Pedaling to victory in the Tour de France, Lance Armstrong, cycle champion and cancer survivor, is lending his celebrity to the cause of early detection of testicular cancer.

            By going public, Armstrong may help men shed inhibitions and check themselves for the disease. He has established the Lance Armstrong Foundation in his hometown of Austin, Texas, to raise funds for education and research on the subject.

During a 1996 competition, the cyclist suffered a painful swelling and bloody cough that betrayed the presence of testicular cancer.  It had already spread to his lungs and brain. Two surgeries and four grueling cycles of chemotherapy later, Armstrong emerged bald and emaciated but cancer-free, says his physician, Larry Einhorn of Indiana University hospital in Indianapolis.

With earlier detection, his treatment course could have been shorter, simpler and less debilitating. His physician hopes his example will prompt men to be vigilant.

"Lance is very open about this," Einhorn says. "He set up the foundation to increase awareness, using himself as an example.  When he was 25, he had never heard of testicular cancer. He had had this lump for six months and logically assumed it was an injury from sitting on the bicycle saddle."

Most 25-year-olds in 1996 had never heard of the testicular self- exam, says Einhorn. But, he adds, "they certainly have now." The exam is simply a manual check of the testes for any unusual swelling, lumps or heaviness. It is free, private and noninvasive.

Testicular cancer will affect 7,400 Americans this year, and cause 300 deaths, predicts the National Cancer Institute. Fortunately, the disease is very sensitive to chemotherapy and is supremely curable. Typically, the cancer affects just one testicle, which is then removed.  When discovered early, the cure rate for the cancer exceeds 99 percent. When nearby lymph nodes are affected, the cure rate is 90 percent to 95 percent. Even when the cancer has spread to distant organs, the cure rate at 70 percent remains relatively high compared  with that for other cancers.

New Yorker Dave Ollendike was a carefree 23-year-old when a wrenching pain drove him to the emergency room.It turned out to be advanced testicular cancer that had invaded his lymph nodes and lungs. Like Armstrong, he underwent two surgeries and four rounds of chemotherapy.

Given regular self-checks, he says, he could have caught it earlier and had simpler treatment. "Maybe it wouldn't have progressed to my lungs," he says. "I wouldn't have had to endure that 10-hour (chest) surgery," or chemotherapy.

Now in remission, his cancer made him a campaigner. Every year, the insurance underwriter, now 26,returns to Garden City High School on Long Island to break through embarrassment and pitch testicular self-exam to the senior boys.  "Once a month is all it takes," he says. "It frustrates me people don't do it." He says parents sometimes are reluctant to have him talk to their children on the subject. "If they could have seen me in chemo, they'd think differently," he says.

Testicular cancer is most common in men 15 to 35, "twice as common as Hodgkin's disease," says his physician, George Bosl, of Memorial Sloan-Kettering in New York. It takes only a couple of minutes to give yourself an exam, Ollendike says.  It's best done just after a warm shower when a person is relaxed. "You take your index finger andthumb, press lightly and go around. It should be smooth, like a hard-boiled egg. Smooth and oblong."

Symptoms to watch out for can range from a painless swelling to a tender lump or a heavy ache. Cancer sometimes feels like a "pebble inside a larger rock," says Ollendike. Many swellings will turn out to be a vein, an inflammation or an infection that is treatable with antibiotics. But any change warrants a call to the doctor.

Don't dismiss it, Bosl says. "A lot of my patients tell me, `My daughter kicked me.' Or they say they got it in sports. Trauma is frequently imputed as the cause. It isn't."  Unfortunately, many men wait, says Jerome Ritchie, of Harvard and Brigham and Women's Hospital in Boston. "I see men with an orange- or grapefruit-size mass. The average delay is four months. Obviously,  the earlier you pick it up, the easier it is to cure."

Robert Ozols of the Fox Chase Cancer Center in Philadelphia points out that after testicular cancer most men lead normal sexual lives.  Ollendike, now a marathon runner, is dating and "moving forward emotionally," he says. Armstrong, now married, expects a child with sperm he banked before chemotherapy.

Cautiously, the American Cancer Society stops short of advocating monthly self-exams. Under the principle of "evidence-based medicine," its policy requires hard data to prove a test saves lives. Such studies haven't been done. So the society simply recommends that men "be aware of their body when bathing or dressing," says screening director Robert Smith.

But the National Cancer Institute calls self-exams a healthy habit. It offers a Web guide at http://cancernet.nci.nih.gov/wyntk(underscore)pubs/testic.htm
Or call 800-4-CANCER for faxed instructions. Men can also visit the testicular-cancer resource center at www.acor.org or the Lance Armstrong Foundation at www.laf.org