Look out below

9th November 2001, 12:00am

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Look out below

https://www.tes.com/magazine/archive/look-out-below
Testicular cancer is the most common form of the disease among men between 15 and 40. But it needn’t be a killer, writes Harvey McGavin.

Blokes don’t like to admit to being ill. Even when they are unwell, they are less likely than women to visit their doctor. And when the part of them that’s poorly is such a sensitive part of the anatomy as their testicles, plenty might want to ignore the symptoms out of embarrassment and hope they go away.

Andrew Parkin, the 28-year-old head of music at a girls’ school in north London, is glad he didn’t. In February this year, he felt a dull ache and noticed what seemed like a swelling in his testicles. Basically, one of his balls hurt. After a few weeks he plucked up the courage to go to his (female) doctor, who prescribed a course of antibiotics, believing it was an infection that would clear up. But the pain didn’t go away. By the time of his second appointment six weeks later, his testicle had grown to the size of a golf ball. Andrew’s GP immediately referred him to hospital. “The next day they rang me at school and said, ‘Drop everything and come in immediately.’ By the end of that day they had made a diagnosis.”

Andrew was told he had testicular cancer. He immediately underwent a series of scans, blood tests and then surgery to remove one of his testicles. Luckily, the cancer had not spread and he breathed another sigh of relief when doctors told him he had a 96 per cent chance of making a full recovery. A debilitating session of chemotherapy followed. Now he has been given the all-clear but will need three-monthly check-ups for the next two years and ongoing monitoring for the next 10.

The suddenness of the diagnosis was traumatic. “There I was on Thursday morning right as rain and then this - looking back now it is almost a blur.” On balance, he feels lucky to have caught the disease so early rather than unlucky to have had it in the first place. Andrew’s mother, who had had breast cancer when he was a teenager, “helped a lot” and could empathise with what he was going through. He is one of only a few male teachers at the school, but he says “staff were very supportive” and his headteacher even accompanied him to hospital.

He has taken courage from the American cyclist Lance Armstrong’s autobiography, It’s Not About The Bike (Yellow Jersey Press, pound;8). Armstrong initially blamed the pain in his scrotum on endless hours spent in the saddle, and didn’t get it diagnosed until the cancer was at an advanced stage. The cancer had spread to his brain, and he was close to death, but, amazingly, made a full recovery and has gone on to win the Tour de France three times in a row.

The openness of Armstrong and other well-known figures, such as footballers Alan Stubbs, Jason Cundy and Neil Harris, snooker player Jimmy White and Grand National-winning jockey Bob Champion, has helped to raise awareness of the disease. And Andrew hopes publicising his case will encourage more young men to check themselves regularly and to seek medical help if they notice anything abnormal. “You’re not really aware of your testicles until somebody kicks you there in a football match, and then you think, ‘Oh God!’ But it can happen to you, and the test is so simple. If you’re worried, don’t delay, go to your doctor.

“Cancer is a scary word. But knowing more and having read more widely about the condition, I know it’s not as scary as many people think. The emotional side is very draining - you think, ‘What happens if it spreads? What’s the treatment going to be like?’ I’d never been to hospital for anything before, so that was a whole new experience. At the time I didn’t have the chance to think about it and dwell on it. Whereas now I think, ‘I’ve had cancer’, which is a funny thing to say, and something I never thought I would say.”

But his experience has had at least one beneficial effect already. Among his male friends, any reluctance to talk about their bodies has disappeared. “Guys usually never talk about illness of any sort,” he says. “But everybody wants to talk about it now.”

TESTICULAR TRENDS

* Symptoms: lump or enlargement of the testicle. Heavy or aching feeling. Sudden collection of fluid. Enlargement or tenderness in the breast.

* Testicular cancer is the most common cancer in men between the ages of 15 and 40, accounting for 1,700 new diagnoses a year. It can be successfully treated in 90 per cent of cases if detected early.

* There was an 80 per cent increase in the number of cases in the UK between the early 1970s and the early 1990s. The reason is unclear. It is four times more common in Caucasian than Afro-Caribbean men. Last year scientists identified a genetic cause for around 20 per cent of testicular cancer cases.

* Boys born with undescended testicles - cryptorchidism - are more likely to contract the disease, although corrective surgery can reduce the risk.

* There are two main types of testicular cancer. Teratomas are most virulent, accounting for 60 per cent of all cases, and are the predominant form of the disease among young men. Slower-growing seminomas are more often found in men between 30 and 50.

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