Previous diagnosis of cancer. Symptoms of testicular cancer. Follow-up Actions If examination findings are nega- tive, counsel employee on impor- tance of monthly testicular self-examination (see figure on page 39) and regular checkups with health care provider. If examination findings are posi- tive: Collaborate with health care provider regarding diagnosis and follow-up. Emphasize importance of med- ical treatment and follow-up. Provide employee with emo- tional support. Counsel employee about return to work restrictions, as indicated. Obtain pertinent history. Assess employee testes. Educate employee about importance of early detection. Inquire about symptoms (see Characteristics above), family history, trauma to area, and testicular self-examination findings. If employee agrees, examine each testicle gently with both hands. One testicle may be larger than the other. This is normal. Feel for any abnormal lumps, approximately the size of a pea, on the front or the side of the testicle. Review with employee signs and symptoms and how to perform testicular self-examina- tion. Guideline continues on next page 14 38 Definition Methods of testicular cancer detection include testicular self-examination, testicular exami- nation by a health care professional, and certain X-ray studies. Testicular cancer is one of the most common cancers in men ages 15 to 34. Men who have an undescended or partially descended testicle and those whose testicles descended after age 6 are at a much higher risk of developing testicular cancer. White men are five times more likely to develop testicular cancer than are black men. Characteristics The most common symptoms are a small, painless lump in a testicle, pain or discomfort in a testicle or scrotum, or a slightly enlarged testicle. Other possible symptoms include a feeling of heaviness in the scrotum, a dull ache in the lower stomach or groin, a change in the way a testicle feels, or a sudden accumulation of blood or fluid in the scrotum. These symptoms also can be caused by infections or other conditions that are not cancerous. Policy Evaluate in the occupational health unit any employee with symptoms of testicular cancer and refer promptly for further medical evaluation. Objectives Clinical Assessments and Interventions Referral for Medical Action Testicular Cancer Detection
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