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Men with Testicular Cancer Who Write Positively about the Experience Show Improved Mental Health, Baylor University Researcher Finds

April 13, 2010

Men who channeled positive thoughts into a five-week writing assignment about their testicular cancer showed signs of improved mental health afterward, in contrast to men who wrote negatively or neutrally about their condition, according to results of a Baylor University pilot study.

As "Get a Grip!" Testicular Cancer Awareness Week approaches on April 1-7, the findings are encouraging for those with testicular cancer who are seeking mental and emotional therapy as well as physical treatment, said researcher Dr. Mark Morman, associate professor of communication studies and graduate program director at Baylor University.

"There's a lot of research that takes this writing-based approach and in a number of varied contexts, but we applied this line of research to the testicular cancer context for the first time that we are aware of," he said. "We think writing about the experience could add to the therapy and can help with recovery and quality-of life issues after treatment, as the men try to get on with their lives."

In the study, 48 men were randomly divided into three groups, with one group assigned to write positively about their cancer experience; one group to write negatively; and one to write about innocuous, unrelated topics. The affect of the writing was measured at the beginning and end of the study, with men responding to 68 questions in which they assessed their mental health, general feeling of well-being, sexual health, and performance and traits of assertiveness and responsiveness.

Participants in the positive expression group reported improvements in their mental health as a result of their writing; those in the negative expression and neutral groups did not.

Testicular cancer is rare, most often striking men ages 18 to 30, and one of the most curable forms of cancer if detected early, according to the National Cancer Institute.

But articles in the Journal of Clinical Oncology cite findings that men with testicular cancer are more likely to be depressed or anxious. Side effects of chemotherapy or radiation treatment can interfere with sexual performance and fertility, although those conditions are usually temporary.

Nevertheless, "there are issues of masculinity, sexuality, relationships and self-image that often have significant effects on a survivor's ability to cope and move forward," said Morman, a former communication consultant for the Lance Armstrong Foundation.

Early detection is important, but men generally are more likely to delay visits to the doctor, Morman said. He noted that seven-time Tour de France winner Lance Armstrong was given a 50-50 chance of survival after he was diagnosed with testicular cancer in 1996. Armstrong waited several months to go to the doctor after finding a testicular lump. By then, the cancer had spread to other parts of his body.

Men also are less likely than women to join support groups or seek online support, Morman said.

"With our approach, we move from simply thinking to performing," Morman said. "We asked our participants not to just imagine or contemplate, but rather we asked them to engage their thoughts by processing them and then putting them down in print.

Morman said that while the "Well Woman" effort promotes yearly health examinations, mammograms and Pap smears for women, "there's no level of promotion or encouragement for men to do so that's equal to or comparable with the messages directed at women to go to the doctor."

"We want to get the message to doctors and therapists that our preliminary data indicates this worked

and can help alleviate a lot of concerns about embarrassment, body image and masculinity."

To encourage candor, "the writing was done on-line in a secure, private website and in a totally confidential manner; we had no way to connect a person's name with what he wrote," Morman said.

The findings were presented in May at the 2009 International Communication Association in Chicago. Other project researchers were Dr. Kory Floyd, professor of communication studies in the Hugh Downs School of Communication at Arizona State University in Tempe, Ariz., and Dr. Perry Pauley, an assistant professor in the Department of Communication Studies at California State University at Fullerton, Cal.

ABOUT TESTICULAR CANCER (Based on 2009 Estimates)

• About 8,400 new cases of testicular cancer would be diagnosed during 2009.

• About 380 men would die of testicular cancer

• A man's lifetime chance of developing testicular cancer is about 1 in 300.

• Because treatment is so successful, the risk of dying from this cancer is very low: about 1 in 5,000

SOURCE: American Cancer Society