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Insight

The Message Behind The Moustache

The Movember (Mo) Foundation challenges men

to grow moustaches during Movember

(the month formerly known as November). Movember aims to spark conversation and raise vital funds for

men’s health programs improving the lives of men affected by prostate cancer, testicular cancer and mental health problems. According to Mo, more than 4 million moustaches have been grown worldwide and over £346 million funding raised supporting over 800 programmes in 21 countries.

There is therefore a really serious message behind the moustache.

Prostate Cancer

Prostate cancer only affects men, as women do not have a prostate gland. The older a man, the more likely he is to be diagnosed with prostate cancer. A man with a father or brother who developed prostate cancer before 60 is twice as likely to develop the cancer.

The prostate is a gland which produces fluid that protects and enriches sperm. It is located immediately below the bladder, in front of the bowels. The prostate is doughnut shaped and surrounds the urethra, the tube that carries urine from the bladder out through the penis. In younger men the prostate is about the size of a walnut.

A tumour occurs when some of the cells in the prostate reproduce far more rapidly than normal.  If left untreated, prostate cancer cells may eventually spread from the prostate and invade distant parts of the body, particularly the lymph nodes and bones. This results in secondary tumours (metastases). Most prostate cancers develop without men experiencing any symptoms in the early stages.

As prostate cancer spreads it can cause urinary symptoms such as:

  • Urinary issues (slow flow, hesitancy, frequency, urgency)

  • Blood in the urine or semen

  • Reduced ability to get an erection

  • Painful ejaculation

How do doctors check for Prostate Cancer?

Rectal Exam


  • During a rectal exam a doctor inserts a gloved finger in the anus, where it is possible to feel part of the surface of the prostate. Irregularities include swelling or hardening of the prostate, or lumps on the surface. The doctor can feel only part of the prostate during the examination, so some irregularities may be beyond reach and therefore missed.

PSA test (PSA)


  • The PSA test is a blood test that looks for Prostate Specific Antigen (PSA) - a protein in the blood that is produced specifically by prostate cells. An elevated PSA does not necessarily mean prostate cancer is present - other medical conditions can lead to an abnormal PSA e.g. inflammation of the prostate (prostatitis) or enlargement of the prostate called Benign Prostatic Hyperplasia (BPH)
An abnormal result should result in a GP referral to a Urologist who will do a biopsy. A biopsy is the only way to determine if cancer is present.

Sometimes the medical care can go wrong. 

I am currently acting for a successful businessman who suffered a negligent delay in diagnosis of his prostate cancer. In December 2008 he attended his GP for a health check. He had no urinary symptoms. The GP arranged some tests including a PSA test.

The blood test showed a raised PSA and the laboratory report said that there was a "significant probability of malignancy" . Follow up was recommended. The GP who received the result did not contact the Claimant directly, nor did she inform the GP who ordered the test. When the Claimant had not received the results of his blood test, he telephoned the surgery receptionist. She was unable to locate the results but said words to the effect that all was fine and a doctor would contact him if there were any problems. The Claimant was reassured and made no further enquiry about the results of the test, as he had no symptoms.

After this the Claimant did not attend the surgery for over 3 years. In 2012 he consulted his GP due to some urinary symptoms. The GP saw the abnormal PSA level of December 2008 had not been acted upon and he referred the Claimant urgently to the urologists at the local hospital. Prostate cancer was promptly diagnosed. At the time of diagnosis the PSA level had risen ten-fold. The cancer has spread to the lymph nodes and to the bones.

The Claimant's case will be that had he been referred to the urologists under the 2-week rule following the abnormal PSA result of December 2008 cancer of the prostate would have been diagnosed by January 2009. He would have been treated with radical prostatectomy or radical radiotherapy, potentially combined with hormone therapy, and he would have been cured of his disease. He has lived since about May 2012 with the knowledge that his expectation of life has been shortened by the Defendants’ negligence.

Whilst the GP has admitted a negligent delay in diagnosis no admission has yet been made about the consequences. I continue to the fight the case on behalf of my client.

Testicular Cancer

If you are male and between the age of 25 and 49 years you are at the highest risk of developing testicular cancer. However, men, regardless of age, who find such an abnormality, should go to the doctor immediately. Testicular cancer starts as an abnormal growth that develops in one or both testicles. The causes are unknown. However there are possible risk factors including:

  • Undescended testes at birth

  • Family history (father or brother with testicular cancer)

  • Previous occurrence of testicular cancer

Things that are not thought to be risk factors include:


  • injury to the testicles,

  • sporting strains,

  • hot baths, or

  • wearing tight clothes.

 Important warning signs to watch for include:


  • Swelling or a lump in either testicle (usually painless)

  • A feeling of heaviness in the scrotum

  • Change in the size and shape of the testicles

  • A sudden build-up of fluid in the scrotum

  • Pain or discomfort in a testicle or in the scrotum
Testicular cancer is a highly treatable type of cancer with a very good cure rate (about 96%) if found and treated early. However, according to Mo because of the relative success in treating this disease, and the relatively fewer cases experienced compared to other cancers, testicular cancer is often the “forgotten cancer”. More work needs to be done to solve the challenges associated with second line treatment, when initial therapy is unsuccessful.

Cancers of the testicle are named after the type of cell in which they develop. More than 90% of testicular cancers develop in germ cells, which are responsible for the production of sperm. There are two main types of germ cell tumours; seminomas and non-seminomas. There can be a combination of different types. A small number of testicular cancers start in cells that make up the structural and hormone producing tissue of the testicles and are known as stromal tumours.

Secondary testicular tumours are caused by cancerous cells that have spread to the testicles from other parts of the body (metastasis).

Self Examination

Regular testicular self-examination can help a man find any changes in the testes early, so that if treatment is needed it can start as early as possible.



Testicular cancer can be cured, if diagnosed and treated early. Advanced testicular cancer can also be cured with proper treatment. In most men with testicular cancer, treatment involves the surgical removal of the affected testicle (orchidectomy). This may be followed with surveillance (watch and wait), chemotherapy or radiotherapy. Chemotherapy or radiotherapy is often prescribed after surgery to treat any remaining cancer cells that may have spread to other parts of the body, such as lymph nodes. The level or amount will differ for each man and will depend on the stage and type of cancer.

But what if it is not diagnosed when it should be or is not treated properly?


Sadly we see the cases where things have gone badly wrong. I specialise in cancer cases and acted for an incredibly brave young man, Graham Higgins who lost his fight against testicular cancer. When I met Graham he was undergoing chemotherapy and radiotherapy and he faced painful experimental treatment with such dignity and courage, it was a privilege to meet him. His wonderful parents continued his case after he died.

I will be taking on the challenge of completing in a half ironman in August 2015 to raise money for Checkemlads, a testicular cancer awareness charity to raise money in Graham's memory.