Testicular cancer PSA

[BSR]

Here is a video demonstrating how to check for testicular cancer, a cancer that can strike men of any age. I'm sure all my fellow horndog forum members will click and watch in the interests of their health, and not because the sexy nude assistant has a helluva nice package :-D

 

http://video.channel125.com/V7yOwnPk

[+ dupontversDC]

That boy is HOT.

[Guest]

Cute video, but, for our younger, perhaps more impressionable viewers, I would like to point out that all major national health care authorities advise against testicular self-exam (harms outweigh the benefits).

Discussion

In 2004, the USPSTF reviewed the evidence for screening for testicular cancer and recommended against screening adolescent or adult males (3). In 2009, the USPSTF performed a brief literature review (4) and found no new evidence that would warrant a change in its recommendation. Therefore, the USPSTF reaffirms its recommendation against screening adolescent or adult males for testicular cancer by clinician examination or patient self-examination. The previous recommendation statement and evidence report, as well as the summary of the updated literature search, are available at http://www.uspreventiveservicestaskforce.org/uspstf/uspstest.htm (5).

 

Recommendations of Others

The American Academy of Family Physicians recommends against routine screening for testicular cancer in asymptomatic adolescent and adult males (6). The American Academy of Pediatrics does not include screening for testicular cancer in its recommendations for preventive health care (7). Finally, the American Cancer Society does not recommend testicular self-examination (8).

 

In other words, all you hot young escorts out there, if your doctor is fondling your genitals during a routine exam, he is following his own agenda, rather than following national guidelines...

http://www.uspreventiveservicestaskforce.org/uspstf10/testicular/testicuprs.htm

 

Also, another correction on the video is that blood in one's semen is NOT a sign of testicular cancer (nor is a urethral discharge or pain urinating--although you should see your doctor if you have one of these two symptoms).

[+ purplekow]

As though anything the American Cancer Society says will keep young men from fondling their balls.

There are organizations which do not suggest a routine exam but which do not suggest it not be done either. The American cancer society is concerned about excess unnecessary testing if there is a finding and the anxiety raised in patients. That is fine as a general rule, but for my dollar, it takes 30 seconds and is a low yield, high benefit exam with little tangible risk to the patient other than the above mentioned. There are plenty of other limitations i can get behind, this one, no.

And Unicorn I am sure your are aware that there are other conditions other than testicular cancer for which a routine exam is necessary. So, i suggest that all hot escorts encourage their doctors to fondle the genitalia but if he starts to lick them then you need to discuss rates.

As a general internist in my 30 or so years of experience, I have found three cases of testicular cancer that was not otherwise suspected and i can recall only one patient in which something was amiss and testing was ordered and it was not cancer, though there was less significant abnormality. I do not think of myself as a super diagnostician (I cannot help what others may say) so for men between the ages of 18 and 32 or so, I do a brief but thorough testicular exam prior to a hernia check. That would be part of a sports physical or school or employment exam and in NJ even the Commercial Drivers License test requires a hernia check, so on those exams as well.

[Diverdan]

The relatively young man who is the son of a good friend of mine discovered he had testicular cancer when he was 22, as a result of a self exam and then a trip to his Dr. He had the one testical removed and had sperm deposited in a sperm bank as he wanted children. He had the one testicle removed and there was no sign of any cancer in the other testicle. However, after anther six years passed, he was doing a self exam and noticed a small lump. Unfortunately that turned out to be cancer too, so he had to have the second testicle removed. Most major medical organizations like ACS, and others like it are much more concerned about unnecessary testing than they are about possible prevention IMHO. That conservative approach has influenced many to disregard having PSA screening. That too is unfortunate IMHO, as I know many who have had their lives saved by routine PSA tests that suggested a biopsy was needed, and in every case they had prostate cancer. So, my humble advise is to check things out, it is inexpensive and might save your life.

[Guest]

As though anything the American Cancer Society says will keep young men from fondling their balls.

There are organizations which do not suggest a routine exam but which do not suggest it not be done either. The American cancer society is concerned about excess unnecessary testing if there is a finding and the anxiety raised in patients. That is fine as a general rule, but for my dollar, it takes 30 seconds and is a low yield, high benefit exam with little tangible risk to the patient other than the above mentioned. There are plenty of other limitations i can get behind, this one, no.

And Unicorn I am sure your are aware that there are other conditions other than testicular cancer for which a routine exam is necessary. So, i suggest that all hot escorts encourage their doctors to fondle the genitalia but if he starts to lick them then you need to discuss rates.

As a general internist in my 30 or so years of experience, I have found three cases of testicular cancer that was not otherwise suspected and i can recall only one patient in which something was amiss and testing was ordered and it was not cancer, though there was less significant abnormality. I do not think of myself as a super diagnostician (I cannot help what others may say) so for men between the ages of 18 and 32 or so, I do a brief but thorough testicular exam prior to a hernia check. That would be part of a sports physical or school or employment exam and in NJ even the Commercial Drivers License test requires a hernia check, so on those exams as well.

 

Sorry, but I have to call BS on this one. As noted in the USPSTF website: "...with an annual incidence rate of 5.4 cases per 100,000 males, testicular cancer is relatively rare compared with other types of cancer." Already the claim of having found 3 by routine exam is highly dubious. First of all, as they state, "Most cases of testicular cancer are discovered accidentally by patients or their partners." Even if that were false, and all of your patients had theirs discovered by routine exam, one would expect someone who found 3 cases to have examined at least 50,000 men from 15 to 35. Most general internists don't see anywhere near that many different patients in their entire career (I'm not talking about the number of office visits, but the number of separate patients). And young men 15-35 are the least likely to go to the doctor. They usually constitute only a small fraction of most internists' office visits. When they do go, it's most often due to accidents (sports, auto, work), and in most of those cases it would be someone inappropriate to do a genital exam.

However, let's assume, for the sake of argument, that your practice does involve examining a large number of different men from 15-35. This might be possible, for instance, if you work for a university student health center, or for an STD clinic (although that's not exactly what I would call a general internist). And let's also assume that your having caught 3 cases is a statistical anomaly, which it would have to be. What is completely impossible is that in all that time there was only one time you found a "less significant abnormality." The overwhelming majority of lumps on testicles constitute benign, innocuous conditions such as cysts or spermatoceles. I review all urology referrals for our very large health care system (over 100,000 patients), and the vast majority of testicular lumps are benign (although, of course, some are cancer). In my own practice, I have found a number of lumps (as have my patients), and have sent many patients for ultrasounds, but have yet to catch my single first cancer by routine exam.

So, sorry, but the claim of having found 3 testicular cancers by routine exam is highly dubious, and the claim of having found only one benign condition during that time simply not possible.

[+ purplekow]

Well Unicorn I see no reason to continue this discussion as you hae decided that I am lying and you are all knowing. Would it be against the odds that two of these were on one day, yes it would be, but that is also true. Have a pleasant day up there on Mt. Olympus.

[Guest]

The relatively young man who is the son of a good friend of mine discovered he had testicular cancer when he was 22, as a result of a self exam and then a trip to his Dr. He had the one testical removed and had sperm deposited in a sperm bank as he wanted children. He had the one testicle removed and there was no sign of any cancer in the other testicle. However, after anther six years passed, he was doing a self exam and noticed a small lump. Unfortunately that turned out to be cancer too, so he had to have the second testicle removed. Most major medical organizations like ACS, and others like it are much more concerned about unnecessary testing than they are about possible prevention IMHO. That conservative approach has influenced many to disregard having PSA screening. That too is unfortunate IMHO, as I know many who have had their lives saved by routine PSA tests that suggested a biopsy was needed, and in every case they had prostate cancer. So, my humble advise is to check things out, it is inexpensive and might save your life.

 

Well, I agree with you to a certain point, at least when it comes to testicular cancer. After all, although the vast majority of testicular bumps are benign, most of the benign bumps can be ruled benign by ultrasound, which is pretty harmless. So, although testicular self-exam doesn't really seem to save any lives, the only harm seems to be some temporary needless worry. So I do have to wonder why they give it "D" rating (meaning the intervention is harmful) as opposed to a "C" rating (the intervention is useless, but not harmful). The same, however, cannot be said for PSA screening, which is not just useless, but truly harmful. Even the most neutral national screening guideline, coming from the American Urological Association, which does not recommend for or against screening, but merely states Men ages 55 to 69 who are considering prostate cancer screening should talk with their doctors about the benefits and harms of testing and proceed based on their personal values and preferences, according to a new clinical practice guideline released today by the American Urological Association (AUA), acknowledging that For men ages 55 to 69 years, the decision to undergo PSA screening involves weighing the benefits of preventing prostate cancer mortality in 1 man for every 1,000 men screened over a decade against the known potential harms associated with screening and treatment. For this reason, shared decision-making is recommended for men age 55 to 69 years that are considering PSA screening, and proceeding based on patients’ values and preferences. In other words, the vast majority of cancers found via PSA screening would never affect the life of the man who has it. Autopsy studies of men who died in the US for reasons other than prostate cancer found that the odds of having prostate cancer roughly equals one's age. Yes, that even applies to 30 year-olds. So doing PSA screening is a little like playing Russian roulette with 5 bullets. If you do it often enough and long enough, you're going to find cancer most of the time. And, unlike the the ultrasound for testicular cancer, there's no way to know which of those cancers is the dangerous kind. And the surgery worsens mortality in more than 1 in 1,000 men, to say nothing of the very substantial morbidity of prostate surgery and/or radiation.

So, although I really don't feel strongly at all about young men examining their balls, I do feel PSA screening is a real danger (and the USPSTF and AAFP agree with me). I suppose there's nothing wrong, of course, with discussing the issue, as the AUA recommends, with men from 55 to 69. But if the discussion doesn't include the fact that (1)the screening does not save lives, and (2)having one's prostate taken out either by surgery or radiation is no joke, then I have a real ethical issue with such a discussion. And for a doctor or other health care provider to order the test without having any discussion is pretty outrageous.

[Guest]

Well Unicorn I see no reason to continue this discussion as you hae decided that I am lying and you are all knowing. Would it be against the odds that two of these were on one day, yes it would be, but that is also true. Have a pleasant day up there on Mt. Olympus.

 

Wow. Those who are mathematically inclined can figure out that the odds of just that one statement being true are 5.4 X 5.4 divided by 100,000 X 100,000. That's a pretty tiny number. The odds of all three statements being true are quite a bit less than that. I want you to buy my SuperLoto tickets!