In addition to your annual physical check-up it is a good idea to examine your body regularly. Health self-examinations will help you to learn what is normal, what is changing and what is abnormal for your body. Detection of abnormalities can improve the chances of surviving a disease like cancer.
Calgary Sexual Health Centre does not provide health examinations like breast exams, pap tests or digital rectal exams. Please contact your family doctor if you would like to schedule an examination.
If you are 40 to 49 years old, you should have a clinical breast examination by a trained healthcare professional at least every 2 years.
Talk to your doctor about your risk of breast cancer, along with the benefits and risks of mammography.
Breast Self Exam (BSE)
There is disagreement amongst health care professionals about whether to promote breast self-examinations or not. In 2007, the Canadian Cancer Society changed its position on breast self-exams and no longer recommends routine breast self-examinations. 1 The Society still recommends that people get to know their bodies by looking at and touching their breasts; however, it no longer recommends regular self-examinations that follow a prescribed method every month at the same time. The change in policy is based on research that shows the most effective ways to detect breast cancer are clinical examinations by a health professional and mammograms. Performing routine BSE may give some people false confidence that they do not need medical assessment.
The Canadian Cancer Society provides the following breast cancer screening guidelines:
If you are 40-49
You should: Have a clinical breast examination by a trained healthcare professional at least every 2 years. Talk to your doctor about your risk of breast cancer, along with the benefits and risks of mammography.
If you are 50-69
You should: Have a clinical breast examination by a trained healthcare professional at least every 2 years. Have a mammogram every 2 years.
If you are 70 or older
You should: Talk to your doctor about how often you should be tested for breast cancer.
Getting to Know Your Breasts
Everyone needs to know how their breasts normally look and what they feel like. Getting to know your breasts means looking and touching your entire chest area and underarms. If you do this regularly, you will be more likely to detect any changes or abnormalities that may require medical attention.
Changes in your breast(s) to watch out for include:
- lump or swelling in the armpit
- changes in breast size or shape
- dimpling or puckering of the skin – thickening and dimpling skin is sometimes called orange peel
- redness, swelling and increased warmth in the affected breast
- inverted nipple – nipple turns inwards
- crusting or scaling on the nipple
If you do notice any changes in your breasts, do not panic. About 80% of all lumps found in breasts are benign (non-cancerous). It is best, however, to follow-up and talk to a doctor about your concerns.
Pelvic Exam and Pap Test
When you are 21, or three years after you are sexually active (whichever is later), it is important to start getting annual pap tests.
Regardless of sexual orientation, when a person with a cervix becomes sexually active or reaches age 18 (whichever occurs first), they should have a pelvic exam and pap test. Pelvic exams and pap tests can detect early signs of health problems including cervical cancer and sexually transmitted infections. This examination should be done by your doctor every year and the best time for a pap test is one week after your period is finished.
What to Expect
Before a pelvic exam, the doctor will likely ask you questions about your period, whether you are sexually active or not, what type of contraception you are using if you are active, and if you noticed any changes in your body such as pain, unusual discharge or bumps. The doctor will ask you to lie down while they place one hand on your abdomen and then two fingers into your vagina. This is called a bi-manual exam and helps the physician feel the shape of the ovaries and the uterus.
The Pap Test
After examining the vulva, the doctor will place an instrument called a speculum into your vagina.
The disposable bivalved plastic vaginal speculum is used in office gynecology
Although it can feel weird to have a speculum inserted into your vagina, it should not hurt. The speculum allows the doctor to see your cervix and insert a small wooden spatula (looks like a popsicle stick) to gently remove some of the cells from your cervix for testing. The cells are smeared onto a glass slide (a “pap smear”) and sent to a laboratory to test for abnormal cell growth and, if requested, sexually transmitted infections (STIs).
If you want STI testing done, you need to specifically ask for it. Getting a Pap test is not the same as an STI test. Doctors cannot do this testing without your permission.
The pelvic exam should not hurt and if at any point it does, make sure to let the health practitioner know. If you feel uncomfortable about having a pelvic exam done you can ask that the doctor’s assistant be present or even bring a friend along for support. If it helps, remember that your doctor has probably seen hundreds of (or more) vaginas.
Testicular Self Exam (TSE)
Although rare, testicular cancer is one of the most common cancers in males aged 20-35. It is also one of the most curable cancers.
Although testicular cancer is relatively rare in teenage boys, it can happen. Starting around age 15, all males should get to know how their testicles look and feel so that they are able to detect any changes that require medical follow-up. Testicular self-exams are an effective way of getting to know your body and to detect any changes that might signal testicular cancer at an early, and very curable, stage.
When you do a TSE, you are looking for:
- a lump on the testicle
- a painful testicle
- a feeling of heaviness or dragging in the lower abdomen or scrotum
- a dull ache in the lower abdomen and groin.
Make sure you have regular medical check-ups with a physician (one a year) and follow-up with a medical professional if you notice any changes or signs listed.
How to Perform a Testicular Self Exam (TSE)
You can do a TSE in front of the mirror or while you are taking a shower or bath. Some men find it easier to do a TSE in the shower because the heat of the water relaxes the scrotum. Check for any swelling on the scrotal skin. Examine each testicle with both hands. Place the index and middle fingers under the testicle with the thumbs placed on top. Roll the testicle gently between the thumbs and fingers – you shouldn’t feel any pain when doing the exam. Don’t be alarmed if one testicle seems slightly larger than the other, that’s normal. Find the epididymis, the soft, tube like structure behind the testicle that collects and carries sperm. If you are familiar with this structure, you won’t mistake it for a suspicious lump. Cancerous lumps usually are found on the sides of the testicle but can also show up on the front. If you find a lump on your testicle, consult a doctor.
Around age 50, it is recommended that males receive a digital (in this case digital means finger, not camera or computer) rectal examination as part of their annual physical check-up to screen for prostate cancer.
What is involved in a rectal exam?
During the exam, a doctor will put a lubricated, gloved finger into your anus in order to feel if your prostate gland is healthy and lump-free. The doctor is checking for growths on the prostate gland or to see if it is enlarged. They may use the other hand to press on your lower belly or pelvis to check for any problems in this area. While uncomfortable, this shouldn’t take more than a few minutes or cause any pain.