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know thy nuts: testicular cancer is '100 per cent curable' when caught early

although testicular cancer is rare, with about 1,300 cases in canada a year, case numbers have risen over the last two decades.

troy moutsatsos, front right (thumbs up), mistook the pain of testicular cancer for the pain of his life in the world of jiu jitsu and muay thai. a year later, he's cancer free and goes for regular checkups and blood work. supplied
troy moutsatsos takes his health more seriously than a lot of people do—especially men who don’t want to tarnish their tough-guy image. they don’t confide any concerns to friends, let alone see a doctor. but that kind of thinking is outdated and, frankly, dangerous, so he’s determined to be an open book about his own health.
“previous generations have all grown up with ‘rub some dirt on it, you’re fine,’ which in some cases i did as well. i scraped my knee when i was a kid, it was like ‘toughen up. it’s fine. you’re fine,’ he says.
it’s not only physical problems that are downplayed, the topic of mental health has been traditionally avoided by men.
“there’s just so much stigma around mental health and it’s taboo to talk about it, which frustrates me beyond belief.”

don’t shrug off lower back or abdominal pain

moutsatsos, now 30, was diagnosed with epilepsy when he was 13, followed by numerous surgeries and trial and error to find the right cocktail of anti-seizure meds to keep him functional. after a long recovery from extensive brain surgery three years ago, he went back to training and teaching martial arts, a passion that has given him an outlet through the years growing up in sudbury, ont. to help deal with his health challenges. (he got his black belt in jiu jitsu in may 2024.)
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“so it was a lot of physical activity. i just attributed the pain in my lower back and my abdomen to my jiu jitsu and my muay thai because of sore muscles. you’re essentially throwing another human around,” he explains. but then the pain got worse, and he noticed the physical size difference between his testicles. almost as bad, he says there wasn’t much in the way of information for men’s health to try to find out the cause.
“i found it extremely frustrating because i remember even in high school the health unit came in and they talked to the whole class together. then they broke us up into groups. all the females went together and they discussed breast exams, pap smears and all this to help them prepare for the future to know what to expect and how to do it on a regular basis. but for the guys, essentially what they told us was don’t add to the population and this is how you don’t add to the population if you don’t want to. there was no information on self-examination or how to make sure you stay in good mental health.” he adds that he’s seen information for breast exams in doctor’s offices, as another example, but nothing for men’s health.
for moutsatsos, it meant a lot of sleepless nights digging for information that he narrowed down to two possible conditions: testicular tortion or testicular cancer. it was cancer.
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why are young men in their prime targets for testicular cancer?

how did this happen? what puts men at risk for testicular cancer?
“it’s largely not known. testicular cancer is a disease where the primary risk factor is young age, to be blunt,” says dr. michael fraser, director of cancer program implementation at movember canada, the charity dedicated to changing the face of men’s health. april is testicular cancer awareness month and movember is encouraging men across the country to know thy nuts by regularly checking them for any changes or inconsistencies and informing them on what to do if they come across something that isn’t normal for them. if something doesn’t feel right—like a lump, swelling or pain—the first instinct should be to see a doctor. movember has an online hub, nuts and bolts, specifically for men going through testicular cancer.
“usually we think of cancer as a disease of older people and it is by and large, but this particular one is more common in men and young boys 15 to 40 as the most common cancer in that age group.” but awareness is not at an encouraging level.
dynata market researchers surveyed a total of 4,000 males aged 16 to 40 across australia, canada, u.k. and the u.s. from february 23, 2024, through to march 4, 2024, revealing the following:
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  • most canadian young men (75 per cent) do not know that testicular cancer is the most common cancer in young men aged 15 to 40.
  • only 22 per cent of canadian young men feel very confident they’d be able to check their testicles for irregularities, and one in four shared they’ve never checked their pair.
  • while 70 per cent of canadian young men say they would make a doctor’s appointment if they noticed something abnormal with their testicles, only 24 per cent say they would share it with their partner and even less (18 per cent) would share it with a family member they trust.
  • nearly one in four (23 per cent) of canadian young men would not visit a doctor unless their testicles were in extreme pain.

      see a doctor if you notice anything that doesn’t feel right in your testicles

      fraser encourages men to visit a doctor if they notice something abnormal with their pair as early detection is crucial for positive treatment results. in fact, testicular cancer is highly curable when it’s caught early. “if you can detect the disease when it’s confined to the testicle itself and hasn’t spread throughout the body, it’s virtually 100 per cent curable.”
      although testicular cancer is rare, with about 1,300 cases in canada a year, case numbers have risen over the last two decades, which could be environmental, he says adding there’s also a lot of maturation going on in the sexual organs during those years. “whenever cells or organs are tasked with changing and developing, that’s when there can be things that happen that can go a little bit askew.”
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      another key point is that when a man is diagnosed with testicular cancer and treated, that person has to live their entire life as a survivor. that comes with anxiety. “you’re always going to feel like, ‘well, what if it comes back?’ and i don’t think you’re ever going to be kind of away from that, no matter how far out you get.” while treatment limits the impact on fertility and sexual function with the removal of a testicle, there’s the cosmetic effect to consider.
      overall, though, movember wants to reach this demographic, to empower behaviours, mental health and other health issues down the line, so men will speak up and say, ‘hey, i’m dealing with this.’

      surviving cancer means facing the waiting game for life

      moutsatsos called his family doctor but the appointment was a two-week wait. he went into a walk-in clinic the next day where the doctor gave him a physical examination and booked him for an emergency ultrasound and blood work. he was also referred to a urologist.
      “it was very severe at that point,” he says of the pain. after another physical exam by the urologist and blood work for tumour markers, the urologist diagnosed moutsatsos with testicular cancer. he went in for surgery in december 2023 to remove the right testicle completely, which then was sent for a full pathology workup to see if the cancer had spread.
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      “that was extremely stressful, because of course i had no issue going in for surgery. i’ve had multiple surgeries and it was just a day surgery. it was the waiting. i didn’t see the radiation oncologist until january 10.” radiation wasn’t advised and he went to see an oncologist who confirmed further treatment was unnecessary because the cancer hadn’t spread and surveillance would be all that he needed.
      “that felt like taking 1,000 lbs. off my chest. i could breathe again. i could move,” he says of the incredible wave of relief. “there was so much negativity surrounding it, of course, because it was cancer. and there were thoughts of ‘oh my god, am i not going be able to have a family in the future because my girlfriend wants kids?’”
      luckily, he says, the cancer isn’t going to limit him in any way. he continues to go for regular imaging and blood tests, but surviving the first year, the chance of cancer recurrence has dropped to three per cent.
      now he’s started his own virtual wellness and life coaching business, and he’s joined movember for fundraising efforts like a spaghetti and meatball dinner at his family restaurant in sudbury, and sharing his health journey.
      “i always knew about movember and what it was for. but then after surgery and after my cancer diagnosis, i went full bore,” he says, offering a final message on testicle self-exams: “i want to tell people, especially guys, learn about what to expect and just check. don’t be afraid to do it and stop being so stubborn that you don’t want to talk to each other because you’re afraid somebody’s going to make fun of you.”
      karen hawthorne
      karen hawthorne

      karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

      read more about the author

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