A rising problem in young men Fight Testicular Cancer The bolded text are notes to you as the speaker. They are not part of the presentation, but can be used for your information or to help you if you are asked. There are opportunities throughout the presentation where you can invite the participants to be involved in the presentation by answering questions. This presentation is meant to be interactive, as we know that people respond positively to more interactive sessions. Always remember to leave a few extra minutes for questions at the end. The text [End of notes] will be at the bottom of each slide’s notes, so that if you print the notes, you can be sure the print off contains all the information. We appreciate you taking the time to give this presentation. Please ensure that if you share personal opinions or recommendations, you are clear with your audience which are your recommendations, and which are those of the Canadian Cancer Society. Hello, My name is ________________and I am one of the Canadian Cancer Society [staff/volunteers] dedicated to making cancer history. Here’s where you can add why you are involved with the Canadian Cancer Society and your personal experience with the Society (including the local office you volunteer with and where it is located). If you are a cancer survivor and are comfortable talking about your personal experience, you can mention it here. If cancer has touched your family or friends, you might include that here — this makes the speech more personal. I appreciate being invited here today to talk to you about testicular cancer and how the Canadian Cancer Society is working towards addressing this. If you have any questions a long the way, feel free to jump in, if not, I would be happy to take questions at the end as well. Before we start, I thought I could start by first telling you a bit about the Canadian Cancer, who we are, and why we are here today…. [End of notes] A rising problem in young men Presentation prepared by: Canadian Cancer Society, Ontario Division, Public Affairs, Prevention May 2012

How we’re fighting cancer doing everything we can to prevent cancer funding research to outsmart cancer empowering, informing and supporting Canadians living with cancer advocating for public policies to improve the health of Canadians rallying Canadians to get involved in the fight against cancer So before we dive into our discussion about testicular cancer, here’s a bit about who we are and how we’re fighting all types of cancer. You may be surprised to hear just how many people are touched by this disease … I know I was: Every three minutes, another Canadian is faced with fighting cancer. It’s for this reason that we’re working tirelessly, alongside our volunteers and donors, to fight back against cancer. Across Ontario we are fighting cancer by: doing everything we can to prevent cancer funding research to outsmart cancer empowering, informing and supporting Canadians living with cancer advocating for public policies to improve the health of Canadians rallying Canadians to get involved in the fight against cancer And it’s thanks to the dedication of our volunteers and the generosity of our donors that we’re having more impact, against more cancers, in more communities, than any other cancer charity. Speaker – Ask: Do you know any good news about the prevention of cancer? The good news is … CLICK that we know that about half of cancers can be prevented through healthy living and policies that protect the health of Canadians. And that is really good news!!! So today I am here to talk about how we as women can do everything we can to prevent some of the most common cancers. [End of Notes]

Outline What is cancer? What is testicular cancer How common is it? What are the risk factors? Early Detection Today, I want to give you an overview of testicular cancer. Most of the questions that we get come from inaccurate information. This presentation will help you to differentiate the myth from the truth when it comes to testicular cancer. We will also talk about what the risk factors for testicular cancer and what men can do to protect their health. [end of notes]

What is cancer? starts in our cells exists when cells do not behave normally not just one disease risk factors increase your chances of getting cancer I thought it may be helpful to give just a little bit of a biology lesson before diving in, since I know taking a science class was a long time ago for me, I thought others might appreciate a refresher. Speaker: Ask the participants “True or False. Cancer starts in the cells of the body?” Wait for answers…. To start, our body is made up of millions of cells. Genes inside these cells order them to grow, work, reproduce and die. Normally, our cells obey these orders and we remain healthy. But sometimes the instructions get mixed up, causing the cells to form lumps or tumours, or spread through the bloodstream and lymphatic system to other parts of the body. The lumps or tumours can be benign or malignant. In this case malignant is another word for cancerous. Sometimes cancerous cells will also spread through the bloodstream and lymphatic system to other parts of the body. Cancer is, in fact, a number of diseases. In fact, cancer is 200 different diseases, and even similar cancers can be different in terms of prevention and treatment. This is important because it explains why some cancers are more deadly than others, why some respond better to treatment, and why two people with the same cancer and same stage of disease can respond differently to the same treatment. Different types of cancers, however, often have many similarities. When we talk about cancer we often mention “Risk Factors”.. What do I mean by “risk factor”? Well a risk factor is anything that increases your chances of getting a disease… in this case cancer. Reducing risk does not always mean cancer will absolutely not develop. Unfortunately, no-one knows for sure why one person gets cancer and another person does not. But we do know that there are certain things we can do to help reduce our risk of getting cancer or to find any abnormal cell changes early, when treatment is likely to be more successful. [End of Notes]

Testicular Cancer starts in cells of testicles Cancers are named after the part of the body where they start. For example, cancer that starts in the bladder but spreads to the lung is called bladder cancer with lung metastases. So it make sense that testicular cancer starts in cells of testicles. The testicles are part of a man's reproductive system. They are the two egg-shaped organs found in the sac of loose skin (scrotum) at the base of the penis. The testicles are held in the scrotum by the spermatic cord. The spermatic cord contains the ductus deferens, some lymph nodes, veins and nerves. Testicles make the male sex hormone testosterone and sperm. Sperm begins to form in “germ” cells inside the testicles. Most testicular cancers start in the germ cells and are called germ cell tumours. There are two main types of germ cell tumours – seminomas and non-seminomas. Each type grows differently and is treated differently. Normally we would say that cancer is a disease of the aged.. But testicular cancers one tends to strike when men are younger, between 15-49. Speaker Ask the question: Our slide says that testicular cancer can be treated successfully… Is this true? Yes! It has one of the best 5 yr relative survival rates (95%) (Canadian Statistics, 2011) This means that, on average, men diagnosed with testicular cancer are 96% as likely to live 5 years (or more) after diagnosis as men in the general population who do not have cancer. Speaker: Ask the question…What do Tour de France Cyclist Lance Armstrong, Figure Skater Scotty Hamilton and Canadian actor and comedian Tom Green all have in common??? They all developed and survived testicular cancer. [end of notes] starts in cells of testicles most common in men between ages 15-49 can be treated successfully

How common is testicular cancer? The incidence is rising. It is estimated that about 940 Canadian men will be diagnosed with testicular cancer in 2012. By comparison, it is estimated that 26 500 Canadian men were diagnosed with prostate cancer. Testicular cancer incidences continue to increase at a rate that is statistically significant (1.5% per year between 1996 and 2005). In fact testicular cancer incidence have been increasing for several decades for reasons which are not well understood. In 2012 it is estimated that there will be 940 new cases of testicular cancer in Canada… By comparison, it is estimated that 26 500 Canadian men will be diagnosed with prostate cancer. Source: Canadian Cancer Statistics, 2012 So why are we focusing on testicular cancer today? [end of notes]

In part because it affects young men, can affect their career paths or chance to have a family. The impact on their lives can be huge. Many young men don’t know they are at risk. The common age range for this type of cancer is 15-49 years of age, much younger than other cancers. What you can see from this graph also that the incidence starts to rise steeply from age 10, peaks in the mid to late 20s, then declines after age 30. Speaker: Ask the question… So what do you think causes testicular cancer? [end of notes] Source: Cancer Care Ontario. Cancer Fact: Testicular cancer is most common in young men August 2007.

Risk Factors delayed descent of the testicles (if not corrected early) age, between 15 and 49 family or personal history of testicular cancer abnormal development of the testicle There is no single cause of testicular cancer but some factors seem to increase the risk of developing it: Test time. What is a risk factor? (A risk factor is anything that increases your chances of developing cancer…. The risk factors for testicular cancer include:  delayed descent of the testicles (if not corrected early) (Sometimes the testicles do not descend into the scrotum in the first year of life, as they should, if this not corrected, there is an increased risk of testicular cancer. age – particularly between 15 and 49 family or personal history of testicular cancer (when we talk about family history, we are usually talking about first degree relative… i.e. brother, father,) abnormal development of the testicle   Some men develop testicular cancer without any of these risk factors. It’s important to note that these are all risk factors you can’t control. Speaker Ask the question: What can you do to do about testicular cancer? [end of notes]

Know what’s normal for you Testicular Cancer Know what’s normal for you See your doctor if you have: a lump on the testicle a painful testicle a feeling of heaviness or dragging in the lower abdomen or scrotum a dull ache in the lower abdomen and groin It is really important to know what is normal for you. All men, from the time they are 15 years old, should learn how to check their testicles. This is a simple, pain-free way to check what is normal for a man’s testicles so that any changes will be noticed. This should be done regularly. Early detection of testicular cancer can make a difference in the treatment of the disease. How to check your testicles The best time to check your testicles is just after you’ve had a bath or shower, when the muscles in the scrotum are relaxed, making it easier for you to feel any lumps, growths or tenderness. Men should see their doctor if they notice: a lump on the testicle (one of the most common a painful testicle a feeling of heaviness or dragging in the lower abdomen or scrotum a dull ache in the lower abdomen and groin Where can you go to find out more information about testicular cancer? www.Cancer.ca and Cancer Information Service. [end of notes]

Fight back against testicular cancer! Be aware of your testicles Don’t be shy, pass on this information Read points on the slide. [end of notes]

For the most up-to-date information: Visit www.cancer.ca call the Canadian Cancer Society Cancer Information Service at 1 888 939-3333 To get the most up-to-date information on cancer or to learn more about cancer prevention, visit our website at www.cancer.ca. Or you can call Cancer Information Service at 1 888 939-3333. It’s free, and available in over 120 different languages. Finally, if you would like to get involved with the Canadian Cancer Society as a volunteer, you can do so by either visiting our website or by calling the Cancer Information Service line. Thank you again for inviting me here today to talk to you about testicular cancer. It is because of people like you, and our volunteers and donors that the Canadian Cancer Society is able to help thousands of people each year. We are fighting back against cancer!!! If you take anything away from this presentation please know that you should be aware of your body and report any changes to your doctor. (Speaker: Questions can be entertained at this time or participants can be referred to speak to you at the display table.)   Please feel free to take home the materials on the display table. I’ll be here for a while longer if anyone has any additional questions. The brochure Facts for Men: Early Detection & Screening   includes information on testicular cancer. [End of Notes] Thank you! Presentation prepared by: Canadian Cancer Society, Ontario Division, Public Affairs, Prevention May 2010