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Time to get checked?
7:00am Saturday 2nd June 2012 in Health
While testicular cancer is usually curable with the right treatment, it has to be caught early. To herald the Everyman Male Cancer Awareness Month (June), cancer experts discuss the symptoms and advances in treatment.
By Lisa Salmon.
Cliched though it sounds, men are notoriously poor at addressing their own health problems, often optimistically assuming they'll just go away.
And while some symptoms do magically disappear, other male health problems will not go away - and if they're left alone, they could be fatal.
That's particularly the case with diseases such as prostate and testicular cancer, which are "rising dramatically", says the Institute of Cancer Research.
Prostate cancer, which usually occurs in men over 60, kills one man every hour in the UK, or 10,000 a year, and has overtaken lung cancer to become the most common cancer in men.
And while it doesn't kill as many, testicular cancer is the most common cancer in young men, and the incidence has more than doubled since 1975. It usually strikes males aged between 15-44, with 2,000 cases diagnosed in the UK each year, and around 90 men dying from it.
Yet testicular cancer has a 99% cure rate if caught early enough, which is one of the reasons why Men's Health Week (June 11-17) is stressing the importance of getting symptoms checked early, and the Institute of Cancer Research's (ICR) Everyman appeal has just launched a renewed funding call for research into male cancers.
ICR spokesperson Tatjana Trposka says: "The incidence of prostate and testicular cancers is rising dramatically, reinforcing the urgent need for more funding to carry out research.
"It's imperative that men recognise the likely symptoms and seek help immediately if they notice anything unusual."
Overcoming reluctance Peter Baker, chief executive of the Men's Health Forum, which runs Men's Health Week, says one of the problems with the early diagnosis of male cancers and "pretty much any other health issue that affects men", is that they're often reluctant to seek help.
"They do go to the doctor eventually, it just takes them longer and they tend to wait until they're in pain, or sure beyond doubt that they've got the health problem," he adds.
While Men's Health Week is encouraging men to adopt healthier lifestyles in general, Baker points out that as there's no obvious cause for prostate and testicular cancers. "There's not a lot you can do to stop yourself getting them," he says.
"All you can do is be on the lookout for the symptoms, and if you have any, get checked as soon as possible."
Past research by Everyman found that 41% of men who discovered a lump chose not to get it checked by a doctor, with 30% saying they hoped it would go away on its own.
Figures also showed that 46% of men don't check for changes in their testicles often enough, with one in five admitting to never checking for lumps.
Baker points out that as well as men's reluctance to seek medical help being related to the way they're brought up and not wanting to admit to vulnerability, working long hours can make it difficult to see a doctor. He says there's also not much health information available in the media for men.
Delays can kill With prostate cancer, he points out that men will often think potential symptoms are just a normal part of ageing.
"They tend to put up with it, and it's also embarrassing to go to the doctor with something like that - it's not a manly thing to admit to," he says.
In addition, there's an illogical fear of a positive diagnosis, says Baker, pointing out: "Men tend to think that they'd rather not know, and then they don't have to deal with it.
"It's certainly about fear, and perhaps they think the brave thing is to keep going as long as possible and be strong and stoical."
Such stoicism and delay can kill. The ICR points out that if prostate cancer is diagnosed early, and contained within the prostate, more than 90% of men will survive for five or more years. If the cancer is slow growing, there may be no treatment and the patient will be monitored with 'watchful waiting'.
However, if the cancer has spread, the proportion of men surviving beyond five years drops to 30%.
With testicular cancer, if it's caught early and hasn't spread, treatment will ordinarily be the surgical removal of the cancerous testicle. This prospect is actually something lots of men fear, but artificial (prosthetic) testicles can be surgically implanted, just as women who undergo a mastectomy may be offered implant replacements.
If diagnosis is late and the cancer has spread, this may be followed by chemotherapy, and a lower chance of survival.
Know the risks Dr Robert Huddart, who specialises in urological oncology for the ICR, admits medics don't know enough about what causes testicular cancer, or how to prevent it.
But known risk factors include having undescended testes at birth, and inherited genetic factors - having a father, brother or son who's had testicular cancer.
"If you have a brother affected with testicular cancer, you're up to 10 times more likely to also get the disease," says Dr Huddart.
"This risk is exceptionally high when compared to other cancer types."
As testicular cancer spread is much less likely if caught early, Dr Huddart advises: "Regular self-examination will help you become more aware of the normal feel and size of your testicles so that any abnormalities can be spotted early on."
Overall, the harsh truth is that men are more likely to develop cancer than women, and also more likely to die from the disease, says Jessica Harris, health information manager at Cancer Research UK.
"The exact reasons for this are unclear," she says. "But it may be related to levels of symptom awareness and whether they're willing to see the doctor."
Because early diagnosis means treatment is often easier and survival chances higher, she points out: "It's so important to talk to the doctor if you notice any unusual or persistent change in your body. It's easy to put changes down to getting older, explain them away or put off making an appointment, but it's really worth making time to get it checked out.
"The likelihood is it won't be cancer, but if it is, getting it diagnosed at an early stage can make all the difference to the outcome."
:: Treatment advances Since 1997, when the ICR launched the Everyman appeal for more research into prostate and testicular cancer, it has helped fund ground-breaking developments including discovering the prostate cancer drug abiraterone, which can extend the lives of late-stage prostate cancer sufferers by more than three months.
Last week it was announced that the drug is to be available on the NHS in England, Wales and Northern Ireland, although it won't be available in Scotland, as the Scottish Medicines Consortium turned the drug down, saying the cost didn't justify the health benefits.
Other recent treatment advances include the identification of numerous new genetic variants that increase a man's risk of developing prostate and testicular cancer, improvements in prostate cancer radiotherapy, and the development of the drug carboplatin, which has helped lead to the 99% cure rate for testicular cancer.
:: Prostate cancer symptoms Cancer Research UK stresses that very early prostate cancer usually doesn't cause any symptoms, as the tumour isn't big enough to put pressure on the tube that carries urine.
Symptoms include: :: Rushing to the toilet to pass urine.
:: Difficulty or pain in passing urine.
:: Passing urine more often than usual, especially at night.
:: Blood in the urine or semen, although pain and bleeding are rare in prostate cancer and are more often a symptom of non-cancerous prostate conditions.
:: Testicular cancer symptoms Cancer Research UK says possible signs of testicular cancer include: :: A lump in the testicle - although most testicular lumps aren't cancerous, and the charity estimates that fewer than four in every 100 are cancer.
:: A cancerous lump isn't usually painful, and can be as small as a pea, or may be much larger.
:: A dull ache in the affected testicle, or in the lower abdomen.
:: Heavy feeling in the scrotum.
:: Possible growth or tenderness of male breasts, due to hormones produced by the cancer.
:: Everyman has created a fundraising pack to encourage people to raise money for research into male cancers. To download the pack, visit www.everyman-appeal.org
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