. Do not delay in seeking medical care when you are having intense pain to this area, particularly when you know you’ve had a trauma there. Even Wolverine and the Man of Steel aren’t that invincible.
Sometimes the testicle doesn’t torse, but it does become “fractured” – not like the image you just conjured up, but meaning there’s a break in the lining in your scrotum – which can affect blood flow and healing (and often requires surgery or at least follow-up with ultrasound). The testicle may also become ruptured in severe instances (of infection or injury), or simply bleed out into the scrotum in less severe cases (called a hematocele). An ultrasound can be used to determine the difference between these.
If a testicular mass is discovered, that doesn’t automatically mean it is malignant (cancerous). There are also benign (non-cancerous) masses of the testicle. However, because testicular cancer is more commonly a disease of younger to middle-aged men (with the average age being around 33), and because the scrotal area is in danger of other trauma and infection-related concerns from very young ages, there is importance in men taking personal responsibility in seeking immediate attention when issues do arise. Most importantly, testicular cancer – along with these other issues – can be treated successfully. The earlier they are addressed, the more successful the treatment.
For information on performing a monthly testicular self-exam: Information