My article from The Times published 30.7.2013 – the original can be found here (£) : http://www.thetimes.co.uk/tto/health/dr-mark-porter/article3828940.ece
“What a load of balls” was my first thought on hearing the news that testicular cancer survival rates are “soaring” – the implicit suggestion being that we have cracked the problem thanks to breakthroughs like new drugs and awareness campaigns encouraging men to check themselves. Actually, nothing could be farther from the truth.
Let me be clear; I dread testicular cancer as much as the next man and I am not belittling the disease. But it is nowhere near as big a threat as most men think. And we have had it licked for some time.
According to the latest statistics (2010) more men in the UK die from breast cancer than from cancer of the testicle. Testicular cancer isn’t rare, but neither is it particularly common with the average British bloke having a 1 in 200 chance of developing it at some stage during his life.
But what about the much vaunted improvements in survival rates – are they really “soaring” as reported by some in the media yesterday? Over 95% of men diagnosed with testicular cancer will now be cured, compared to just 67% in the early seventies, but a closer look at the trends reveals that, far from soaring, survival rates have actually plateaued.
They have been 90% or more ever since I qualified in the mid-eighties, and there has been no major improvement over the last decade. Hardly surprising given that the single biggest breakthrough in treatment – the chemotherapy drug cisplatin – was launched back in 1978.
Indeed the rate of improvement in testicular cancer has actually lagged behind some other more common cancers. While men today may have a 40% higher chance of surviving the disease than their equivalents in the seventies, there has been a 60% increase in breast cancer survival rates in women over the same period.
But so what if campaigners over egg the pudding? One could argue that there is no such thing as bad publicity when it comes to cancer, or that you can never do too much to boost awareness. The obvious upside being that if every man in the UK is concerned about lumps in his testicle, the unlucky minority who develop a problem are likely to spot it earlier, seek help quicker and have a greater chance of beating the disease as a result. And that is true, but there are downsides.
First, there are more important things that men should be worrying about. Men’s health campaigners often focus on prostates and testicles because that is what differentiates us from women, but it is the bits we share – our hearts, brains, waistbands and lifestyles – that are much more likely to kill or maim us.
Second, like the boy who cried wolf, if we resort to hyperbole and exaggerate the threat to public health, then we are likely to be ignored when we highlight something that is really important.
And, last, although public health education has to use some scare tactics to get the message across, the worry created can exact a toll on individual health, and consume a disproportionate amount of NHS resources. In 25 years of clinical practice I must have examined hundreds, if not thousands of anxious men’s testicles, but I have only had one that turned out to be testicular cancer. And the average GP is unlikely to see more than two or three cases in their entire career.
Please don’t ignore your testicles. Check them every so often in the bath or shower and make sure you report any changes promptly to your doctor – particularly if you have a family history of testicular cancer (see below). But don’t get the risk out of proportion. Or, to put it another way, a breast lump in a man is likely to be more sinister than a lump in his scrotum, but how many men check their breasts?
For more information on self-examination and the diagnosis and treatment of cancer of the testicle is at www.cancerresearchuk.org
• Most cases of cancer of the testicle occur in younger men under the age of 45, but it can strike later in life too. Men with undescended testicles, or those with a family history of the condition are most at risk
• The first sign is usually a small hard lump, or generalised swelling of one of the testicles. Pain is less common
• Most lumps in the scrotum tend to be non-cancerous and nothing to worry about