Today marks the beginning of an awareness month you might not have heard much about -- testicular cancer.
Testicular cancer is a relatively rare disease. In most of the western world, this cancer accounts for around one percent of cancer diagnosis in men, however it remains the most common cancer in boys and men aged 15 - 40 (except for Australia, where the incidence of testicular cancer in this age group is second only to skin cancers).
Treated early, the survival rate is exceptional compared to other cancers -- better than 95 percent for much of the world. However, incidence is on the increase -- the disease is twice as prevalent now as it was 50 years ago. Here in Australia, around 800 men are expected to be diagnosed with a testicular cancer in 2016. That's around two men every day.
In many circles, testicular cancer is referred to as a great success story in modern-day oncology. This is certainly true when you look at just the statistics, and certainly no one would wish for a different scenario given that the vast majority of patients treated for the disease survive.
However, this only paints part of the picture. Effectively and completely removing cancer from a patient's body does prevent them from dying of the disease, however the impact of this treatment can be significant and also long lasting. There is evidence that men who are treated for testicular cancer suffer long-term physical and psychological distress as a result of the chemotherapy treatment oncologists use to kill the cancer cells.
One of the biggest problems in determining just how big this issue is, is that methods we use to measure psychological distress were developed to either measure other cancers, or specifically for women (most commonly those with breast cancer). Many of these tools are simply not relevant to testicular cancer patients, or the aspects of the disease that are the most concerning for men travelling the cancer journey aren't actually measured at all.
Testicular cancer is also unique in that for a disease which has great survival statistics, there is often very little time for men to effectively digest and understand their treatment options before these treatments commence. We hear stories time and time again that the period between sitting in a urologist's office and being told you have cancer to being in the operating room having a testicle removed is measured in hours, not days.
When time is limited, it is critical to have access to sensible, relevant and evidence-based advice for these men.
Testicular cancer is a relatively poorly understood cancer. There is currently no simple or accurate way to determine who will be cured of the disease and who won't. To beat this disease, we need to better understand the biology of testicular cancer and, in particular, understand how, when and why men relapse.
We also need to better support men through the long-term physical side-effects of treatment. Men who have had chemotherapy or radiotherapy are at a higher risk of further cancers, a higher risk of heart disease and other neurologic, kidney and fertility disturbances later in life. Many of these risks can be minimised with good medical management, but there needs to be a concerted effort to better understand these long-term risks and the ways that they can be mitigated.
Evidence is also emerging that there is a unique set of long-term psychological impacts on being labelled as a testicular cancer survivor. With survival comes living with the impact of the cancer -- men with testicular cancer face long-term effects such as fear of recurrence (the cancer coming back), questions about fertility and masculinity as well as struggles with ordinary life tasks such as being able to find employment, health insurance, partners etc.
Given the disease strikes men most often between the ages of 15 and 40, men who are treated for this disease are already on a journey of self-discovery; in many cases, they haven't yet met a life partner or even contemplated having children.
During April, the Movember Foundation, the number-one global funder of testicular cancer programs, is encouraging men and boys to get to "Know thy Nuts" this Testicular Cancer Awareness Month.
All men -- from their teenage years onwards -- need to know what feels normal and seek the advice of a doctor if something doesn't feel right with either of their testes. Beating this cancer relies on early detection. If caught early, the disease is ultimately treatable and the notion of a world where no man need die of testicular cancer inches ever closer.
So what are you waiting for, guys? Next time you're in the shower, acquaint yourself with what feels normal downstairs. You never know -- it might just save your life.Suggest a correction