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Mar 02 2013

Something for the Men

I think before I start…

Special thanks are in order. For all the people who laughed at my alleged bankruptcy due to not getting to speak at any conferences (If you knew how they worked then speaking at conferences would INCREASE the chance of bankruptcy!), who sent me messages calling me slacktivist (I don’t think you know what I do for a living. It’s possibly the only insult that is plain oxymoronic) and suggesting that I write a load of bollocks and wank.

And that inspired me to write something entirely about bollocks (and a little bit about wank). What ensues is probably NSFW if you work amongst prudes but is entirely suitable for children if you think children should know a bit about their own bodies.

What we are discussing is no laughing matter.

The testicles (Witness of Virility) are the male gonads and are the equivalent organ to the female ovary. They are both reproductive and endocrine in nature and are responsible for the production of both sperm and testosterone (which causes the development of male characteristics).

The testicles are controlled by hormones secreted from the pituitary gland.

They are also dangly and often put onto trucks by people with a questionable sense of humour.

They are one of the few “external” abdominal organs and actually form at a much higher level in the body and descend through the abdominal wall. Ever push your finger through a sandwich bag? Kind of like that. This is the evolutionary side of the issue.

Why are testicles “external”? Well? The truth is we don’t exactly know. There are 3 main hypothesis.

1. Keeps them cool.

The testes are kind of built to be cool. They are firstly external and so are more prone to being air cooled. The artery and venous supply is also shaped like a radiator. It’s believed that spermatogenesis is ideal at a lower temperature and indeed a lot of the musculature of the testicles are aimed with temperature regulation in mind. The cremastric muscle can tighten and loosen raising and lowering the entire scrotum from the body to help with regulation.

In addition it’s a good idea not to put your laptop on your “lap”.

2. Evolution

We kind of evolved from small squishy rodent like animals. Like the hamster they probably had relatively large testicles.

Yes. I googled it for you

These needed to be external because the body couldn’t fit them internally. These allowed for extremely virile ancestors (more sperm = more sex = more babies) and also increased sperm competition.

What may have occurred is that a bunch of proteins may have evolved for an external testicle which performs best at an ideal temperature a few degrees below that of the body making the change more permanent.

3. Mobility

When you move you actually have transient changes in your abdominal pressure. The testicles are actually pretty “fragile” so rather than take a beating inside your abdomen it may have been more advantageous to be outside where they are (relatively) protected from compression damage from eating a particularly large meal or hurdling a particularly high shrub.

However all these 3 ideas mean that the actual testicle is extremely bad at surviving in the body. There is a condition called cryptorchidism (undescended testes) which can blossom into testicular cancer because of the internal temperature of the body.

The major downside to this descent of testicles? Well the pathway is called is called the inguinal canal and actually has a bunch of protective mechanisms. However, it still happens. Sometimes your intestines can extrude through this canal. This is what we call “A Hernia”. And it hurts like fuck.

Okay with this little lesson in anatomy and history out of the way let’s delve into the crux of my message.

In the USA alone there are around 8000 cases of testicular cancer a year. In the UK around 2000. You as a man have a 0.4 to 0.6% chance of developing testicular cancer. It is a cancer of young men and mainly affects people aged 20 – 39 years of age. It is the male equivalent of breast cancer as it is not only easily treatable but also easily preventable.

On the plus side? It’s got one of the highest rates of cure. Nearly 100% if it hasn’t metastasised and an overall rate of 90%.

The original complaint is usually a “lump” discovered by a patient. However? Not all lumps are tumours and not all tumours are malignant (cancerous/Neoplasm). They can be cysts, hydatid of morgagni and cysts.

Treatment

Well? The first stage is the removal of the affected testicle. It is not advised to abrade or remove just the tumour as pre-cancerous cells are spread throughout the testicle increasing the risk of recurrence.

In some cases you would need to do a lymph node dissection to determine if the cancer has metastasised or not. This retroperitoneal lymph node disection (RPLND) is generally done in western nations where the expertise and technology is available and is one of the primary reasons to why our cure rate is so high. You can also opt for surveillance but it has less of a rate of reduction in recurrence of cancer while RPLND can result in damage to the nerves of ejaculation.

As with all cancers, both chemo and radiation therapy are vital in ensuring the prevention of spread.

Prevention

There simplest method is to report any detected lumps or swellings of the testicles to your doctor. Don’t delay, as with all medical conditions the earlier you detect the earlier the treatment and the better the prognosis.

There are a fair few links between masturbation and survivability of this cancer but I feel that’s mainly due to an increased chance of detecting a lump.

This is one of the most easily treated cancers out there and one of the biggest cancers that affect young men. While less serious than breast cancer or uterine cancer due to it’s good prognosis it is however still a major cancer and can easily be treated.

6 comments

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  1. 1
    Cuttlefish

    A side note: if you are male, you might want to think twice before using your laptop computer…on your lap.

    http://freethoughtblogs.com/cuttlefish/2011/08/03/a-public-service-announcement-for-bloggers/

  2. 2
    abbeycadabra

    Cysts and more cysts?

  3. 3
    testostyrannical

    Didn’t know that it affected young men. I guess I just lumped all the junk oriented cancers together, assumed it was like prostate cancer.

  4. 4
    Marcus Ranum

    One of our family friends, a very popular and well-known doctor from Johns Hopkins, passed away in 2009. I thought it would be a good idea to tell his family and friends a story about him and my view of him as a kid growing up. Since it has something to do with testicles, I’m appending it below.

    I’m sure you remember how, in high school, I bicycled everywhere – as
    if my bicycle was somehow grafted onto my body. Fast and furious was
    my style; I always had someplace else that I wanted to be, so I
    was almost always standing up on the pedals, pumping madly as I
    passed the slow-moving cars and wove in and out of Baltimore’s
    potholes. One day, a pothole got me! I was stuck with a parked
    car on one side and a panel truck in the car lane to my left, and
    had to ride at near top speed right into a miniature concrete
    “grand canyon” in the road. As I flew through the hole, the rear
    wheel of my bicycle hit the lip and bounced up, hard, and the
    seat-post slammed up into my testicles like a hammer. It was
    blindingly painful and I skidded to a stop, bent over and whooping
    like a steam engine. That evening, they were incredibly sore and
    I checked them out carefully and discovered to my horror that
    one of them appeared to be crushed so that some of the stuff
    on the inside had squished out – I was absolutely paralyzed with
    terror.

    So, I screwed up my courage and walked next door to ask Dr D,
    of course. I don’t even remember exactly how I managed to
    explain the incident and my “diagnosis” of the problem, but
    the great doctor sat and listened as carefully and graciously
    to my nervous kid self as he would have to the president of
    the united states, then offered to examine the injury. After
    a brief exam, performed in the kitchen, he explained clearly,
    concisely (and, to my ears, beautifully) that what I was
    feeling was part of the normal development of a male, and
    that what I took for “squished tissue” was just changes that
    occur during puberty and it was perfectly normal and I probably
    hadn’t noticed it as a matter of course (until the accident)
    and there was nothing to worry about. I limped back home
    feeling about 2,000lbs lighter and the next day I felt just
    fine. What I remember so clearly, though, was the gentle
    voice, and the incredible courtesy showed to a scared kid. In
    today’s medical environment, where you get a 5 minute slice
    of an overscheduled doctor’s attention, the comparison is
    unescapable. And, any of you who remember Dr D know exactly
    what I’m talking about: he had this way of – how do I say
    it? – “listening gently” not making much expression, but
    utterly intent and yet somehow you felt loved, cared for,
    and you knew he was focused on your problem and you, the
    patient, were the center of Dr D’s universe at that
    moment. Even today, when I’m listening to NPR and people talk
    about how “doctors can’t pay attention to their patients,
    anymore.” I remember a summer day in Baltimore around 1976,
    and I count myself fortunate to know what “a good doctor”
    really means.

  5. 5
    ohno

    it’s always good to have health info posted…. but I take exception to your definition of prevention. What you are describing (finding a lump) is early detection, same as with breast cancer. Prevention is all about eating right and avoiding environmental dangers (laptops, etc.) For prevention, remember that cancer is a “lack of fruit and veg disease”. Not 100%, but pretty good odds.

  6. 6
    Argle Bargle

    They are one of the few “external” abdominal organs

    Besides the penis, what are the other external abdominal organs?

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