Friday, June 6, 2014

Blog Post 5: Skills Based Tutorials



Skill Based Tutorials

Self examination of the testicles is usually the first step taken in the diagnosis process but can be performed by the patient. To ensure that an examination is performed properly, please adhere to the guidelines in the following tutorial.


For men who undergo the removal of both testicles, testis prosthesis may be an option for you. During the procedure, saline implants are placed in the scrotum. During recovery, patients must refrain from sexual activity and monitor alcohol activity and are limited to the amount of physical activity they may engage in. Other skills that men with testicular cancer must perform include: proper hygiene of the genitals, proper diet, engage in healthy sexual practices, and monitor testicular abnormalities.


Below are guidelines for a testicular self examination:


More information on testicular self examination provided by the American Cancer Society:

The best time to do the self-exam is during or after a bath or shower, when the skin of the scrotum is relaxed. To do a testicular self-exam:

·         Hold your penis out of the way and check one testicle at a time.
·         Hold the testicle between your thumbs and fingers of both hands and roll it gently between your fingers.
·         Look and feel for any hard lumps or smooth rounded bumps or any change in the size, shape, or consistency of the testicles.




Blog Post 4: Questions To Ask Your Healthcare Provider



Being diagnosed with testicular cancer and the subsequent treatment and management; can be traumatic and confusing, however, becoming informed about cancer and its effects will better prepare you to undergo the challenges associated with testicular cancer. Here are a few questions to ask your healthcare provider:

Initial Visit
  • I feel an abnormal lump on my testicle, what could it be?
  • What is testicular cancer?
  • What are the causes of testicular cancer?
  • What are the symptoms of testicular cancer?
  • What are the symptoms of testicular cancer?
  • Will people be able to tell that I have testicular cancer?
  • What is the prevalence of testicular cancer?
  • Who is at risk for developing testicular cancer?
  • How is testicular cancer diagnosed?
  • What are the symptoms of testicular cancer?
  • What lifestyle habits contribute to the development of testicular cancer?
  • Is testicular cancer genetic?
  • How can I prevent testicular cancer?
  • How is testicular cancer diagnosed?

After a Positive Diagnosis
  • How will testicular cancer affect my sex life?
  • Should I inform my family, friends, and co-workers of my diagnosis?
  • What are the stages of testicular cancer?
  • Can I become infertile?
  • What are my treatment options?
  • Can it be cured?
  • What is the survival rate?
  • Can my cancer spread? 

Preoperative
  • Will the treatment cause any discomfort?
  • How much time will I need for recovery?
  • Will my treatment take place at an outpatient facility?
  • What medications will I be taking?
  • Which treatment option is best for me, chemotherapy, radiation, or surgery?
  • Which type of treatment do you recommend?
  • Is one type of treatment more effective than another?
  • Can the cancer return?
  • What side effects can I expect from the treatment?
  • Will I need to see other doctors?
  • Should I seek another opinion?
  • What are my fertility options?
  • What are testicular implants?
  • Will the treatment affect my ability to gain and maintain an erection?
  • How will my testosterone levels be affected?
  • What are some alternative and holistic treatment options?
  • How should I prepare for my treatment?
  • Is testicular cancer painful?
  • Does testicular cancer put me at greater risk for developing certain STDs?
  • How will a treatment option affect my appearance?
  • Should I abstain from sexual intercourse, if so, for how long?
  • Will testicular cancer and treatment affect my sperm count?
Postoperative/Follow Up
  • What is remission?
  • Is my cancer in remission?
  • Will I need further treatment?
  • I’m feeling discomfort, is that normal?
  • Testicular Cancer Management
  • What are the lifestyle changes that I have to make?
  • How often should I perform a testicular self examination?
  • How can I prevent my can from reoccurring?
  • How often should I have a check up with my physician?
  • Am I at risk for developing other types of cancer?
  • Can my son get testicular cancer?
  • Should I limit my alcohol consumption?
  • Should I quit smoking?
  • How can I change my diet
  • How often can I have sex?
  • Can my partner and I try to have children?
  • How long do I have to take testosterone?

Sunday, June 1, 2014

Blog Post 3: Recommendations for Family Members

Upon the diagnosis of testicular cancer, it can be extremely difficult not only for the patient but for family members as well. However, support from family, friends, and colleagues offers the opportunity to develop effective coping skills that lessen the burdens associated with a positive cancer diagnosis. In Essentials of Patient Health Education, it is stated that "the patient's family is perhaps the single most significant determinant of the success or failure.." Using the six dimensions of wellness as a guide, familial support can be provided in the following ways:




Social Support

The most important dimension of wellness in regard to recommendations for family members with relatives who have testicular cancer is social support. Individuals who have support prior to diagnosis, during treatment, and recovery; exhibit better pain management skills, better coping skills, faster recovery, and a higher self esteem. Social support can come from any interpersonal relationship but is especially effective when support comes from family, especially a spouse of significant other. There are many ways to demonstrate support. Families can attend support groups together, attend all physician appointments, engaging in active listening, and accommodate family activities to the needs of the patient. Counseling is a great way to overcome any challenges that exist within the family due to a positive diagnosis. A psychologist will be able to assist families communicate thoughts and feelings.

Physical Support

It is essential to recovery to remain active and the family unit creates the perfect opportunity to engage in manageable physical activities. Families can participate in marathons (especially those geared toward garnering funding for cancer research, i.e. American Cancer Society Relay for Life), camping trips, or a hike. It is also important to note that if chemotherapy is the chosen treatment method, then the patents appearance may be greatly affected in the form of hair loss, low BMI (Body Mass Index), rash, and muscle/joint pain and that the utmost care must be taken to not offend them or comment on appearance.

Depending on the stage of cancer and type of treatment, physical activity may not be an option; however, physical support can be provided in a number of ways. For example, relatives can assist with errands that may be too taxing on the patient, including: walking household pets, grocery shopping, home maintenance, and assistance with the care of small children.

A simple table for determining BMI is below. Heights are at the bottom the chart and weigh is to the left:


Occupational Support

It is important that family members take an active role in the patient's occupational challenges that result from a cancer diagnosis. Simple tasks such as preparing lunch, organizing prescribed medications, and  transportation to and from work will lessen the burden of the patient. Co-workers can also alleviate work related stressors by donating sick time, running errands, and assist with work overload. Employers should take the opportunity to establish work site health education and promotion programs to educate the staff about cancer, risk factors, and a myriad of health related information. Everyone can take part in the recovery efforts of a loved one. More information regarding occupational support can be found at the American Cancer Society website.

Emotional Support

One of the disheartening effects of testicular cancer is the possibility of infertility. This can have devastating effects on the family unit and requires open communication amongst its members. For a young man to be told that he is unable to bare children, it can burden young couples with no children or established couples seeking to add to their family. If one testicle remains, fertility prospects are improved but reproductive options should be discussed openly and as a family.Testosterone levels may dwindle during treatment, which may affect the emotional output of the male. It is important for family members to realize that this is simply a side effect of treatment and not a personal affect.

Spiritual Support

Spiritual support can occur in many forms and for people with cancer, may be an influential determinant in their treatment and recovery. Often, many people going through difficult circumstances supplement treatment with faith. Families can attend church services together, seek spiritual advice, rely on alternative medicine, or participate in meditation. Some patients find relieve by being in soothing and sensual environments, like a beach or an open field. Music also provides soothing benefits and calming effects. So, creating a spiritually enriching environment can be very supportive.

Intellectual Support


Supporting the patient by becoming informed on the specifics of testicular cancer; will show them that you are empathetic towards their situation. By remaining informed on the statistics, latest research, and implications; a family member is subconsciously saying that they are there for you. With all members taking part in the intellectual support, the patient will gain confidence in knowing that his family is fighting the battle with him. Family members should engage in the in the health education of the patient by determining literacy of written material, asking questions to ensure understanding, and reiterate important instructions from health care providers. 

Tuesday, May 27, 2014

Blog Post 2: Daily Management of Testicular Cancer


Primary Care


The greatest impact a patient can have in the management of any disease is during primary care. Primary care consists of taking preventative measures to eliminate or reduce risk factors and prevent the onset of a particular disease. This includes: getting an annual physical from a primary physician that includes an examination of the penis, testicles, prostate, vitals, blood work, and an examination of family medical history. Self examination of the testicles is usually the first step taken in the diagnosis process but can be performed by the patient. Below are guidelines for a testicular self examination provided by the American Cancer Society:


The best time to do the self-exam is during or after a bath or shower, when the skin of the scrotum is relaxed. To do a testicular self-exam:

  • Hold your penis out of the way and check one testicle at a time.
  • Hold the testicle between your thumbs and fingers of both hands and roll it gently between your fingers.
  • Look and feel for any hard lumps or smooth rounded bumps or any change in the size, shape, or consistency of the testicles.
For more information, please visit the American Cancer Society website




Maintaining a balanced diet is also a preventative measure that can be implemented daily to reduce the risk of testicular cancer and/or alleviate the symptoms associated with its treatment (radiation, chemotherapy, etc.) Some general dietary guidelines include:  A diet rich in fiber and low in fat, consuming a diet that includes vitamin C, vitamin E, beta carotene, and selenium, and reducing the intake of alcohol. These vitamins are essential in the diet of someone at risk for or diagnosed with testicular cancer because a deficiency in these vitamins have been shown to increase overall health and treatment effectiveness, especially vitamin C which has been studied as a potential treatment for cancer. You can create your own meal using this infographic from the University of Texas Anderson Center:



Life Stage
Recommended Amount
Birth to 6 months
40 mg
Infants 7–12 months
50 mg
Children 1–3 years
15 mg
Children 4–8 years
25 mg
Children 9–13 years
45 mg
Teens 14–18 years (boys)
75 mg
Teens 14–18 years (girls)
65 mg
Adults (men)
90 mg

Excellent sources of Vitamin C include: organs, guava, bell papers, grape fruit, and cantaloupe


Life Stage
Recommended Amount
Birth to 6 months
4 mg (6 IU)
Infants 7–12 months
5 mg (7.5 IU)
Children 1–3 years
6 mg (9 IU)
Children 4–8 years
7 mg (10.4 IU)
Children 9–13 years
11 mg (16.4 IU)
Teens 14–18 years
15 mg (22.4 IU)
Adults
15 mg (22.4 IU)

Excellent sources of Vitamin E include: wheat germ, sunflower, corn and soybean oils, hazelnuts, and green vegetables


Table 1: Recommended Dietary Allowances (RDAs) for Selenium [6]
Age
Male
Female
Pregnancy
Lactation
Birth to 6 months
15 mcg*
15 mcg*


7–12 months
20 mcg*
20 mcg*


1–3 years
20 mcg
20 mcg


4–8 years
30 mcg
30 mcg


9–13 years
40 mcg
40 mcg


14–18 years
55 mcg
55 mcg
60 mcg
70 mcg
19–50 years
55 mcg
55 mcg
60 mcg
70 mcg

Excellent source of Selenium: muscle meats, grains, dairy products, fish, and poultry

Physical activity also needs to be incorporated into the daily routine of individuals with testicular cancer. The American College of Sports Medicine recommends at least 20 minutes of moderate cardio three times a week, strength training four times a week, and stretching flexibility exercises should be incorporated into both with sufficient rest time each week.


Secondary & Tertiary Care

In secondary care, screenings are implemented for the purpose of diagnostics. Following a self exam, a patient should make an appointment with a primary care physician whom will then be able to make a positive diagnosis. At this point, the patient should become informed with testicular cancer through the plethora of information available online and the past and ongoing research; and pending the results of a diagnostic exam, seek the assistance of a certified health education specialist in tailoring a health care plan for the patient.

Tertiary care consists of alleviating the pain or discomfort associated with a positive diagnosis of testicular cancer and its treatment. For day to day management, alternative and holistic approaches should be considered given the approval of a physician. Some naturopahic therapies from the Cancer Treatment Centers of America are listed below:


  •  Herbal and botanical preparations, including herbal extracts and teas.
  • Dietary supplements, including vitamins, minerals and amino acids.
  • Homeopathic remedies, extremely low doses of plant extracts and minerals that gently strengthen the body's healing and immune response.
  • Physical therapy and exercise therapy, including massage and other gentle techniques used on deep muscles and joints for therapeutic purposes.
  • Hydrotherapy, which prescribes water-based approaches like hot and cold wraps, and other therapies.
  • Lifestyle counseling: Many medical conditions can be treated with exercise, improved sleep, stress reduction techniques, as well as foods and nutritional supplements.
  • Acupuncture: Your naturopathic oncology provider may also recommend incorporating acupuncture into your treatment plan.
Many alternative medicine enthusiast recommend yoga to alleviate some of the ailments associated with cancer and the effects of treatment. Below is a video demonstrating a simple yoga pose:



Once diagnosed and a treatment plan has been selected, it is important for a patient to have diet and fitness plans tailored to their specific needs and preferences. Grueling chemotherapy or recovery from radical inguinal orchiectomy can put limitations on diet and physical activity. An assessment should be completed to determine which programs are most suitable for you. Often, patients are fatigued and nauseous from treatment, so activity might be limited to a brisk walk or light swimming and diet would consist of liquids, soft foods, and minimal spices and peppers as to not agitate the digestive system. It is important to note that once diagnosed and treated, cancer prevention should be an ongoing task for those at risk or recovering and requires guidance, dedication, and consistency in order to live optimally.

 


Blog Post 1: Testicular Cancer: An Introduction

Introduction

Testicular cancer happens when abnormal cell growth occurs in the testicles. It is most common in males between the ages of 15 and 34 and the rates have been increasing but fortunately, it is very treatable. A man only has about a 1 in 270 chance of developing testicular cancer. About 8,800 new cases are diagnosed each year (Centers For Disease Control) .The average age of diagnosis is 33. It is not as prevalent as prostate cancer, which is still the most common cancer for males (American Cancer Society).

Symptoms

• (usually occurring in only one testicle)
• Lump or enlargement of testicle
• A feeling of heaviness in the scrotum • Ache or pain in the abdomen
 • Fluid in the scrotum
• Pain or discomfort in the scrotum
(Mayo Clinic)

Causes


Like many cancers, the exact cause is unknown but some environmental factors may contribute to testicular cancer and a genetic factor is currently being researched. Testicular cancer develops in the germ cells of the testicle that are responsible for producing immature sperm. Risk Factors Testicular factors usually affect young, Caucasian men. A male is more likely to develop testicular cancer if a family member was diagnosed with it or if they have an undescended testicle.

Diagnosis

Diagnosis is completed through various tests including: ultra sound, biopsy, and blood tests. Prognosis To determine the stage of cancer, CT scans (Computerized tomography) and blood tests are performed. The stages are as follows:
• Stage I. Cancer is limited to the testicle.
• Stage II. Cancer has spread to the lymph nodes in the abdomen.
• Stage III. Cancer has spread to other parts of the body.

Testicular cancer most commonly spreads to the lungs, liver, bones and brain. Testicular cancer can be one of two types; a seminoma, which occurs in older men or a nonseminoma, is more aggressive and occurring in younger men.

Treatment

Treatment is determined based on type of cancer and prognosis. The most common treatments are: surgical removal of the testicle ((radical inguinal orchiectomy), chemotherapy, or radiation therapy. Each treatment method has advantages and disadvantages and patient preference should be considered when choosing a treatment plan.