WHAT’S GOING ON IN YOUR SUIT PANTS? UNCROSS YOUR LEGS

It’s a puzzle: why are men in suits who spend all day seated at a desk more likely to develop cancer in their testicles than blue-collar workers? No-one knows for sure, but some researchers have a theory based on keeping cool.

They say that to be healthy and function efficiently testes need to be kept cool. To this end, the human scrotum acts like a natural airconditioning unit and keeps them about 3°C cooler than the rest of the body. If, however, testes fail to descend into the scrotum and remain in the warm abdomen, they may begin to malfunction. They may make mistakes with sperm production and are more liable to become malignant.

The major risk factor for testicular malignancy is maldescent of the testis. The higher the testis remains in its migration from the abdomen to the scrotum, the greater the risk of later malignancy. They say the dress and work habits of the professional classes often recreate the environment of a warm abdomen. Wearing tight-fitting underwear under suit pants and sitting with legs crossed under a desk raises the temperature in the scrotum.

In contrast, blue-collar workers who wear loose-fitting clothes and stand with legs apart at a work bench all day keep cool.

There are other possible explanations for testicular cancer being more prevalent among the professional classes. One may be that their lifestyle is more sedentary. By studying a map of a city, it is possible to predict where the highest rates of testicular cancer will be found.

When this exercise was done in Melbourne, the lowest incidence was found in the poorer suburbs of Sunshine, Port Melbourne and Broadmeadows. The incidence was three times as high in the affluent suburbs of Kew, Malvern and Brighton.

When incidence and occupation were examined, it was found that men in professional and administrative occupations were three times more likely to develop testicular cancer than tradesmen or labourers.

A British study into the causes of this cancer published in the British Medical Journal found that men who sit at a desk all day are more likely to develop it than those who take more exercise.

In Australia today, the lifetime risk of men developing testicular cancer is one in 300, and the incidence is increasing. In Victoria alone it trebled between 1950 and 1990. Throughout the world the incidence rose dramatically between the end of World War II and the 1980s. This puzzling phenomenon could be due to a change in clothing habits or a change in diet caused by cattle being fed large quantities of hormones. It is certainly not due to the population ageing, because testicular cancer is a young man’s disease.

There are two basic types of this cancer: seminomas, which arise mostly in men aged 18 to 45, and the more aggressive non-seminomas, which arise in the 16-to-35 age group. Both can occur in older men, but only rarely.

Young men should examine their testicles regularly and have any abnormality checked by a doctor. If there is a lump present, about 98 per cent of the time they will feel it. It is possible to live with a lump the size of the yolk of a hard-boiled egg and not realise it is there until it is found during self-examination. It may or may not be painful.

Men should not disregard a mass that does not subside after injury. As abnormal testes are more susceptible to damage or haemorrhage after minor trauma, a history of recent injury should not be accepted as the sole explanation for swelling and discomfort.

Modern treatment for testicular cancer is excellent. Although advanced cases of seminoma are difficult to manage, doctors can now achieve close to 100 per cent survival for many years, with only a few late recurrences. Early detection can almost guarantee a cure.

During the past three decades the 5-year survival rate for patients diagnosed with nonseminomas has risen from 50-60 per cent to 90 per cent.

Men who have a testicle removed because of cancer need not be concerned about their sexuality or fertility. The remaining healthy testicle can provide enough testosterone to drive a healthy libido and enough sperm to father a nation.

(It wasn’t always widely known that men could remain fertile after losing a testicle. In a celebrated case in the fifties, an Australian man sued his wife for adultery. A well-meaning but ignorant doctor advised him after the operation that he would never be able to have children. When his wife became pregnant, he accused her of infidelity and successfully dragged her through the divorce courts.)

There is no cause, either, for men to worry about emotional problems following the removal of a testicle: a recent British survey into the psychological after-effects of such an operation found nothing significant. All the men seemed to cope very well.

If the cosmetic appearance following surgery is a problem, a plastic prosthesis that looks just like the missing testis can be inserted into the scrotum.

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