Ask a woman how many irregular periods she’ll have before she gets concerned or gets medical help. The answer is two, or maybe three at most. That fast. Do men have a similar barometer of health? Honestly, what besides pain or a threat-to-life brings young men to medical care? Answer: Not much.
A Hard Example
Nothing drove this message home to me faster than when I published a paper on men with benign scrotal masses. Spermatoceles are relatively common, sperm-containing cysts that form next to the testicles in adolescent and adult males. As they enlarge, they can bother men from the “mass effect” of pushing things around in the pouch. In my study, I predicted that when these cysts achieve a certain size, they bother men enough to seek treatment, which is surgical excision. The magic size, I thought, would be when the spermatocele became the size of a testicle.
The research showed that this was true. When spermatoceles reached a 4-5cm (about 2 inches) diameter, then men sought care.
A Painful Message
But there was another message there for me. There were a chunk of men in this study in whom a solid, slowly growing mass, that could very well be cancerous, had to grow to the size of a golf ball before it raised concern. And how long might that be? Months? A Year? Is this truly a lack of detection or simply denial? And just so you know, this is absolutely typical male behavior in cases of testicular cancer.
What is the problem here? How have we culturally miswired young men to respond to medical issues? Why aren’t there the appropriate “gauges” to help men run longer and harder? And more for me to ponder: What biomarkers exist to help men help themselves? These things are top of mind as I prepare a lecture to the National Institutes of Health in Washington next month on exactly this topic. If you have any insights or opinions, please chime in!