ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, October 15, 1996 TAG: 9610150069
SECTION: EXTRA PAGE: 1 EDITION: METRO
COLUMN: HEALTH NOTES
SOURCE: SANDRA BROWN KELLY
Champion U.S. cyclist Lance Armstrong has done other young men a huge favor by talking candidly about the cancer that began in his testicles and has spread to his lungs and stomach.
The 25-year-old is a two-time Tour de France stage winner and two-time Tour DuPont title winner, in tremendous physical shape and really aware of his body's potential in cycling.
But he wasn't enough aware of his body, he now says.
Armstrong says he had an enlarged testicle for years, but never thought anything about it. But he began spitting up blood one day and saw a doctor. The blood was a sign that the cancer had spread.
Armstrong had one testicle removed and then began 12 weeks of chemotherapy a week ago. He likely will need more surgery and chemotherapy after the 12 weeks. The prognosis is excellent because advanced testicular cancer generally responds to treatment.
However, testicular cancer, like breast cancer, is more easily cured if found in its early stages. Males need to be taught how to examine their testicles, and then they need to do it regularly.
But how do guys learn the importance of this self-exam, especially since it needs to become a routine when they're quite young and sometimes still uncomfortable about their entire bodies, especially their sex organs?
Testicular cancer is the most common type of cancer for men ages 15 to 35.
I asked three young male co-workers if their doctors, or anyone, ever told them they should regularly check their testicles for lumps. Two said no one "EVER" mentioned it to them. The other said, yes, a family doctor encouraged him to do the exam.
Then a fourth, slightly older co-worker overheard the conversation and said, "Ask me about it. I just had a lump checked."
His family doctor felt a lump in one testicle, told him it likely was nothing, but referred him to a urologist for further testing.
The specialist was able to reassure the man that the lump was a water-filled cyst that wouldn't do any harm. But my co-worker said the days of waiting until he got that diagnosis were anxious ones.
Four guys is not a large survey, but I'm willing to bet that these men are representative of the young male population. Most young men don't know they should do the exam and therefore don't do it.
Armstrong would agree.
He compared the issue of testicular cancer to women's attitudes toward breast cancer 10 to 15 years ago.
"Men don't want to talk about testicular cancer. It's a private part of their body. Men don't want to talk about examining their testicles," Armstrong said. "But I'm here to tell you if I had done it five years ago, I wouldn't be in this position."
Armstrong is now campaigning to make men more aware of the need for self-examination.
Testicular cancer, more common in white males, is rare and rarely fatal.
The cause is unknown, but there are many father-son cases. Also, men with fertility problems are slightly more at risk for testicular tumors, and men who as boys had undescended testicles appear to have a higher risk, according to Time-Life's The Medical Adviser reference book.
Ironically, men who exercise regularly are less prone to the disease, but we know they can get it, because Armstrong did.
The signs of testicular cancer are a change in size or shape of a testicle; swelling or thickening of the testicles; a firm, smooth, initially painless, slow-growing lump in a testicle; or a feeling of testicular heaviness.
Other symptoms, according to the reference book, are urinary problems; abdominal pain; persistent coughing, sometimes with blood-tinged sputum; shortness of breath; loss of weight; fatigue; lower-back pain; tenderness in the nipples; or breast enlargement.
The self-exam takes about three minutes to do, and here's how it should be done.
A good time to perform the examination is after a warm bath or shower because the scrotal sac is most relaxed then.
Using both hands, roll each testicle gently between the thumbs and index fingers. If you find any lumps, see your doctor. Painless lumps or swelling may signal cancer.
Once you're at the doctor's, he likely will give you antibiotics to see if the swollen area or lump disappears. The doctor might also order ultrasound imaging and chemical analyses of urine and blood to narrow the cause.
If cancer is suspected, the testicle is surgically removed so that a biopsy can be performed. Losing a testicle does not mean a loss of sexual ability nor necessarily the loss of the capability of fathering a child.
If cancer is found, additional surgery usually is done to remove nearby lymph nodes. If the cancer is advanced - as with Armstrong - chemotherapy and sometimes radiation are recommended.
Remember, three minutes a month is all the time it takes. That's less than the time it takes to shave.
- You can reach Sandra Brown Kelly at (800)346-1234, ext. 393, or a 981-3393, or through biznews@roanoke.infi.net
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