By Dr. Michael J Rovito
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The following post is paraphrased from one of my recent guest lectures. It sparked enormous debate and I was very pleased to see college students taking the initiative to discuss their health among peers. Although the topic was testicular cancer and testicular self-examination, I told the females in the class to parallel the discussion to breast cancer and breast self-examination.

…and so the lecture/discussion began:

Would you rather feel a strange bump on your testicle, get anxious and worried, make an appointment (still stressed out, mind you), go to your physician and have him/her perform a manual examination on your testicles and have them tell you it’s nothing (a false positive), or would you rather not even think about your testicular health and not screen yourself, or get screened, for cancer? Let’s face it, statistically you have a very slim chance of developing the disease so why would you even worry yourself over something that could be absolutely nothing?

Perhaps for false positive cases a trip to the physician might cost you a co-pay and your insurance company a couple hundred dollars for the 30 minute visit. But as long as you do not have cancer, all is good. Right? On the other hand, what if you did not perform regular testicular self-examinations or, if you did, you did not perform it thoroughly? Perhaps you may have missed something. You would think you don’t have cancer as you feel no lumps. Maybe even you refuse to realize you are vulnerable and therefore have no reason to perform self-screening. But again, what if you actually do have the disease but you believe that you don’t (false negative)?

So back to the original question, would you rather have some anxiety and worry about whether or not you have cancer because you felt a lump on your testicle erroneously or would you rather ignore or misperceive possible symptoms (lumps, heaviness in the groin, etc) and believe you do not have testicular cancer when actually you do?

…after some initial reactions from the students, I continued:

Testicular is nicknamed the “hurricane cancer” for a reason. The tumor usually doubles in size over the course of a few weeks. So the answer to your question should be pretty clear. You would probably want to be a bit more involved with your bodily health and understand what the warning signs are for the disease. If you look at Lance Armstrong’s situation, all signs and symptoms were not paid proper homage. When he was diagnosed with testicular cancer, it was already metastasized to his lungs and brain. He was only given approximately a 40 to 50% chance of survival. If you catch testicular cancer in its early stages, your chance of recovery is 99%. Do the math.

…again, more debate followed. At this point I was surprised at the passionate exchange of ideas. Perhaps traditional barriers of modesty and embarrassment to discuss such topics among not only other men, but females as well (and vice versa), are being eroded. I concluded with the following:

Men need to understand their health is indeed at risk. Under no circumstances should a man be uninformed of what those risks are and what he can do to limit them. Although risks rise and fall with certain demographic variables, generally a man should understand his body and how to achieve and maintain healthiness. Just because you are a man does not give you a free pass to get out of unhealthy situations. In fact, the traditional societal roles imposed onto men can indeed put them more at risk. You’re a human. You are going to get sick at some point in your life. Some people more than others. However, you have the power to help shape your health outcomes. So if the question of whether you would prefer a false positive or false negative (in the case of testicular cancer), you would probably rather be more safe than sorry.

…I left the discussion pleased. Maybe students are being more efficacious with their health and well-being. That’s indeed something positive to hear amidst the endless stream of bad news we experience every day from our cable news channels, particularly what’s been going on in the Gulf of Mexico and Afghanistan.

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Blurb about today’s Guest Blogger:

Michael J Rovito received his M.A. in Geography and Ph.D. in Public Health from Temple University in Philadelphia. Michael currently is an Assistant Professor of Public Health at Temple University. His research specializes in health behavior change, men’s health, and audience segmentation. His most recent research developed the “Control Identity” Personality Typology that aims to assist health education and intervention efforts for tailoring messaging strategies. Michael is a Fellow of the Foundation for Informed Medical Decision Making, the Albert Schweitzer Foundation, and the Information Technology in Society Research Group. His interests include military and World War II history, outdoor sports, and political strategy.

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By Adam Dougherty, MPH

Great news for individuals suffering from prostate cancer and men’s health advocates everywhere, as this week the FDA-approved a new treatment for men with the advanced stage of the disease. The vaccine, called Provenge, is not a traditional preventive cancer vaccine (such as those for cervical cancer), but rather boosts the patient’s immune system to combat the already-diagnosed disease. The immunotherapy is derived from the patient’s own white blood cells, where antibodies are tailored to attack the tumor cells.

The drug is more effective and has fewer side effects than chemotherapy, the common course of action for these cancer patients. According to the National Cancer Institute, about 27,000 men died from the disease in 2009. The drug will soon be available to about 2,000 patients at 50 centers that were previously designated as Provenge clinical trial sites, with increased capacity over the next year. The vaccine is the first product approved by Dendreon Company, which hopes to use the same technique in the future for other diseases like bladder cancer.

As the second most common cancer in men with nearly 192,000 diagnoses in 2009, early detection and appropriate treatment are paramount in the fight against the disease (see our March 22, 2010 post by Ramon Llamas for a commentary on the recent developments in PSA screening). We will continue to monitor and promote advances in research and development, in order to sustain a national dialogue aimed at improving the wellbeing of men and their families.

For Provenge’s press release, click here to read the PDF.

What’s your thoughts about the new FDA-approved treatment for men?

by Brandon Leonard

This past weekend, the Prostate Cancer Research Institute held its annual conference in Los Angeles, hosting over a dozen experts on prostate health and 600 participants.  According to PCRI volunteers, the purpose of the conference is to provide an avenue for those with prostate cancer and their loved ones to get more information about managing the disease.  The theme of this year’s event was “Making a Positive Impact on Quality of Life,” and among the topics discussed were the benefits and pitfalls of interventions such as chemotherapy, radiation, surgery, and hormone therapy.  Understanding effective diet choices and dealing with erectile dysfunction as a consequence of certain treatment options were also highlights of the agenda.  Throughout the weekend, attendees were encouraged to ask specific questions of the speakers. 

It was also evident that this conference is a gathering place for support, where old friends and new ones have come to share their stories with each other – sometimes just to talk to someone who understands, and sometimes to share information that may be useful to another.  Many of these men have joined support groups in their own communities and have been strengthened by the understanding that they do not need to go through this alone.  Indeed, this is one of the big issues that men suffering from prostate cancer – and other health issues – must overcome.  We are not trained to seek help, but to solve problems in isolation.  On the other hand, drawing on the resources, knowledge and care of others – whether they be friends, family, medical professionals or those who simply understand what we are going through – is what gets both men and women through their most difficult health and life challenges.

Not coincidentally, the PCRI conference is held during September, Prostate Cancer Awareness Month.  One of the big messages I heard from those who stopped at the MHN table during this event was that men need to start thinking about their prostate health – and their health in general – at a much earlier age than they do now.  One of our goals in educating men about their health must be to reach them with effective information and support, early and often, so that these messages stay with them as they mature. 

Those present at the event are certainly doing their best to get these messages across.  Since its founding in 1998, PCRI has contributed to a significant increase in the number of doctors involved in prostate cancer research, as well as public education about the disease.  The organization offers a quarterly newsletter with new developments in prostate cancer research, as well as a helpline for patients who need some support finding the right resources.  Their website, which includes a wealth of information about prostate cancer, can be found at http://www.prostate-cancer.org/. 

I came across a very interesting article given to me by a co-worker which shows how cancer funding is distributed. I was very surprised with its contents. Prostate cancer, which is the most common cancer by tens of thousands of people, is given the LEAST amount of funding per every new case. I believe the National Cancer Institute needs to revaluate how it allocates its money and perhaps focus more on a cancer that affects so many men and their families and has such a high rate of curability.

Click here to read the article.

“Men’s health care showing disparity” – The San Diego Union Tribune

“Center starts program to help men stay healthy” – Washington Square News

“Study: 1 Out of 4 Homeless Are Veterans” – New York Times

“In Tests, AIDS Vaccine Seemed to Increase Risk” – New York Times

“Causes of Death Are Linked to a Person’s Weight” – New York Times

“I Just Couldn’t Sacrifice My Son”, By David Nicholson (registration required)
- Update, my colleague Malia at Boys and Schools has written a great post about this story.

Low testosterone in men linked to earlier death

Smoking linked to teen alcohol and drug use

Men need children more than women according to study (found via – That’s Fit)

Net Giants test web Health