How can I help a friend who thinks they have cancer get help?

Dear E,

First of all, kudos to you for being a supportive and approachable friend. The thought of a friend’s potential illness must be difficult and painful for you, and it's great that you're hanging in there and trying to help him out.

A bit of background about testicular cancer: Although rare, testicular cancer most frequently impacts people with testicles between the ages of 15 and 44. It can be hereditary, meaning family history of the disease can increase a person's risk. It's most often discovered by the patient, but seeing a physician is necessary to rule out other explanations for whatever symptoms a patient is experiencing.

It seems like your friend may be self-diagnosing his illness based on his own observations. Monthly testicular self-exams, where someone examines each testicle with their fingers after bathing in warm water to look for any abnormal observations, are recommended by some medical providers to catch testicular cancer early. Symptoms of testicular cancer that may be discovered through a self-exam include swelling or a lump in one testicle (which may be painful, but is more likely to be painless), a general feeling of heaviness in the scrotum, or pain or aches in the groin, testicle, or scrotum.

That being said, these symptoms aren't necessarily definitive signs that your friend has testicular cancer. Other potential causes of such symptoms include epididymitis (or epididymis swelling) or hydrocele (fluid buildup within the scrotum). Only a health care professional, after performing a series of diagnostic tests, can tell for sure if such observations or symptoms are due to testicular cancer, or perhaps some other cause.

If someone is diagnosed with testicular cancer by a medical professional, the first step is typically to identify the stage of cancer by using computerized tomography (CT) scans. CT scans are used to identify if the cancer had spread to any other parts of the body. If tumors are only found in the testicles, this would be considered stage I cancer, while spread to areas like the lungs may constitute stage III testicular cancer. Once the cancer and stage are diagnosed, there are several options that might be available to treat it. Most often, radical inguinal orchiectomy, or the removal of the testicles, is offered as the main treatment because it can be done at any cancer stage. To ensure the treatment was successful, and that patients stay tumor-free, there are usually follow-up visits with a specialist for anywhere from a few months to a few years following the procedure. 

It's understandable that someone would feel apprehensive about starting a process that could possibly result in a cancer diagnosis or medical procedures, and it may help your friend to know that he's not alone. People with testicular cancer symptoms often feel embarrassed and may feel stigmatized when accessing health care. Because of this, it's not unusual for people to wait about five months after symptoms of testicular cancer arise to bring it up to their health care providers. Unfortunately, in that timespan, cancer or other illnesses can become more severe, so it's key that your friend talk to his providers as soon as he's able. To make appointments a little less scary, the American Cancer Society has created a list of questions that he can ask a professional when potentially faced with a testicular cancer diagnosis. It may also be helpful for your friend to know that testicular cancer is one of the most treatable cancers out there if caught early. Almost 100 percent of low stage/early disease tumors are cured with combined treatments.

So what’s the best thing for you to do? If maintaining his trust is valuable to you, it may be best to continue to gently remind him that you're thinking about him and his well-being. The words you used in your question were powerful — that you care about him and you want him to be healthy. If you haven’t already, you may consider telling him this and reminding him that there are likely others in his life who feel the same way. Telling him how his actions (or inactions in this case) are impacting you may be a good communication strategy. In doing this, you aren't telling him what to do; instead, you're simply communicating how it makes you feel. While you don’t want to bombard him, checking in about it regularly may be helpful in reminding him that you care and are concerned. Trust yourself to know how often and in what settings to bring it up. 

Hopefully, with a little loving assistance from you, he'll come to a place where he's ready to speak with a health care provider about the potential causes of his symptoms. If he doesn't, it isn't your fault. While it's great to share information and be a source of support for your friend, also remember that he's his own person, and the decision to seek medical care is ultimately his.

Take care,