Dear Dr. D.,

I read your column, "No one is too young to get educated about breast cancer detection," (SN 10/4), on breast cancer and women, and it started me thinking about my health. As a man, what should I be doing to prevent such things as cancer and heart attacks? Do I really have to worry about testicular cancer? I've always been in pretty good health and never really gave much thought to "monthly checkups" down there. Should I?

-Man

"I love you, man!"

The famous Budweiser commercial refrain is appropriate here because I rarely get questions like this from men who actually care about the topic. Let's look at some of the things you should be screening for at your age first, and then we can talk about a testicular self-exam, or TSE. There will be a "testes" later!

Assuming you are an average-aged undergraduate male, you should have your cholesterol checked every five years. You should have your blood pressure taken every time you visit the doctor or at least every two years. If it turns out you have high blood pressure, you might want to be tested for diabetes.

If you are sexually active, you also might want to be screened for sexually transmitted infections. Frankly, you should have a complete physical checkup done every two years, whether you want it or not. If you are at risk due to family history for other illnesses, such as a thyroid problem, talk to a health care provider. If you are feeling sad, hopeless, anxious or notice a change in the pleasure you find in life, talk to your health care provider to see if they can screen you for depression or anxiety, or if they could recommend someone who can.

A lot of the conditions I have referenced here are rare for young men. However, it is important to know what is "normal" for your body, so you will be able to notice if there is a change. And early diagnosis is your best bet for the most effective treatment. Even testicular cancer, if caught early, is curable.

Now, should you worry about testicular cancer at your age and do a TSE every month? Well, my answer in a nutshell — no pun intended — is you're never too young to start taking your health into your own hands — pun intended.

Remember the lyric, "Hey, kids, feel your balls" from Tom Green's song? Well, as insane as he was from time to time, he actually was right on with this advice.

Here's a guide on how to do it. A testicular self-exam should be done once each month, starting at age 15. It is usually best to do it after a warm bath or shower. Position yourself in front of a mirror, and examine the skin of the scrotum. Look for swelling. Using both hands, examine both testicles. Put your index and middle fingers underneath the testicles, and place your thumbs on top. You want to gently roll one testicle and then the other between the thumbs and fingers.

So you don't freak out, it is normal for one testicle to be larger than the other. You are looking for pea-sized lumps that are usually painless on each testicle. Locate the epididymis — the comma-shaped cord behind the testicle — and the vas deferens — the tube-like structure at the back of each testicle — and examine them both for lumps. The self-exam is easy and should only take a few minutes each month.

If you find any abnormal lumps, swelling or fluid in the scrotum or aches in the abdomen, groin or breasts, contact your health care provider. We have cards here at Olin Health Center to hang on your shower if you need a guide.

Bottom line: Your health is a matter of deciding how you want your life to proceed. You can hope you always have it, or you can take it into your own hands. What's it going be, "Man"?

Peace, Dr. D.