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Tuesday, January 19, 1999 Published at 12:15 GMT


Health

TV first for testicular check

This Morning became the first programme to show the cancer check

This Morning has become the first television programme to show men how to check themselves for testicular cancer - the most common cancer in young men.

Alan Reeves agreed to go before the cameras to raise awareness about testicular cancer.

Just before This Morning's GP Dr Chris Steele demonstrated the check, Richard Madeley announced that it had been cleared with the Independent Television Commission.

ITC guidelines state that genitalia should not be shown on screen unless it is for "responsible medical reasons".

Viewers were told that checks should ideally be done after a hot bath or shower because the testicles then hang down to cool.

To do the test, a man should:

  • Stand in front of a mirror and look at his testicles to spot any changes. The left side should hang slightly lower than the right;
  • The man should hold the scrotum and test for any weight changes;
  • He should then put his fingers behind the left side and his thumb in front and start feeling the skin on the front and side, where the cancer is most likely to be found. The back and top of the scrotum is likely to feel very irregular. This is normal;
  • The man should then go through the same process on the right side of the scrotum.

One symptom of cancer is finding a lump in the testicles. This is normally pea-sized, but may grow as big as an egg.

Other symptoms include any enlargement or significant shrinking of a testicle, a feeling of heaviness in the scrotum, a dull ache in the lower abdomen or in the groin, a sudden collection of fluid in the scrotum, pain or discomfort in a testicle or in the scrotum and enlargement or tenderness in the breast area.

Many of these symptoms are present in other conditions so they are not sure indicators of cancer, but should prompt a visit to the doctor.

About half of all cases are in men under 35 years old and prevalence has doubled in the last 20 years with 125 men a year dying from the disease.

However, the cancer is almost always curable if caught early.

But men's ignorance about checking themselves and their reluctance to go to the doctor means many do not take action in the early stages.

Different forms

There are several different forms of testicular tumours.

The most common are seminomas and nonseminomas.

Seminomas account for about 40% of all testicular cancer. Usually, seminomas are slow-growing and tend not to spread quickly.

Nonseminomas tend to be more aggressive than seminomas and are much more likely to spread.

When testicular cancer is first diagnosed, doctors will check to see if it has spread to other parts of the body via the lymphatic system.

There are three stages of testicular cancer: the first stage involved cancer which is only found in the testicle; the second involves cancer which has spread to the lymph nodes and the third, and most serious, concerns cancer which has spread to other organs in the body.

Survival rate

The survival rate for men with early stage seminoma is approximately 97%.

For people with nonseminoma type cancers the survival rate depends on which stage the cancer is caught at and treated.

For stage on cancer the survival rate is nearly 99%, but for stage two it is 87% and for stage three 57%.

No-one is really sure what causes testicular cancer, which accounts for only 1% of all cancers in American men.

Some men are, however, thought to be more at risk, including those whose testicles have not dropped into the scrotum.

Exposure to pollution may also be a factor.

Treatment

Treatment depends on whether the cancer has spread.

It can be treated with surgery, radiation therapy, chemotherapy and regular monitoring.

One method or a combination of methods may be used.

Through surgery, the testicle and sometimes infected lymph nodes are removed.

Radiation therapy targets high-energy rays at the cancer to stop it growing.

Seminomas are highly sensitive to radiation, but nonseminomas are not. Patients with this type of cancer usually have other types of treatment, such as surgery and/or chemotherapy.

There are side effects linked to treatment.

Many men worry that losing one testicle will affect their ability to have sexual intercourse or make them sterile. But a man with one healthy testicle can still have a normal erection and produce sperm.

Men can also have an artificial testicle, called a prosthesis, placed in the scrotum.

Surgery to remove the lymph nodes does not change a man's ability to have an erection or an orgasm, but the operation can cause sterility because it may interfere with the nerves involved in ejaculation.



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