The educational campaign "Check Your Balls" aims to educate men about their bodies and encourage them to notice changes.

2024-04-04

Testicular cancer is not a common disease, but it is the most frequent type of cancer affecting young men (aged 15-44) and one of the most treatable forms of cancer. In April – Testicular Cancer Awareness Month – the Lithuanian Urological Association and the Lithuanian Basketball Federation are launching an educational campaign, "Check Your Balls," aimed at young men.

“This initiative aims to emphasize the importance of educating young men from an early age, teaching them to understand their bodies, recognize changes, and seek medical attention from urologists when necessary. In our practice, we see cases where men come in with advanced symptoms, requiring more complex treatment and greater human resources. It is still surprising to witness young men either feeling too embarrassed to visit a urologist or failing to notice obvious changes in their bodies,” highlights Dr. Marius Kinčius, Deputy Director of the National Cancer Institute, stressing the lack of self-examination skills.

According to Dr. Kinčius, testicular cancer cases are not numerous, but the consequences are serious, as this disease affects young men with their whole lives ahead of them. The country, society, and families lose men in their most productive years. “If men notice any changes in their testicles, they should first visit their general practitioner, who will refer them to urologists at specialized centers. The 'green corridors' in these centers ensure that, once diagnosed, patients can see the necessary specialists within a few days and begin appropriate treatment. Currently, Lithuania has six medical institutions providing specialized oncological care: Vilnius University Hospital Santaros Clinics, the National Cancer Institute, the Lithuanian University of Health Sciences Kaunas Clinics, Klaipėda University Hospital, Šiauliai Republican Hospital, and Panevėžys Republican Hospital,” explains Dr. Kinčius.

During youth, when one is full of energy and vitality, it is easy to overlook cancer risks. Young people, in particular, tend to ignore the dangers of this disease. However, this does not mean they can afford to ignore bodily changes, especially those related to masculinity and fertility. Fertility preservation is an important consideration in the treatment of testicular cancer. As Dr. Albertas Čekauskas, Head of the Urology Department at Vilnius University Hospital Santaros Clinics, explains, men who are newly diagnosed often experience immense stress and focus solely on starting treatment as quickly as possible. They rush to undergo procedures, including surgery to remove the affected testicle if necessary, and this urgency can overshadow critical discussions about fertility and sperm preservation.

"Some men still lack knowledge about testicular tumors and the necessity of showing any palpable lumps or abnormalities in the testicles to a urologist. Sometimes, young men read misleading information online, engage in self-diagnosis, or even attempt self-treatment. This is a mistake that often leads to delayed diagnosis. Another group of young men misunderstand or fear chemotherapy, which results in them either refusing this treatment or postponing their first visit to a specialist. All of this reflects a lack of awareness and an overestimation of one's own medical judgment."
Mindaugas Jievaltas, MD, PhD

"Young men who receive this diagnosis should consider this, even if it may not seem like a priority at the time when their focus is on treatment. Even in complex cases, successful treatment is possible, and then the issue of fertility arises. The only place in Lithuania where men diagnosed with an oncological disease, including testicular cancer, can freeze a sperm sample before starting treatment is the Fertility Center at Santaros Clinics, where this can be done with a doctor's referral. Although sperm quality may recover within a year after systemic treatment, there are cases where it does not. In such situations, assisted reproduction procedures can be utilized, which are performed at university hospitals, with two cycles covered by the State Health Insurance Fund," explains Dr. A. Čekauskas on the importance of fertility preservation during treatment.

According to the urologist, fertility recovery largely depends on the intensity and complexity of the treatment, which is why early detection of the disease is crucial. If testicular cancer is diagnosed at an early, localized stage, treatment may be limited to the removal of the affected testicle, followed by long-term monitoring, allowing the patient to return to a full and normal life, work, and daily routines.

"Some men seek medical help too late. In such cases, distant metastases are often already present at the time of diagnosis, significantly reducing their chances of recovery. In my opinion, many men still lack knowledge about testicular tumors and the importance of showing any detected lumps to a urologist. Some young men read misleading information online, engage in self-diagnosis, or even attempt self-treatment. This is a mistake that often leads to disease progression. Others have misconceptions about chemotherapy or fear it, leading them to refuse or delay essential treatment," says Prof. Mindaugas Jievaltas, Head of the Urology Clinic at LSMU Kaunas Clinics, discussing the issue of late-stage testicular cancer, lack of awareness, and overestimation of one's own medical judgment.

Dr. Aušvydas Patašius, a urologist at the National Cancer Institute, also emphasizes the importance of early diagnosis. "We want to draw men's attention to the fact that regular self-examination is a simple, easily accessible, and cost-effective screening method. Testicular cancer is a completely curable disease, even in cases of significant spread, with appropriate surgical treatment and risk assessment based on modern tests. Treatment outcomes depend on the accuracy and speed of diagnosis, as well as the characteristics of the disease. For many years, blood serum markers have been used, but they do not fully meet clinical needs. There are rare histological tumor types that, even with minor changes, do not show up in blood tests.

It would be highly beneficial for Lithuania to introduce one of the most sensitive next-generation tests, miR-371a-3p, which allows for more precise diagnosis, detection of disease recurrence, and improved post-surgical treatment outcomes. Personalized cancer care helps identify the unique characteristics of each patient's disease, making treatment even more effective," summarizes Dr. Patašius.

In his opinion, Lithuanian patients would greatly benefit from such testing, which could be initiated and supported by the Lithuanian Urological Association. This would allow for scientific evaluation of how the introduction of this test in Lithuania could impact patient treatment, survival rates, and overall healthcare outcomes. "Investing in a young man's life is an investment in the future of the country," states Dr. Patašius.