From: David Rind <drind@caregroup.harvard.edu>
Newsgroups: sci.med
Subject: Re: Undressing for medical examinations:
Date: Sun, 20 Mar 2005 18:04:06 -0500
Message-ID: <d1kvfu$gs1$1@reader1.panix.com>

bae@cs.toronto.no-uce.edu wrote:
> In article <n9sp315ioso89vvetddusv3973trh4jgsb@4ax.com>,
> PF Riley  <pfriley@watt-not.com> wrote:
>
>>On Sat, 19 Mar 2005 12:49:12 -0800, jason@nospam.com (Jason) wrote:
>>
>>>PF,
>>>I would not have any problems if the doctor that I mentioned had conducted
>>>the testicular exam the way that you conduct testicular exams. I discussed
>>>this issue with the doctor that failed to conduct a testicular exam. He
>>>told me that since I was only 38 years old (at the time) that it was a
>>>waste of time as a result of statistics. He said that he did not conduct
>>>the exam until his patients were 50 years old or older.
>>
>>Well I certainly hope the he also conducts the exams in men under 30
>>because he will may miss a case of testicular cancer at least once in
>>his career if he doesn't.
>
>
> IIRC, testicular cancer is the most common cancer, the most common
> cause of death from cancer, and one of the most common causes of death
> in men aged 20-40.
>
> It's sometimes recommended that men check their testicles periodically,
> just as women check their breasts, for suspicious lumps.  You can get a
> booklet, or find info on the net, about how to do it.  It seems to me
> that it should be part of the physical exam for young men.  After all,
> it's not expensive nor invasive nor very time-consuming and as Dr.Riley
> says, could save a life.  (I'm not a doctor.)
>
> I wonder if the physician who spent several minutes examining this
> poster's testicles may have been trying to determine whether what he
> felt was abnormal enough to follow up or not.  A doctor doesn't want
> to needlessly alarm a patient, but this is a cancer that can be very
> successfully treated if caught early, but very hard to control once
> it spreads.

I believe testicular cancer is the most common cancer cause of death in
men under age 35, however, despite that, it is a relatively rare cancer,
is usually curable, and is not one of the common causes of death in
young men.

There is no good evidence that yearly testicular exams by a physician or
self testicular exams are of any benefit. The US Preventive Services
Task Force recommends against such screening. I think the reason
screening for testicular cancer became "popular" with pamphlets and the
like was that people felt like there should be some male equivalent of
screening for breast cancer. (Not that there's any evidence that self
breast exams are of benefit, but at least it's a very common cancer in
women.)

--
David Rind
drind@caregroup.harvard.edu

From: David Rind <drind@caregroup.harvard.edu>
Newsgroups: sci.med
Subject: Re: Undressing for medical examinations:
Date: Sun, 20 Mar 2005 18:35:04 -0500
Message-ID: <d1l19q$l15$1@reader1.panix.com>

David Rind wrote:
> I believe testicular cancer is the most common cancer cause of death in
> men under age 35, however, despite that, it is a relatively rare cancer,
> is usually curable, and is not one of the common causes of death in
> young men.

I realized right after posting that the above may be wrong. Testicular
cancer is the most common solid cancer (as opposed to hematologic
cancer) in men under age 35, but I don't know whether it is the most
common cause of cancer death in men that age. I don't have time to look
up the statistics right now.... In any case, it is not a common cause of
death in young men.

--
David Rind
drind@caregroup.harvard.edu

From: David Rind <drind@caregroup.harvard.edu>
Newsgroups: sci.med
Subject: Re: Undressing for medical examinations:
Date: Mon, 21 Mar 2005 18:52:19 -0500
Message-ID: <d1nmm5$2p3$1@reader1.panix.com>

Jason wrote:
> In article <2005Mar21.105444.29468@jarvis.cs.toronto.edu>,
> bae@cs.toronto.no-uce.edu wrote:
>
>
>>In article <d1kvfu$gs1$1@reader1.panix.com>,
>>David Rind  <drind@caregroup.harvard.edu> wrote:
>>
>>>I believe testicular cancer is the most common cancer cause of death in
>>>men under age 35, however, despite that, it is a relatively rare cancer,
>>>is usually curable, and is not one of the common causes of death in
>>>young men.
>>
>>Thanks for the no doubt more accurate information.
>>
>>
>>>There is no good evidence that yearly testicular exams by a physician or
>>>self testicular exams are of any benefit. The US Preventive Services
>>>Task Force recommends against such screening. I think the reason
>>>screening for testicular cancer became "popular" with pamphlets and the
>>>like was that people felt like there should be some male equivalent of
>>>screening for breast cancer. (Not that there's any evidence that self
>>>breast exams are of benefit, but at least it's a very common cancer in
>>>women.)
>>
>>Well, when I suggested to my husband that he read the booklet and examine
>>himself periodically, he told me that he'd let me do it. ;-)
>
>
> Thanks to all that responded. I learned from one of my doctors how to
> conduct an exam on myself related to testicular cancer. It's really easy.
> It's my guess that many doctors don't conduct the exam since they hate it.
> I believe that doctors or their nurses should give pamplets to all
> patients after yearly physical exams related to breast cancer (for women)
> and testicular cancer (for men). The pamplets should explain how to do
> self examinations. I should add that I am now 54 years old and during my
> last physical exam--my female doctor did NOT conduct an exam for
> testicular cancer or give me a pamplet about the subject. Is this common?
> I don't know. I did not care about it at the time since I know how to
> conduct my own exam related to this subject. Thanks again.

Well, in my post that you quoted above, I pointed out that there is no
good evidence to support doing such an exam or teaching patients to do a
self exam and that the main US body on preventive services recommends
against it.

So your doctor who did not do such an exam and did not give you a
pamphlet was following published recommendations.

That said, even those people who advocate testicular exams usually don't
recommend doing them in 54 year olds since testicular cancer would be
extremely rare in a man that age.

--
David Rind
drind@caregroup.harvard.edu