HD de Boer comments: “Early recognition of testicular carcinoma is essential as it has been shown that a treatment delay of more than 3 months is correlated with a significantly decreased 5-year survival rate. Delay in diagnosis may depend on several factors including patient’s lack of knowledge, embarrassment, ignorance, or fear of cancer and of emasculation. It is important to encourage testicular self-examination and to emphasise the need for prompt medical advice in the event of change in a previously normal testicle.”
In an accompanying Commentary (p 1632), Jeremy Steel from St Bartholomew’s Hospital, London, UK, concludes: “…examination of the external genitalia is an essential part of the abdominal system examination and should be taught to medical students at the beginning of their training. Some men with large testicular lumps continue to evade the medical profession despite all efforts. The 17-year-old man in the Case report may have contributed to his own death by not seeking medical advice earlier...Medical professionals and the general population, especially men, need to be educated to recognise that testicular lumps are a medical emergency.”
Contact: Dr HD de Boer, Department of Anaesthesiology, UMC St Radboud, PO Box 9101, 6500 HB Nijmegen, Netherlands; T) +31 24 361 4406; F) +31 24 354 0462; E) hadobo@hotmail.com
Professor Jeremy PC Steele, Department of Medical Oncology, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK; T) F) E) j.p.steele@qmul.ac.uk
The Lancet