Putting the (Very Gentle) Squeeze On Testicular Cancer

Thu, 2008-01-31 06:47

So I’ve mentioned several times that I’m in school full time Winter quarter, and you’ve probably guessed that’s why posting and, especially, comment replies have been so light. My apologies. I may not recover completely till mid-March when the quarter ends. Still, since it’s a combined women’s studies, sex education and interpersonal-communications theory class it was an opportunity I couldn’t pass up, and one that ought to reflect well in future posts. (Once I’m out from under my other avalanche of homework and classwork.)

Case in point: One of the homework assignments is a two-page paper on self-examinations for cancer. This morning I woke up way too early (after a way too late evening adventure) to conduct and document a self-exam for testicular cancer.

Now breast cancer gets a lot of attention, not least because for so long it was, um, overlooked since it was a disease that mainly affected women. (Interesting and creepy point: While only around 2% of breast cancers occur in men — yes men get breast cancer too — all the early studies, models, and treatments of breast cancer were developed using… male patients!) And while the women in our class will be writing their own papers on breast self-examination the odds are that since most of them are college age they’re more likely just establishing baselines for themselves. For most breast cancer, if they get it, will be decades in their futures. The good news, though, is that thanks to some really excellent and much-needed outreach, there’s a lot of good information encouraging women of all ages to regularly screen themselves for cancer.

Not so for college-age men though! When the professor asked for a show of hands of those of us who’d gotten instructions in testicular self-examination from their doctors only one man (not me) had. Our professor covered her eyes with her hand and expressed, um, exasperation. Because, it turns out, testicular cancer is the number one cancer in men ages 15-35. It’s also pretty easily detected and, if detected, pretty easily and successfully treatable. If not, though, it’s also one of the biggest cancer killers of young men.

So this morning I woke up early, got out of my warm bed, stumbled downstairs, and didn’t realize till I had the coffee half made that it was still barely 2:00 in the morning. Nevertheless my body was warm from my warm bed, which meant my testicles were warm, which meant my scrotum (mmm, sexy term “scrotum,” eh?) was also soft and warm and dangly and loose. Perfect for a testicular examination. Which I performed diligently, if somewhat gingerly. (Multiple surgeries for vasectomy, a reversal, and then another vasectomy can make you a little tender.)

About halfway through the exam, thanks in part to the cool air and in part to what must have been a too-light, too-tickly touch all the muscles in my scrotum (that word again) tightened, giving my testicles a little elevator ride. Now when the tiny muscles in women’s nipples and areola tighten due to chill or tactile sensation we usually call them “perky.” I’m not sure we have a similar word for what happens to scrotums but it’s probably not “perky,” even though they crinkle up the same way nipples do, and for almost all the same reasons.

Anyway, before I could complete my self-examination I had to warm my testicles back up again and I did that by warming my hands on the radiators and then gently cupping and rolling them in the warm palms of my hand. And while that was all very well and good I have to say it would have been nice if someone else had been there who wanted to help. For purely educational reasons of course! :-)

But I digress. I wanted to mention this little bit of homework for a couple of reasons but here’s the big one: young men need to do this! I’ve had one close friend who caught it in time and he went on to father a lovely child with is partner. Others aren’t so lucky. I don’t know if very many young men read my blog at all (greetings if you do) but I know a number of my readers have children in the at-risk age group. We all already know to warn our daughters, and even not to feel uncomfortable about bringing it up. If you or someone you love is a man in that age group, even if you’re a little uncomfortable bringing it up, you can save them quite a bit more discomfort (or worse) if you do mention it to them.

Here are a couple of good links selected at semi-random from a Google search:

Teens Health
The Testicular Cancer Resource Center
MenWeb

And here’s a thumbnail overview (I almost said “nutshell!” Doh!) of how to do it:

The testicular self exam is best performed after a warm bath or shower.
(Heat relaxes the scrotum, making it easier to spot anything abnormal)

The TCRC recommends following these steps every month (keep in mind that the point is not to find something wrong, it is to learn what everything feels like so that you will know if something changes):

Stand in front of a mirror. 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, tubelike 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. Lumps on the epididymis are not cancerous.

If you find a lump on your testicle, see a doctor, preferably a urologist, right away. The abnormality may not be cancer, it may just be an infection. But if it is testicular cancer, it will spread if it is not stopped by treatment. Waiting and hoping will not fix anything. Please note that free floating lumps in the scrotum that are not attached in any way to a testicle are not testicular cancer. When in doubt, get it checked out – if only for peace of mind!

Source: The Testicular Cancer Resource Center

Oh, by the way, my self-exam turned out just fine. A few little bumps and a few more scars but nothing to worry about. I might add that even though one is not in the high-risk group one is generally still at some risk. Self-exams, and of course medical exams, are never a bad idea.

Submitted by 1905 (not verified) on Thu, 2008-01-31 12:25.

A friend's husband developed testicular cancer while we were in law school (he was 28). It was caught early and he has survived 16 years since without a recurrence. It was his wife who detected the lump, not him - it would never have occurred to him to check himself for such things! I have always encouraged my lovers and (now) husband to do regular exams because of his experience.

(My friend's husband was even offered the option of a prosthetic to replace the testicle he lost to the cancer. He declined, but it's nice to know that is available!)

[Yeah, just one more way homophobia, patriarchy, and anti-feminist loathing of men conspire to help us kill ourselves. I'm so glad you're helping spread the word, Bunny. Thanks on behalf of all of us. --fl]

Submitted by 1905 (not verified) on Thu, 2008-01-31 14:51.

Husband had his mystery lump found last year when he went for a vasectomy consult. It turned to be nothing but that was some stressful months of waiting for answers. After all that handling and scans he hasn't felt up to going back for that vasectomy yet but he's been very good about regular self checking since.

[It's totally and always the individual's decision to do any body alterations but he can take it from me that the outcome is... pretty darn nice, Adela. --fl]

Submitted by 1905 (not verified) on Thu, 2008-01-31 15:49.

I mention testicular cancer to my students, too. And the guys - being mostly about 20 years old - stare at the floor. That's their job. But it won't keep me from doing mine. :-)

I talk to them about prostate cancer too, since the odds a man will get it in his lifetime (1 in 6) are even higher than a woman's lifetime odds of breast cancer (1 in 7). If caught very early, though, prostate cancer is highly curable, more so than early-stage breast cancer.

Testing for prostate cancer is somewhat controversial, though, because the PSA test results in a lot of painful biopsies, the majority of which are negative. And those that show cancer don't always signal a need for treatment, because many elderly men are likely to die of something else first.

Nonetheless, men should get their PSA checked, IMHO, because the price of missing early-stage cancer is just unacceptably high. (The toll treatment takes is still unacceptably high, too, but that's another story.)

Submitted by 1905 (not verified) on Fri, 2008-02-01 01:42.

The son of very good friends was away travelling for a pre-university year in South America when he found a lump in one testicle. Fortunately he had the sense to do something about it, but even so he has lost both testes. It didn't stop him going on to university, graduating, entering the army. He has just returned from 8 months in Iraq.

It does result in some awful situations for him though, not least of which is the fact that the sperm sample which was frozen when he started treatment must be destroyed when he is only 30 years old. Nevertheless he is leading a very full life.

Submitted by 1905 (not verified) on Fri, 2008-02-01 09:01.

"It does result in some awful situations for him though, not least of which is the fact that the sperm sample which was frozen when he started treatment must be destroyed when he is only 30 years old."

Why? This seems harsh to me, given that many of us are putting off reproduction longer and longer.

Submitted by 1905 (not verified) on Fri, 2008-02-01 13:11.

It does seem harsh but it's what he has been told. I did question it when I heard that. Things may have moved on since then because I know at least in some parts of this country they are prepared to consider extending the time. I beleive the initial reason was that the quality of the sperm would decline too much.

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