Movember is an annual event in November which starts with a simple idea of growing a moustache to raise awareness of cancers affecting men.

In the past, the Movember Foundation has been involved in charity events, aiming at changing “the face of men’s health”, literally.

The awareness campaign has been focusing on discussions for men to come forward for early cancer detection, diagnosis and effective treatment, mainly prostate and testicular cancers.

Besides annual check-ups, the campaign also encourages men to adopt a healthier lifestyle and raise mental health issues affecting them.

Ultimately, the goal is to increase the quality of life in men and reduce the number of preventable deaths.

Here I address the concerns of a young chap on testicular cancer, and how to self-examine your own balls.

Dear Dr G,

I am Joshua and I am 23 years old, and hope you can help me with some concerns regarding my balls.

I have this embarrassing problem that my testicle is smaller on the left, but feels heavier and more uncomfortable on that side.

You often mentioned about the importance of self-examination, can you describe how it is done? (As detailed as you can anyway!)

I have concerns about testicular cancer, as my uncle suffered from it when he was 25 years old. My uncle said he was fit and healthy and was convinced this was caused by excessive exercise.

I also noticed many celebrities who suffered from testicular cancers are athletes; is there a link between being an athlete and testicular cancer.

Finally, how do I prevent testicular cancer?

Thanks for your effort.

Regards

Joshua.

Testicular cancer is the cancer that develops in the male sexual reproductive organ. It is not a very common cancer, but the incidence is increasing in the past few decades.

Despite being the “most curable” cancers, globally testicular cancer resulted in 8,300 deaths in 2013, up from 7,000 deaths two decades ago.

The worldwide prevalence of testicular cancer is rising, and the exact reason is unknown.

In the US, about 8,000 cases of testicular cancers are diagnosed and 2,000 in the UK. This translates to a lifetime risk of one in 200, or about 0.5% in all men.

The bad news is, testicular cancers almost exclusively affect young men, aged 20 to 40 years old; the good news is the cure rate can be as high as 99%, especially in those who had the cancer detected in early stages.

In recent years, many celebrities have come forward and participated in the testicular cancer awareness campaigns.

Perhaps the most vocal and famous testicular cancer survivor is Lance Armstrong. Regardless of your opinions about Armstrong’s doping scandals, despite the spread of his testicular cancer to the brain and lungs, he lived to tell the tale of achieving so much in life.

Above all, spreading the word about male cancers and providing hope for those confronting the disease.

Interestingly, most of the other celebrities coming forward are almost exclusively sporting legends. However, I can assure you, the disease does not just strike the fit and healthy.

The other sporting personalities affected by testicular cancers include Jason Cundy (English football legend), Tony Marsh (Kiwi-born French rugby player) and Eric Shanteau (American Olympian Swimmer).

All these sportsmen have recovered from the cancer and live normal lives with normal sexual and reproductive functions.

Above all, they have courage in helping men to be active in self-examination and prevention.

In reality, there is no prevention for testicular cancer. Many clinicians advocate self-examination to identify testicular cancer at its early stages. This raise the question of how do you “examine your own balls”?

First of all, we recommend the best condition to examine your own balls is after a warm bath or shower. The heat usually relaxes the scrotum making it easier to identify any abnormal structure.

To examine properly, it is useful to do it in front of a mirror (remember to lock the door). Look for any swelling on the scrotal skin, it is not unusual to detect the left testicle is lower and heavier than the right.

But in reality, the left side is marginally smaller is size. Then, place the index and the middle fingers under the testicle, while placing the thumb on the top. This is will help to stabilise and fixes the testicle for ease of examination.

Gently roll the testicle between the thumb and fingers. The normal texture of the testicle is oval-shaped, feels smooth and firm.

There is a cord leading upwards from the top of the testicle, this is a normal part of the testicle, called epididymis. This structure is like an ear lobe attached to the testicle that stores matured sperms.

Like most clinicians, Dr G recommends fortnightly testicular self-examinations. Of course, some men may argue more frequent intimate familiarisation with their crown jewels is mandatory.

There is really no “hard and fast” rule for the intervals of testicular examination.

The most important rule is to detect changes that might be of concern, and seek immediate medical attention if necessary.

Finally, wishing all men Happy Movember and happy self-examining!

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