by Norma Erickson

If that exclamation is unfamiliar to you, then you are probably an American who has not been streaming a lot of British telly during the recent months. In the UK, bollocks are a vulgar term for testicles. The word is frequently used as an expletive when something is deemed ‘utter nonsense’ or fraudulently exaggerated. Americans use the word ‘bull!’ in the same capacity. It seems somewhat paradoxical that prim and proper Brits would use a more earthy description than the free-wheeling Americans. But, of course, a bull isn’t a bull without the bollocks, right?

Image: Cells from a testicular specimen.

All this talk of testicles reminds us that June is Men’s Health month and concern over testicular cancer (TC) rightly brings out advocates for men’s self-checks and frank conversations with their physicians. While TC remains a rare form of cancer, as cancers go, it is still the leading form of malignancy for men between the ages of 20-40. The good news—it is a highly treatable disease. There is a 95% survival rate after five years.  The American Society of Clinical Oncologists estimates 1 out of 250 men and boys will be diagnosed in their lifetime. The bad news—half of men with it don’t seek treatment until it has spread to other parts of the body. Guys---you really need to get on this.

The reason for the good news of the successful recovery rate is actually a bit of Indiana’s medical history, thanks to the dedicated work of two outstanding physicians at Indiana University School of Medicine—the oncologist Lawence H. Einhorn and the urologic surgeon John Donohue. Together, their efforts rocketed the survival rate from 5% in the early 1970s to 95%. Dr. Thomas Ulbright, of the IU School of Medicine’s Department of Pathology and Laboratory Medicine, is a world-renowned pathologist in the area of diagnosis of testicular cancer. He says that even with good treatment, there are still patients who die of the disease, mainly because they present with advanced stage disease—tumors the size of a baseball or softball that have metastasized to other organs. Guys, you have to do your part—early detection, right?  Early detection begins with self-examinations.

How can men be motivated to do better in this regard? Currently, there is a “Three Fs” approach:

1) Fear— Although 95% overall survivability is great, not letting it get out of hand is better. Besides the effects that might include gynecomastia (breast enlargement) and sexual problems, did you know it can affect the brain? There’s a serious related disease that affects some with TC called "testicular cancer-associated paraneoplastic encephalitis”.  These patients experience progressive loss of control of their limbs, eye movements, and sometimes, even their speech. So the earlier detected the better. Often these neurological issues regress with simple excision of the tumor-bearing testis, but again time is of the essence.

2) Fun- Catchy slogans to take away the squeamish idea of self-checks. There’s the Australian Movember website with its ‘know thy nuts’ campaign. The BaggyTrouserUK charity in England and Wales that challenges to “have the guts to check your nuts”. In Brazil, there is the mascot Mr. Testicle that seems to be what is under those square pants of SpongeBob’s.

3) Fandom—Celebrity spokespersons help the cause. Often, sports personalities draw attention. Before his doping confession, Tour de France champion Lance Armstrong, a former patient of Dr. Einhorn’s, was front and center as THE success story of beating the disease.  The #FafChallenge features the Springbok Rugby team posing in Speedos sporting the South African flag, in an effort to remove the stigma of self-examination. Note: the website has a strange video testimonial made by “John’s left testicle”. From the entertainment world, Cahonas Scotland has received the support of the Starz Outlander TV series star Sam Heughan (a.k.a. Jamie Fraser—King of Men). Based on the romantic historical novels of Diana Gabaldon, the show’s viewer base is comprised of 50% men.  Besides his charitable donations through his My Peak Challenge fitness organization, he has also provided the voice-over for a testicular tutorial.

The procedure is outlined on many TC websites like https://testicularcancer.org/. Learn it for health, guys. And that’s no bull.

References:

https://www.cancer.net/cancer-types/testicular-cancer/statistics

https://newsnetwork.mayoclinic.org/discussion/scientists-discover-autoimmune-disease-associated-with-testicular-cancer/