Malignancy, masculinities, and psychological distress: Comparisons made between men with testicular cancer and healthy controls.

OBJECTIVE: Psychological distress is common in men with testicular cancer (TC), and masculinities may work to explain this. This study aimed to compare masculinities and distress in TC and healthy control (HC) populations and explore relationships between correlates of distress (psychological flexibility and coping style) and masculinities in TC. METHODS: A cross-sectional, online survey was completed by 92 men with TC (Mage  = 34.8) and 90 HC (Mage  = 30.7). Measures included psychological distress (Patient-Reported Outcomes Measurement Information System Depression/Anxiety, fear of cancer recurrence inventory-short form), masculinities (gender role conflict-short form, inventory of subjective masculinity experiences/subjective masculinity stress scale, masculinity in chronic disease inventory), coping style (mini-mental adjustment to cancer ) and psychological flexibility (comprehensive assessment of acceptance commitment therapy). Linear regressions were conducted to compare groups and analyse associations. RESULTS: There were no differences in masculinities or psychological distress between populations (all p > 0.05 and all Cohen's d < 0.20), except for subjective masculine stress and restrictive affectionate behaviour between men. For men with TC, restrictive affection/emotion, conflicts between family/work and subjective masculine stress were associated with psychological distress (rs 0.21-0.58). Optimistic action was negatively associated with depression/anxiety, helplessness/hopelessness coping (rs -0.27 to -0.42) and positively associated with psychological flexibility (r = 0.35). CONCLUSIONS: Masculinities are implicated in psychological distress in men with TC. Psychological flexibility as well as leveraging masculine beliefs (e.g., optimistic action) may be modifiable targets to reduce distress in men with TC.

Effects of Information Provided to University Students Through an Educational Brochure on Health Beliefs and Testicular Self-Examination.

This study aimed to examine the effect of an educational brochure about testicular cancer and its early diagnosis on the health beliefs and self-examination of participants. The pretests/posttests were conducted in a quasi-experimental design with non-randomized groups and a control group of university students. The study recruited students enrolled in the psychological counseling and guidance department of a Turkish public university. The research sample comprised 92 students, 48 in the experimental and 44 in the control group. An educational brochure about testicular cancer and self-examination was provided to the experimental group. The data includes a personal information form, testicular cancer and health beliefs scale about testicular self-examination, and the form for self-examination. Mann Whitney U, Wilcoxon, and chi-square analyses were performed for data analysis. A significant difference was found between the scores of the experimental and control groups regarding seriousness/caring, benefit and health motivation, obstacles, and self-efficacy (p < 0.05). Moreover, the testicular self-examination ratio was determined as 83.3% in the experimental group and 4.5% in the control group. It can be asserted that the training brochure is effective in promoting the self-examination of testicles. It may be recommended to conduct experimental studies with larger study groups to increase testicular self-examination.

The effect of educational intervention based on health belief model and social support on testicular self-examination in sample of Iranian men.

BACKGROUND: Testicular Self-Examination (TSE) causes earlier diagnosis of Testicular cancer (TC). Hence, all men aged between15 to 35 years should perform TSE every month. This study aims to survey the effect of educational intervention based on health belief model and social support on testicular self-examination in men aged between 15 to 35 years of Fasa City, Fars province, Iran. METHODS: In this quasi-experimental study, 200 men (100 in the experimental group and 100 in the control group) in Fasa City, Fars, Iran, were conducted from June 2018 to August 2019. The educational intervention for the experimental group consisted of six training sessions (testicular cancer, its prevalence and types, its risk factors, symptoms, infected areas, diagnosis, side-effects and its severity, understanding about testicular self-examination and its importance, benefits, and barriers of self-examination and correct way of doing TSE were discussed, role of social support). A questionnaire consisting of demographic information, knowledge, HBM construct, and social support was used to measure testicular self-examination before, 3 months after the intervention, and 6 months later. Data were analyzed using SPSS-22 via chi-squared, independent samples t-test, Mann-Whitney, and repeated measures ANOVA at a significance level of 0.5. RESULTS: The mean age of the men was 27.26 ± 3.16 years in the experimental group and 27.39 ± 3.12 years in the control group. Three months after the intervention and 6 months after the intervention, the experimental group showed a significant increase in knowledge, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, cues to action, social support, and testicular self-examination performance compared to the control group. CONCLUSION: This study showed the effectiveness of the intervention based on the HBM constructs and social support in the adoption of testicular self-examination in 3 and 6 months post-intervention in men aged between 15 to 35 years. Hence, these models can act as a framework for designing and implementing educational interventions for testicular self-examination.

The impact of chemotherapy on cognitive function: a multicentre prospective cohort study in testicular cancer.

PURPOSE: The causal link between chemotherapy and cognitive impairment is unclear. We studied testicular cancer patients' objective and subjective cognitive function longitudinally, comparing a surgery group with a surgery + chemotherapy group, addressing prior methodological issues using a computerized test to limit assessment issues, and controlling for confounding variables. METHODS: Prospectively, of 145 patients from 16 centres with sufficient data, n = 61 receiving surgery + chemotherapy (etoposide and cisplatin ± bleomycin, BEP/EP; or single agent carboplatin) were compared to n = 41 receiving surgery alone. CogHealth assessed six objective cognitive tasks. The Cognitive Failures Questionnaire assessed self-perceived cognitive dysfunction. The Functional Assessment of Chronic Illness Therapy-Fatigue and the Hospital Anxiety and Depression Scale assessed psychological influences. Linear mixed models compared changes from baseline (< 6 months post-surgery/pre-chemotherapy) to follow-up (12-18 months post-baseline), controlling covariates. RESULTS: There were no significant interaction effects for five objective cognitive function tasks suggesting that changes over time were not due to group membership. However, psychomotor function (controlling for age) and physical well-being were significantly worse for the chemotherapy versus the surgery group at baseline, with groups converging by follow-up. Groups showed no differences in subjective cognitive dysfunction. The chemotherapy group showed higher anxiety, poorer functional well-being and worse fatigue compared to the surgery-only group at baseline, but not by follow-up. For both groups, emotional well-being, functional well-being and anxiety significantly improved over time. CONCLUSION: No substantive differences in objective or subjective cognitive dysfunction in either group persisted 12-18 months post-baseline. Patients undergoing chemotherapy for testicular cancer differ from findings in breast cancer populations. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: ACTRN12609000545268.

Fertility managment in testicular cancer: the need to establish a standardized and evidence-based patient-centric pathway.

OBJECTIVES: The aim of the present paper was to determine the impact of testicular cancer (TC) and its treatments on fertility and to review the current management options for the infertile patient with TC, both before diagnosis and after treatment, with the aim of providing practical recommendations to update contemporary guidelines and standardize clinical practice. PATIENTS AND METHODS: Searches were conducted for relevant articles on Pubmed and Google Scholar between 2000 and 2017, with additional articles sourced from reference lists of included publications. RESULTS: At time of diagnosis, 6-24% of patients with TC were reported to be azoospermic and 50% oligozoospermic. Without conducting semen analysis at diagnosis, these patients cannot be identified and may be at further risk of subfertility. Gonadotoxic therapies cause an overall decrease in male fertility by 30% and there is currently no method to predict which patients will become azoospermic after treatment. Patients with larger, more invasive tumours, however, are at greater risk of infertility from local tumour effects, and are also more likely to undergo several different type of therapy, which has further detrimental effects on conception rates. Most treatment-induced infertility recovers 2 years post-treatment, but paternity can be delayed during a couple's peak reproductive years. Semen cryopreservation remains the procedure of choice in preserving fertility, but the service is underused, with only 24% of patients banking sperm. Microdissection testicular sperm extraction (microTESE) at the time of orchidectomy (onco-microTESE) is a successful infertility treatment option for those found to be azoospermic or severely oligozoospermic at diagnosis, while microTESE may still retrieve sperm in azoospermic patients after chemotherapy. CONCLUSION: The underutilisation of semen analysis and sperm cryopreservation results in the failure to identify the azoospermic or severely oligozoospermic patient at diagnosis who may benefit from fertility-preserving procedures, for example, onco-microTESE at the time of orchidectomy. Fertility preservation and counselling needs to be broached earlier in the TC treatment pathway and made a greater priority. Given the advances in treatment, more patients with TC are surviving and looking to return to a normal life. Preserving their future fertility plays an important role in achieving this.

Long-Term Cognitive Functioning in Testicular Germ-Cell Tumor Survivors.

BACKGROUND: Treatment for cancer may lead to development of cognitive difficulties in cancer survivors. This study aimed to evaluate long-term cognitive functioning (CogF) in germ-cell tumor (GCT) survivors. SUBJECTS, MATERIALS, AND METHODS: GCT survivors (n = 155) from the National Cancer Institute of Slovakia completed the Functional Assessment of Cancer Therapy Cognitive Function at a median of 10 years of follow-up (range: 5-32). The study group consisted of survivors receiving a cisplatin-based chemotherapy, radiotherapy to the retroperitoneal lymph nodes, or both, whereas the control group included survivors treated with orchiectomy only. RESULTS: Of the total survivors, 138 received treatment beyond orchiectomy and 17 controls had orchiectomy alone. Any treatment resulted in significantly greater cognitive difficulties on the overall cognitive function score. Treatment with radiotherapy was associated with cognitive declines in overall cognitive functioning and in subscales for perceived cognitive impairment and cognitive impairment perceived by others (both p < .05). The burden of chemotherapy plus radiotherapy or radiotherapy versus controls resulted in the impairment in all cognitive functioning domains (all p < .05). Overall long-term cognitive impairment was independent of age in the multivariable analysis. CONCLUSION: This prospective study shows that GCT survivors suffer from a long-term CogF impairment. These results may help guide clinicians' decisions in treatment and follow-up of GCTs. IMPLICATIONS FOR PRACTICE: In this study, long-term survivors of germ-cell tumors have reported cognitive impairment after curative treatment with radiotherapy and chemotherapy compared with controls who had treatment with orchiectomy only. These data provide an argument against the use of adjuvant radiotherapy for stage I seminoma. Unnecessary overtreatment with chemotherapy and additional radiotherapy after chemotherapy should be avoided.

International phase IV validation study of an EORTC quality of life questionnaire for testicular cancer patients: the EORTC QLQ-TC26.

BACKGROUND: Given the high cure-rate for testicular cancer (TC) and the patients' young age, comprehensive evaluation of health-related quality of life (HRQOL) is an important consideration in this patient population. The EORTC QLQ-TC26 questionnaire module has been developed to supplement the EORTC QLQ-C30 in assessing TC-specific HRQOL in clinical trials and routine clinical practice. This international, multicentre phase IV validation study evaluated the psychometric properties of the new module. METHODS: This international, multicentre phase IV validation study enrolled testicular cancer patients from seven European countries. Patients completed the EORTC quality of life core questionnaire EORTC QLQ-C30 and the QLQ-TC26 at two consecutive time points and a debriefing questionnaire regarding the QLQ-TC26 after baseline assessment. Psychometric evaluation included examination of the hypothesized module scale structure, internal consistency and test-retest reliability, known-groups validity, responsiveness to change over time and cross-cultural acceptability. RESULTS: Data from 313 patients (mean age 38.6, SD 9.5) were analysed. All items exhibited a high completion rate with less than 2.4% missing values except for the sexuality items (up to 8.8%). The confirmatory factor analysis supported the hypothesised scale structure of the QLQ-TC26. Test-retest reliability was good for 8 of 12 scales (intraclass correlation: R t1|t2 ranged from 0.71-0.91) and four scales did not meet the acceptable criteria. Internal consistency was good for all twelve scales (Cronbach alpha = 0.79-0.90), except Communication (alpha = 0.67) and Sexual Functioning (alpha = 0.62). The module was able to distinguish clearly between patients with differing clinical status. Responsiveness to change over time was acceptable. CONCLUSION: The EORTC QLQ-TC26 is a valid, reliable and well-accepted condition-specific questionnaire, supplementing the EORTC QLQ-C30, for the assessment of testicular cancer patients' HRQOL in clinical trials.

Testicular self examination among Bahir Dar University students: application of integrated behavioral model.

BACKGROUND: Though the incidence of Testicular cancer among young is rising, little attention is given to promoting testicular self-examination which is recommended for its early prevention in developing countries. This study aimed to assess testicular self-examination and associated factors among Bahir Dar University students using integrated behavioral model. METHODS: Cross sectional study was conducted among Bahir Dar University students in September, 2016. Systematic sampling technique was used to select 884 participants. Data was collected using self-administer questionnaire, entered into EPI Data 3.1 and exported to SPSS 21 for analysis. Path analysis was done using STATA 14.2 to check causal effect of integrated behavioral model constructs on testicular self-examination. Internal reliability of the items was checked using Cronbach's alpha. Multivariable linear and Logistic regression were used to predict the role of independent variable on Intention and TSE respectively. Findings with p-value <0.05 at 95% confidence interval were considered as statistically significant in the final model. RESULTS: Only 11.8% of the students practiced testicular self-examination in the previous year. Experiential and Instrumental attitude, Perceived control and Self-efficacy were significantly predicted behavioral intention with ß coefficient 0.33, 0.12, -0.08 and 0.36. Students' academic unit [OR = 0.31, 95% CI: 0.15-0.63], educational status of student's father AOR = 2.25; CI: 1.15-4.44] and [AOR = 3.00; CI: 1.36-6.64], Intention [OR = 1.2, 95% CI: 1.1-1.31], Know-how of TSE [OR = 3.35, 95% CI:1.94-5.80] and knowledge [AOR = 3.93; CI: 2.30-6.72] were the significant predictors of testicular self-examination. The finding of path analysis also demonstrated as Experiential and Instrumental attitude, Perceived control and Self-efficacy have significant effect on intention with path coefficient of 0.33, 0.12, -0.07 and 0.36. Intention, Knowledge and Know-how have effect on testicular self-examination with path coefficient of 0.2, 0.36 and 0.22 respectively. CONCLUSIONS: Magnitude of testicular self-examination is low among university students and it is a product of the type of the college, family educational status, intention, Know-how and knowledge. So, behavior change communication strategy that focus on these behavioral factors should be designed and implemented to improve students' regular practice of testicular self-examination.

A systematic review of quantitative observational studies investigating psychological distress in testicular cancer survivors.

OBJECTIVE: Testicular cancer (TC) affects young men and may cause psychological distress despite a good prognosis. This systematic review evaluated the prevalence, severity, and correlates of anxiety, depression, fear of cancer recurrence (FCR), and distress in TC survivors. METHODS: A systematic search of literature published 1977 to 2017 was conducted to find quantitative studies including TC survivor-reported outcomes relevant to review objectives. The quality of included articles was assessed, and a narrative synthesis conducted. RESULTS: Of 6717 articles identified, 66 (39 good, 20 fair, and 7 poor quality) reporting results from 36 studies were included. Testicular cancer survivors' mean anxiety levels were higher than in the general population, while mean depression and distress were no different. Clinically significant anxiety (≈1 in 5) and to a lesser extent distress (≈1 in 7), but not depression, were more prevalent in TC survivors than the general population. Approximately 1 in 3 TC survivors experienced elevated FCR. Poorer psychological outcomes were more common among TC survivors who were single, unemployed/low socio-economic status, suffering from co-morbidities, experiencing worse symptoms/side effects, and using passive coping strategies. CONCLUSIONS: Many TC survivors do not experience significant psychological morbidity, but anxiety and FCR are prevalent. Inadequate coping resources (eg, low socio-economic status and social support) and strategies (eg, avoidance) and greater symptoms/side effects were associated with poorer outcomes. Theoretically driven prospective studies would aid understanding of how outcomes change over time and how to screen for risk. Age and gender appropriate interventions that prevent and manage issues specific to TC survivors are also needed.

Danish translation and pilot testing of the European Organization for Research and Treatment of Cancer QLQ-TC 26 (EORTC QLQ-TC26) questionnaire to assess health-related quality of life in patients with testicular cancer.

BACKGROUND: The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 is a core questionnaire designed to evaluate health-related quality of life (HRQoL) of cancer patients participating in international clinical trials. It is available in several languages including Danish. The EORTC QLQ-TC26 is a supplemental module developed for patients with testicular cancer, which can be useful in clinical trials. Despite Denmark holding a high prevalence and incidence of testicular cancer, no Danish translation was previously available. This paper describes the translation process and pilot testing of the Danish translation of QLQ-TC26. METHODS: The English language EORTC QLQ-TC26 was translated into Danish using forward and backward procedures with reconciliation. The translated instrument was assessed in semi structured cognitive interviews in a sample of 10 patients ages 20-56 receiving treatment for testicular cancer. RESULTS: In one round of pilot testing, no changes were required for the Danish translation based upon patient comments. The Danish translation was agreed by participants to be both culturally acceptable and semantically comprehensible. CONCLUSIONS: The pilot testing of the Danish translation of the EORTC QLQ-TC26 was performed in one round of patient interviews; these results support the Danish translation as a comparable instrument to the English language version. However, further validation is required to ensure complete equivalency. These results support the use of the EORTC QLQ-TC26 in future clinical trials conducted with Danish-speaking patients.

Clinical features and psychological aspects of the decision-making process in stage I testicular germ cell tumors.

Testicular germ cell tumors (TGCTs) are the most prevalent malignancies in young Caucasian men. Clinical stage I (CSI) TGCTs present the highest cure rate and treatment options after orchiectomy depend on histology and risk factors. Nevertheless, the management of CSI TGCTs is controversial due to the availability of multiple treatments and the lack of randomized trials. An integrated multidisciplinary approach that includes clinicians (surgeons, radiotherapists and oncologists) and psychologists is crucial to maximize the patients' compliance and must be acknowledged with appropriate tools. The aim of our work is to review the oncological and psychological aspects of the decision-making process, discussing the fundamental role of the patient involvement in the personalized management of CSI TGCTs.

The Effect of Testicular Self-Examination Education on Knowledge, Performance, and Health Beliefs of Turkish Men.

Testicular cancer is the most common cancer among young adult men and easily detected at an early stage by periodic testicular self-examination (TSE); however, health care providers seldom teach TSE, thus opportunities for early detection are missed. We aimed to evaluate the efficacy of TSE education on the knowledge, performance, and health beliefs of Turkish young men. This quasi-experimental follow-up research was conducted on 174 male Health Science university students in Turkey. The data was collected by a modified socio-demographic form and questionnaire, and the Turkish version of Champion Health Belief Model Scale which was performed at two stages: before and 3 months after education. Before education, 66.2% of the students did not know anything about TSE, and the main reason for not to perform TSE was the lack of knowledge prior to education. The results showed a significant increase in the perceived benefits in terms of TSE after education (p < 0.05). Furthermore, a positive improvement in the behavior of the students toward TSE was observed after education. These results indicate that TSE training is effective in young men, but TSE training should be repeated periodically for better efficacy. These results support that health professionals should have a more active role in the training of adult young men in colleges in terms of TSE.

Mechanisms of navigating goals after testicular cancer: meaning and emotion regulation.

OBJECTIVE: The navigation of major life goals can be challenging to cancer survivors, particularly during young adulthood. This study examined the relationships of goal navigation skills (e.g., goal identification, goal clarification, and goal adjustment) with having a sense of life meaning, emotion regulation coping processes, and physical and psychological health indicators in young adult survivors of testicular cancer. METHODS: Men ages 18 to 29 years (N = 171; M age = 25.2, SD = 3.32) with a history of testicular cancer were recruited via the California State Cancer Registry and completed questionnaire measures including assessments of goal navigation, sense of meaning, emotional approach coping, and indicators of physical and psychological well-being. RESULTS: Goal navigation skills were negatively related to depressive symptoms (r = -0.41, p < 0.01) and positively related to physical functioning (r = 0.28, p < 0.01). Controlling for participant age and months since diagnosis, mediation models revealed significant indirect effects of sense of meaning on depressive symptoms (-0.50, p < 0.05) and physical functioning (0.34, p < 0.05). Similarly, emotion-regulating coping had significant indirect effects on depressive symptoms (-0.08, p < 0.05) and physical functioning (0.11, p < 0.05) CONCLUSIONS: Consistent with a self-regulation framework, goal navigation skill is related to physical and psychological well-being via its association with maintenance of a sense of meaning as well as successful attempts at regulation of emotions. The study provides preliminary evidence that these skill-based processes relate to adjustment to cancer in young adults. Copyright © 2016 John Wiley & Sons, Ltd.

International evaluation of the psychometrics of health-related quality of life questionnaires for use among long-term survivors of testicular and prostate cancer.

BACKGROUND: Understanding of the physical, functional and psychosocial health problems and needs of cancer survivors requires cross-national and cross-cultural standardization of health-related quality of life (HRQoL) questionnaires that capture the full range of issues relevant to cancer survivors. To our knowledge, only one study has investigated in a comprehensive way whether a questionnaire used to evaluate HRQoL in cancer patients under active treatment is also reliable and valid when used among (long-term) cancer survivors. In this study we evaluated, in an international context, the psychometrics of HRQoL questionnaires for use among long-term, disease-free, survivors of testicular and prostate cancer. METHODS: In this cross-sectional study, we recruited long-term survivors of testicular and prostate cancer from Northern and Southern Europe and from the United Kingdom who had participated in two phase III EORTC clinical trials. Participants completed the SF-36 Health Survey, the EORTC QLQ-C30 questionnaire, the QLQ-PR25 (for prostate cancer) or the QLQ-TC26 (for testicular cancer) questionnaires, and the Impact of Cancer questionnaire. Testicular cancer survivors also completed subscales from the Nordic Questionnaire for Monitoring the Age Diverse Workforce. RESULTS: Two hundred forty-two men (66% response rate) were recruited into the study. The average time since treatment was more than 10 years. Overall, there were few missing questionnaire data, although scales related to sexuality, satisfaction with care and relationship concerns of men without partners were missing in more than 10% of cases. Debriefing showed that in general the questionnaires were accepted well. Many of the survivors scored at the upper extremes of the questionnaires, resulting in floor and ceiling effects in 64% of the scales. All of the questionnaires investigated met the threshold of 0.70 for group level reliability, with the exception of the QLQ-TC26 (mean reliability .64) and the QLQ-PR25 (mean reliability .69). The questionnaires were able to discriminate clearly between patients with and without comorbid conditions. CONCLUSIONS: The currently available HRQoL questionnaires exhibit acceptable psychometric properties and were well received by patients, but additional efforts are needed to ensure that the full range of survivor-specific issues is assessed.

e-TC: Development and pilot testing of a web-based intervention to reduce anxiety and depression in survivors of testicular cancer.

e-TC is an online intervention designed to address common psychosocial concerns of testicular cancer survivors. It aims to reduce anxiety, depression and fear of cancer recurrence by providing evidence-based information and psychological intervention. This paper details the development and pilot testing of e-TC. During pilot testing, 25 men (with varying psychological profiles) who had completed treatment for testicular cancer, 6 months to 5 years ago (which had not recurred), used e-TC over a 10-week period and provided quantitative and qualitative feedback on the feasibility and acceptability of the programme. Six men also completed a qualitative interview to provide detailed feedback on their experiences using e-TC. Fourteen men (56%) completed at least 80% of the programme. Participants reported a high level of satisfaction with the programme. Men's limited time was a barrier to programme use and completion, and participants suggested that men with a more recent diagnosis and a higher level of distress may be more likely to engage with the programme. e-TC appears to be a feasible and acceptable online intervention for survivors of testicular cancer. Findings from this study are currently being used to refine e-TC and guide the design of a larger efficacy study.

Masculine norms about emotionality and social constraints in young and older adult men with cancer.

Beliefs that men should restrict their display of emotions, or restrictive emotionality, might contribute to adjustment to cancer and this might be sensitive to social receptivity to disclosure. The present research examined relationships of restrictive emotionality, social constraints, and psychological distress in young adults with testicular cancer (N = 171; Study 1) and older men with prostate cancer (N = 66; Study 2). Study 1: positive associations were observed for social constraints and restrictive emotionality with depressive symptoms. Social constraints moderated the relationship, such that high restrictive emotionality was associated with higher depressive symptoms in those with high constraints. Study 2: only social constraints (and not restrictive emotionality) was positively associated with depressive symptoms and cancer-related intrusive thoughts. The social constraints × restrictive emotionality interaction approached significance with depressive symptoms, such with high social constraints low restrictive emotionality was associated with higher depressive symptoms compared to those with less constraints. No significant associations were found for intrusive thoughts in either study. Findings demonstrate unique relationships with psychological distress across the lifespan of men with cancer given perception of constraints and adherence to masculine norms about emotionality.

Is it safe to insert a testicular prosthesis at the time of radical orchidectomy for testis cancer: an audit of 904 men undergoing radical orchidectomy.

OBJECTIVE: To compare the complication rate associated with synchronous prosthesis insertion at the time of radical orchidectomy with orchidectomy alone. PATIENT AND METHODS: All men undergoing radical orchidectomy for testis cancer in the North West Region of England between April 1999 to July 2005 and November 2007 to November 2009 were included. Data on postoperative complications, length of stay (LOS), re-admission rate and return to theatre rate were collected. RESULTS: In all, 904 men [median (range) age 35 (14-88) years], underwent a radical orchidectomy during the study period and 413 (46.7%) were offered a prosthesis, of whom 55.2% chose to receive one. Those offered a prosthesis were significantly younger (P < 0.001), with a median age of 33 vs 37 years. There was no significant difference between the groups for LOS (P = 0.387), hospital re-admission rates (P = 0.539) or return to theatre rate (P = 0.999). In all, 33/885 patients were readmitted ≤30 days of orchidectomy, with one of 236 prosthesis patients requiring prosthesis removal (0.4%). Older age at orchidectomy was associated with an increased risk of 30-day hospital re-admission (odds ratio 1.032, P = 0.016). CONCLUSIONS: Concurrent insertion of a testicular prosthesis does not increase the complication rate of radical orchidectomy as determined by LOS, re-admission or the need for further surgery. Prosthesis insertion at the time of orchidectomy for testis cancer is safe and concerns about increased complications should not constrain the offer of testicular prosthesis insertion concurrently with primary surgery.

Goal Navigation, Approach-Oriented Coping, and Adjustment in Young Men with Testicular Cancer.

BACKGROUND: Cancer can challenge important life goals for young adult survivors. Poor goal navigation skills might disrupt self-regulation and interfere with coping efforts, particularly approach-oriented attempts. Two studies are presented that investigated relationships among goal navigation processes, approach-oriented coping, and adjustment (i.e., social, emotional, and functional well-being) in separate samples of young adults with testicular cancer. METHODS: In study 1, in-depth interviews (N = 21) were analyzed using thematic analysis to understand experiences of goal pursuit following cancer. In study 2, 171 men completed measures of goal navigation, coping, and adjustment to cancer. RESULTS: In study 1, three prominent themes emerged: goal clarification, goal engagement and disengagement, and responses to disrupted goals. Regression analyses in study 2 revealed that goal navigation skills were positively associated with emotional (B = .35, p < .001), social (B = .24, p < .01), and functional (B = .28, p < .001) well-being, as was approach-oriented coping (B = .22, p < .01; B = .32, p < .001; B = .26, p < .001, respectively). Goal navigation moderated associations between approach-oriented coping and well-being, such that those with low goal navigation ability and low approach-oriented coping reported lower well-being. CONCLUSIONS: Goal navigation skills and approach-oriented coping have unique and interactive relationships with adjustment to testicular cancer. They likely represent important independent targets for intervention, and goal navigation skills might also buffer the negative consequences of low use of approach-oriented coping.

Tweeting About Prostate and Testicular Cancers: Do Twitter Conversations and the 2013 Movember Canada Campaign Objectives Align?

Prostate cancer is the most frequently diagnosed cancer of the reproductive system in men. Mass media campaigns have long been a tool for raising awareness of important health issues and changing health behavior. The Movember campaign was launched in Canada in 2007 with the goal of creating conversations about men's health in order to raise awareness and understanding about prostate cancer. In 2012, testicular cancer was added to the Movember Canada campaign agenda. Social networking sites such as Twitter are popular platforms for conversations in the digital age. Our objective was to determine if the Movember Canada 2013 campaign accomplished the goal of creating conversations about prostate and testicular cancers on the social media platform of Twitter. We conducted a content analysis of 4222 Canadian tweets posted during the November 2013 Movember Canada campaign to investigate whether tweets were health-related or non-health-related and to determine what topics of discussion were present in the tweets. There were significantly fewer health-related (n = 673) than non-health-related (n = 3549) tweets (p < 0.05). Few tweets (0.6 % of all tweets) referenced prostate or testicular cancers. Community engagement activities as well as moustache and grooming references were the most frequent topics in the health-related (10.49 and 1.97 %) and non-health-related (32.83 and 32.76 %) categories, which were significantly different by topic (p < 0.05). Findings from Twitter suggest that the Movember Canada 2013 did not meet the stated campaign objective of creating conversations about men's health and, specifically, about prostate and testicular cancers.

[Impact of Treatments to Improve Cognitive Function and Quality of Life on Cancer Patients with Carcinoma of the Testes]. / Vplyv liecby na kognitívne funkcie a kvalitu zivota u pacientov s karcinomom semenníkov.

BACKGROUND: Testicular cancer is one of the most common and most treatable cancers in men aged 15-49 years. The high survival rates mean that it is essential to maintain quality of life and minimize adverse effects associated with treatment. Both malignant tumors and the modalities used to treatment them can have adverse effects from both a psychosocial and a neurocognitive function perspective. Recently, attention has focused on the negative impact of the disease and its treatment on the brain and on cognitive function, which can result in a form of neurocognitive dysfunction known as "chemo brain" or "chemo fog". Both cancer itself and the modalities used to treat it are associated with neurotoxicity and cognitive deficit, which are manifest in key areas of cognitive function. These problems may adversely affect both patients undergoing treatment and those in remission, with a consequent reduction in quality of life. Because many patients survive testicular cancer, it is important to understand the characteristics, range, and time course of disease symptoms, treatment, and side effects, all of which can lead to long-term physical, psychological, and social problems. Testicular cancer has a high potential for cure; therefore, patients suffer not only short-term but also long-term side effects associated with therapy. AIMS: This article aims to offer a complete and concise overview of cognitive dysfunction and quality of life for patients with testicular cancer. CONCLUSION: It would be beneficial if research into testicular cancer also focused on the relationships between psychosocial factors, psychological disorders, and cognitive function. KEY WORDS: cognitive functions - quality of life - sexuality - body imageThe author declares she has no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 1. 12. 2015Accepted: 20. 3. 2016.