Examinations are so vital, guys!

PUBLISHED: 18:48 21 June 2007 | UPDATED: 13:55 21 May 2010

JUNE this year is medically commemorated as male cancer awareness month. The breasts and testicles mark taboo areas of the body which patients often feel uncomfortable about examining for abnormalities.

JUNE this year is medically commemorated as male cancer awareness month. The breasts and testicles mark taboo areas of the body which patients often feel uncomfortable about examining for abnormalities. Checking for breast lumps has been high profile for many years now and most women when questioned do examine their breasts regularly. Men however rarely examine their testicles, I am sure most of this is attributable to social stigma that it is abnormal to do so. This is a pity as testicular cancer affects young men and is detectable early, and if done so has a good prognosis.

The testes develop beneath the kidneys whilst a foetus and slide down the abdominal wall, at around 30 weeks gestation the testes glide through the inguinal canal and pop into the scrotum. A quite remarkable journey. This is why many premature boys have apparent absent testes when born, they are still migrating! The testes are deliberately kept outside the abdominal cavity to promote sperm development in a cooler environment.

It is not generally appreciated that testicular cancer can develop from the age of 15 years, although much commoner in young middle aged men. The disease is still rare but there are 2000 new cases each year and the incidence has quadrupled in the last 50 years. The reasons for a rising incidence are not clear but we are aware of risk factors. Firstly if the testicles fail to descend into the scrotum, the increased abdominal temperature causes a definite increase in risk. In fact as a precaution testes are removed if they cannot be placed in the scrotum surgically. Having a first-degree relative with testicular cancer increases risk. A rogue gene has now been identified which predisposes to the condition. Being a wealthy Caucasian (with the exception of Maoris) is a further risk factor. A common misconception is that vasectomy increases risk of testicular cancer, it does not!

Paramount in the drive to reduce the rising incidence is self-examination of the scrotum. Testicles are suspended within the scrotum on a tube carrying sperm (the vas deferens). The body of the testicle should feel firm and smooth, the size of a walnut. Both usually have same size, shape and consistency. Leading away from the testicle the vas may have small pea sized swellings called epididymal cysts. These are not cancerous but should be checked by a health professional.

Alerting symptoms apart from lumps include lower abdominal discomfort, scrotal heaviness and due to hormone manipulation chest development and tenderness. (It is important to emphasise that transient breast swelling in adolescent boys is physiological). All of these should make men check the scrotum!

GPs will refer men with suspicious lumps urgently to the hospital. Blood tests can help discriminate tumour type and ultrasound of the testicle will give a much clearer picture of the lump. Most lumps discovered are none cancerous. However should the testicular swelling be cancerous surgery coupled with, chemotherapy or radiotherapy will produce good responses. Sperm can be salvaged from the testicle during the operation if fertility is an issue. The scrotum can be reconstructed by insertion of an implant to produce a cosmetically good appearance.

If caught late the cure rate is 95% but if caught early testicular cure can be in excess of 99%. As I have alluded to the secret to success is early diagnosis. So boys please familiarise yourself with those objects subject to such ridicule!

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