No man thinks this can happen to him, but could this be testicular cancer?
Testicular Cancer is the most common malignancy (aka cancer) in men of ages 15-34; and is responsible for approximately 1% of all cancers in men. It is estimated that roughly 8,500 new cases of Testicular Cancer will be diagnosed in men this year; and close to 400 men will die of the disease this year. This disease does have an ethnic predisposition, with much higher rates occurring in Caucasian populations. Other associated risk factors for Testicular cancer are a family history of testicular cancer, gonadal dysgenesis, Klinefelter Syndrome, and an up to seventeen times the average risk in men with cyptorchidism (a testicle that has not descended into the scrotum).
The patient first detects most Testicular cancers, either by monthly self-exam or unintentionally by some other way. However, no medical studies have been performed to determine the effectiveness of testicular self-examination or clinical exam performed by a physician in reducing testicular cancer mortality. This may be due to the fact that Testicular cancer is one of the few cancers with a high Cure rate. Approximately 99% of patients will be Cured if they have their disease contained only to the testicle. The percentage drops to 96% cure rate if the cancer has spread to other lymph nodes in the groin or abdomen; and drops to 73% if cancer has spread further then previously stated.
Testicular Cancer is usually found as a nodule, which feels like a lump, or as a painless swelling, or enlargement, of the testicle. Occasionally there can be the sensation of a dull ache or heaviness in the lower abdomen or scrotum. Rarely, approximately 10% of the time, acute pain can be present.
As this condition affects primarily young males, can the preparticipation sports physical exam (PPE) be a way to help detect testicular cancer in this population? This may be a beneficial portion of the PPE and general medical education as many young male athletes are unaware that this testicular disease affects their age group and even why the testicular examination is performed. According to an Australian study most young men utilize the masculine frame reference of stoicism and avoidance; which could become a barrier to this age group performing a testicular self-exam or even to them visiting a physician if a concern has arose.
Few studies have been conducted on this topic, but a study in the Journal of Athletic Training did examine the role of athletic trainers as health care advocates for testicular self-examinations. It was discovered that approximately 51% of athletic trainers had reported that a male athlete had discussed with them about a testicular concern. However, only 13% of athletic trainers were educating their athletes about cancer; and this is despite the fact that almost 30% of athletic trainers had worked with an athlete who had some form of cancer.
This shows that the PPE for young males can provide a benefit for their overall health. This is an opportunity to examine a patient to ensure their health and also provide the setting for a health care provider to educate males about their health. It can also serve as an opportunity for a young male patient and a health care provider to establish a relationship that can harbor a trusting, non-judgmental environment for a young male to voice any concerns.
If you, or a loved one, have questions or concerns about testicular health, or general overall health, please schedule an appointment with Dr. David Carfagno to discuss your concerns.
Chase King, MS-IV
David Carfagno, D.O., C.A.Q.S.M.
American Cancer Society. "Testicular Cancer Survival Rates." <i>Testicular Cancer Survival Rates</i>. N.p., 20 Jan. 2015. Web.
Congeni, Joseph, Stephen F. Miller, and Cynthia L. Bennett. "Awareness of Genital Health in Young Male Athletes." <i>Clinical Journal of Sport Medicine</i> 15.1 (2005): 22-26. Web.
Dewald, Lori, EdD, ATC, CHES, and Candice Zientek, PhD, CCAAASP. "A Survey of Athletic Trainers as Health Care Advocates for Testicular and Breast Self-Examination in Athletic Populations." <i>Journal of Athletic Training</i> (1996): 19-22. Web.
NIH National Cancer Institute. "Testicular Cancer Screening." <i>National Cancer Institute</i>. N.p., n.d. Web.
Singleton, Andrew. ""It's Because of the Invincibility Thing": Young Men, Masculinity, and Testicular Cancer." <i>International Journal of Men's Health</i> 7.1 (2008): 40-58. Web.
Steele, Graeme, MBBCh, FCS, Jerome Richie, MD, FACS, William Oh, MD, and M. Dror Michaelson, MD, PhD. "Clinical Manifestations, Diagnosis, and Staging of Testicular Germ Cell Tumors." UpToDate, n.d. Web.
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