Men are protective about their balls. Maybe that’s why not everyone finds it easy to broach the subject of testicular cancer

When was the last time you had a good feel of your testicles? Or your partner’s testicles, assuming they’re male of course? Needless to say, if you’re reading this at work or on the train, now is not the time to do it. But please, do it when you get home.

Having had testicular cancer myself last summer - losing one of the crown jewels in the process - checking up on your balls is something I feel really passionate about. Obviously I’m passionate about encouraging every aspect of men’s health (women’s too for that matter) but this one area could be so easily improved.

To me, it’s a no-brainer. There is nothing to be gained by putting it off and everything to be gained by doing it. And if you do find something you’re worried about, go and visit the doctor. They’ll have seen thousands of testicles in their time - even more if we count both of them individually - so no need to be embarrassed. It could save your life. It really did save mine.

It goes without saying that men are protective about their balls. Maybe that’s why not everyone finds it easy to broach this subject. It’s just one of the reasons I’m filled with admiration for the Movember campaign. This simple idea, started at a pub table in Adelaide, Australia many years ago has turned into a global phenomenon. They’ve done an incredible job of raising money to fight testicular cancer, prostate cancer and now to support men’s mental health.

But it’s what the Movember campaign does for awareness around these issues really blows me away. After all, every individual Mo’ is a little top-lip billboard, it advertises the fact that its proud wearer is doing his bit to support the campaign, but it’s also a conversation-starter. In the age of social media, for every mo’ that grows, hundreds of people get to see it. While the conversation might begin with a discussion of Tom Selleck’s best movie roles, it’s one that segues quite naturally into men’s health issues.  And let’s face it guys, when it come to personal health issues, we’re not the best at keeping track, nevermind discussing these things with partners, friends or the local doctor. Who knows how many lives have been saved by this little conversational prompt. Men of Movember, I salute you.

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As the co-founder of Headspace, much of my time is spent encouraging people to look after the health of their mind by taking some time out each day. Apart from feeling calmer and clearer, there is some great scientific evidence showing it improves our physical health too.

But of course there are some things that happen in life which are out of our control, no matter how well we take care of ourselves. Having a clear, calm mind and a good sense of perspective in these situations is invaluable. But I think that, in the end, you need to remember that you can’t do it on your own. Talking about your health problems might feel impossible. But there’s nothing butch about dying of something you were too embarrassed to mention.

So please, just for me, when you get a quiet moment, check those balls.

The Discovery

Waking up to find one testicle three times bigger than the other is never a good start to the day. The first few minutes are spent looking at it from a distance, as though it is something that doesn’t really belong to you. When you eventually pluck up the courage to touch it and discover it’s as hard as rock, there are a number of thoughts that flash through the mind. The first and most obvious one is cancer. It’s a funny thing, the thought is there and yet at the same time it feels a little extravagant, as though you may be making a mound out of a molehill - so-to-speak. Either way, from that point on, there is only ever going to be one possible destination.

The Emergency Room

Walking into a crowded ER and describing to the registrar that you have a swollen testicle, loud enough so she can record the details, but quiet enough so that the information is not shared with everyone else in the room is, it turns out, an art form I have yet to perfect. You hope by partly covering the mouth, perhaps coughing under your breath, or avoiding eye contact that they might somehow get the gist. But it turns out the best way is to abandon all shame and just tell it like it is. Fortunately, I’ve not got all that much dignity, so dropping my trousers over and over again is no big deal. That said, there is something undeniably odd about discussing the upcoming wedding arrangements of the attending nurse as she gently cups the testicles with cooling transmission gel to do an ultra-scan. That’s not to say that I don’t share her happiness in securing the golf club for the reception next month.

The News

There’s a feeling, right? You just know. The other person doesn’t need to say anything. You can see it in the way they walk, the way they move their body and the way they move their eyes. And so when they finally ask you to join them in a quiet room, clasping the obligatory clipboard and gently closing the door, you just know. All of a sudden the idea it might be cancer doesn’t seem so extravagant. Instead it feels very real, as though the thought is staring you in the face, unwilling to move. It is, unquestionably, shocking. In fact the memory still gives me goosebumps now.

The Diagnosis

So, just 24 hours has passed by and although the situation has not changed, although you know the outlook is not good, there is nonetheless a spark of optimism, perhaps the faintest hope that the first diagnosis was wrong. Once again, the process begins by dropping the trousers. But the stakes are now high enough that there is barely an acknowledgement of the act. There’s perhaps a little too much eye contact as the doctor checks downstairs, but he is nonetheless meticulous in his examination. He is also incredibly caring, genuinely interested as much in the person as he is the disease. In fact it’s strange that we should even think of the two things being separate really. He asks me to dress and to meet him in his office. I look at my wife a little nervously. She returns the same look.

The Prognosis

You know when the doctor starts drawing pictures that it isn’t going to be straightforward. He talks, a lot. He is kind, considerate and caring in his tone and yet somehow the words evaporate into the air. The weight of the situation begins to settle and as it does, just the odd few words stand out. He is describing the surgery and I find myself squeezing my wife’s hand a little tighter. Next he is talking about fertility and I find my wife squeezing me even harder in return. By this stage there is complete and utter silence in my mind, as he tells us how testicular cancer typically spreads through the body, from the testicles to the lymph system, into the kidney and lungs and finally to the brain. To see just how far the cancer has already traveled we are booked in for a scan the following day. We are also told that we need to deposit some sperm in the next day or so before surgery, as chemotherapy will follow the operation and quite possibly leave me infertile. We leave in a daze. 

The Cryo Bank

Ok, so I should start by saying that the Cryo bank is where you go to store your sperm for a rainy day. I should also tell you that Mrs P mistakenly directed me to Citi Bank rather than Cryo Bank, giving us both some much needed cause for laughter. Good old auto-correct. Having found the right place, we register at the desk and begin the consultation - because it’s not just like you swing by with a tupperware container, there’s a bit more to it than that. First you have to sign papers to say that if an earthquake should hit the building and they are unable to save your sperm that you won’t sue them. You also have to specify who can have access to it. I have to say that I never even considered the possibility that anyone other than my wife would be interested.

The Deposit

So this is probably one of those things that isn’t talked about very much. Maybe rightly so, but perhaps not. If you think about the implications of the act, for any couple forced into making this kind of deposit, there is nothing strange about it. Neither is there anything sexy about it for that matter. This is the business end of things. It feels serious, very medical. They direct me to a corridor with a number of rooms. They ask my wife if she would like to join me. We weren’t expecting that. But as she’s not allowed to touch and by this stage I’m in agony, we decide it’s better that she doesn’t.

The rooms are not at all as I’d expect. It’s a bit like being shown around a boutique hotel. They begin with the sterile room. White walls and a chair. It’s for the uncomplicated man, a man with a strong imagination. The rooms then increase in, how shall I say, encouragement. Next along the corridor is what I called the ‘arty’ room. Black and white images of naked women, posing provocatively, covered the whitewashed walls. There was a pile of magazines in the corner. I didn’t check, but I’m pretty sure they weren’t Readers Digest. Finally I was shown the ‘strong’ room. There was no confusion what this room was for, although with the amount of adult DVDs they had in there, it could well have been mistaken for a porn shop. Whether it was my British reserve or all those years living in a monastery, I mumbled something under my breath and headed back to the first of the three rooms.

The Scan

Back at the hospital the following day, I find myself subject to a whole series of CT scans which I’m reassuringly told is the equivalent to 16,000 x-rays. As the doctor joked, ‘hey, if the cancer doesn’t kill you, the treatment will’. At least I assume he’s joking. As I lay there on the icy cold slab, I can see the technician on the far side of the lab, writing notes as he scans each part of my body. I look for a sign, any indication of what he might be seeing on his computer. After an hour or so, he walks across the room towards me. I nervously ask him how it looks. He places his hand on my chest, he has love in his eyes, and simply replies “I will pray for you” before leaving the room. I lay there silently, alone. Inside my mind raced to decipher those words. What does that mean? Am I about to die?

These are a small selection of journal entries from an upcoming book by Andy Puddicombe. Andy Puddicombe is co-founder of www.headspace.com

For more information, visit http://www.nhs.uk/conditions/Cancer-of-the-testicle/Pages/Introduction.aspx

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