Men, we need to talk… about your health!

It’s well-known that men are much less likely to talk about their health and seek help for it, than women. It’s time to change that.

This Mens Health Week, we want to discuss two of the most common cancers that affect men - prostate cancer and testicular cancer.

Prostate cancer occurs when abnormal cells develop in the prostate - part of the male reproductive system. In Australia, it is the most commonly diagnosed cancer in men, affecting up to 1 in 7 men by the age of 75. Over 24,000 men were diagnosed with prostate cancer in 2022 alone.

While testicular cancer is not an overly common cancer, it is actually the second most common cancer in young men aged 15 to 45 (excluding skin cancer) and around 850 men are diagnosed every year.

Both of these cancers affect different organs, however, they have some similar risk factors and other links. For example, some studies have down that men who have had testicular cancer may have a higher risk of developing prostate cancer later in life [1].

It’s important for men to know what bodily changes and signs to watch out for so they can speak to their doctor if anything concerning arises.

There is no known cause of prostate cancer, nor a single, simple test to detect it. This is why knowing the symptoms of prostate cancer is so important, so it can be detected as early as possible. The earlier prostate cancer is detected, the more treatment options that may be available - more on this later.

Some risk factors that may make someone susceptible to prostate cancer are:

• Ageing - particularly after 50 years of age
• Family history of prostate, breast or ovarian cancer, especially BRCA1 and BRCA2 gene mutations
• A father or brother diagnosed with prostate cancer before age 60

There is a blood test you can request, called a prostate-specific antigen (PSA) test. This checks if your PSA level is normal for your age. You can speak to your doctor about whether this test is applicable to your circumstances.

Now, as for the symptoms that may indicate prostate cancer. These include:

• Weak urine flow

• Difficulty emptying the bladder

• Pain or burning when urinating or ejaculating

• Frequent and urgent need for urination

• Waking up multiple times during the night to urinate

• Blood in the urine or semen

• Signs of anemia - such as pale skin

• Pain in the back, hips and/or pelvis

While many of these symptoms can be linked to other conditions, it’s important if you start experiencing any of these that you speak with your doctor as soon as possible.

Tests involved in diagnosing prostate cancer include:

Digital rectal examination (DRE) - your doctor will insert a gloved and lubricated finger into the rectum to feel the prostate’s size and check for anything uncharacteristic.

PSA test - the blood test we mentioned earlier that checks the specific antigen levels in your blood to see if they are indicative of cancer.

An MRI scan - this will show a detailed image of your prostate to identify any early signs of cancer.

A biopsy - your doctor will refer you to a urologist who will remove some cells from your prostate using a thin, hollow needle. The cells are then examined to check for cancer.

If you are diagnosed with prostate cancer, the type/s of treatment you receive will depend on its severity. Doctors will grade prostate cancer on a scale of 1 to 5 (known as a grade group system) which is based on how likely the cancer is to grow and spread. Grades 4 and 5 are considered high-risk. You can read more about this process here.

Treatment options for prostate cancer can include:

This is the process of monitoring prostate cancer that isn’t causing any symptoms and is considered low risk (small and slow growing/unlikely to spread). Active surveillance can include PSA tests every 3-6 months, rectal examination every 6 months and MRI scans and biopsies at 12 months and 3 years.

Known as radical prostatectomy, this surgery removes the whole prostate, part of the urethra and the seminal vesicles. Incontinence after prostate surgery is a common side effect to be aware of, however, it is completely manageable with pelvic floor rehabilitation and using the right continence management products.

Our range of male guards, pull-ups and all-in-one slips suit different levels of incontinence. If you’re not sure which is best suited to you, we’re here to help! Take our online Help Me Choose quiz or call our helpful product specialists on 1800 861 199 or email hello@confidenceclub.com.au  and they can assist you in choosing the right product for you.

This treatment is usually offered to men with early prostate cancer and/or if surgery isn’t an option. Radiation therapy can either be given with external beam radiation therapy (EBRT) or by implanting radioactive seeds (brachytherapy). Side effects of radiation therapy are similar to surgery.

Prostate cancer needs testosterone to grow, and this therapy (formerly known as hormone therapy) is used to slow the production of testosterone. It’s usually used before, during or after radiation therapy. It can be given in the form of injections or oral tablets.

In severe cases of prostate cancer, your medical team may speak to you about palliative care, which aims to improve your quality of life by alleviating symptoms of cancer. It can help relieve pain and manage other symptoms.

In most cases, only one testicle is affected by testicular cancer. About 90 to 95% of testicular cancers begin in the cells that develop into sperm, known as germ cells.

There are two main types of testicular cancer. The first is seminoma tumours which develop more slowly and usually occur between the ages of 25 and 45, but can still occur in older age. The second is non-seminoma tumours, which develop more quickly and are more common in late teens and early twenties. There are four sub-types of non-seminoma tumours, these are teratoma, choriocarcinoma, yolk sack tumour and embryonal carcinoma.

Risk factors for developing testicular cancer can include:

• Family history of testicular cancer

• If you were born with undescended testicles

• Infertility

• Having HIV & AIDS

• Congenital defects such as hypospadias (abnormality of the penis) or inguinal hernia (lump in the groin)

As for symptoms of testicular cancer, they’re mostly not noticeable and can go unmissed, or be picked up during tests for other conditions. However, what you should watch out for is:

• Swelling or a lump in the testicle (often painless)

• A change in a testicle’s size or shape

• A feeling of heaviness in the scrotum

• A feeling of unevenness between the testicles

• Pain in the back, lower abdomen, testicle or scrotum

As with the symptoms of prostate cancer, these can often be related to other conditions and don’t always indicate cancer. However, if you begin to experience any of these, you should always see your doctor.

Tests involved in diagnosing testicular cancer include:

• Ultrasound - this imaging can help show if a tumour is present and how large it is.

• Blood tests - are used to check how your organs are working and check general health.

• CT scans & MRI scans - these will be used following an ultrasound if more detailed imaging is required.

If the above shows any signs of testicular, the only way to cement the diagnosis is to surgically remove the affected testicle and have it sent to a lab for testing and examination.

The operation is called an orchidectomy and only takes around 30 minutes.

During the surgery, the surgeon is most often only required to remove one testicle. You can also decide to have that testicle replaced with an artificial one, called a prosthesis.

Following the surgery, you will have stitches where the incision was made which will dissolve after a few weeks. There may be some bruising around the scrotum which will disappear over time. For the first couple of weeks post-surgery, it’s recommended to wear underwear with cupping support for the scrotum, which you can find at most pharmacies. You should avoid heavy lifting and vigorous exercise for at least six weeks following surgery, and you can drive again after two to four weeks.

If your doctor confirms the cancer was completely removed during the orchidectomy, you will not need further treatment but instead be required to do surveillance of regular blood tests, x-rays and scans for 5-10 years.

In some cases, radiation therapy can be given to a patient with seminoma cancer to prevent it from spreading or coming back.

If the testicular has a high chance of spreading or returning your doctor may also consider chemotherapy. Note that the chance of testicular cancer spreading to other parts of the body is rare.

In some cases, an operation called a retroperitoneal lymph node dissection (RPLND or lymphadenectomy) is required to remove lymph nodes at the back of the abdomen that may contain cancer cells.

It’s important to note that testicular cancer has the highest survival rates of any cancer (other than common skin cancers). Regular monitoring is extremely important in ensuring the best outcome for your health, so always attend your doctors appointments and follow-ups.

If the above shows any signs of testicular, the only way to cement the diagnosis is to surgically remove the affected testicle and have it sent to a lab for testing and examination.

It’s not always possible to prevent either of these cancers, however following the below lifestyle suggestions is crucial for maintaining overall health and cancer prevention:

• Maintaining a healthy body weight

• Exercising regularly

• Eating a balanced, whole foods diet and drinking enough water daily

• Avoiding smoking and drinking alcohol

If you have any of the risk factors for either cancers, be sure to speak to your doctor about putting a surveillance program in place to watch for any symptoms.