Analysis: researchers have developed a new virtual reality game to show men the importance of seeking help for testicular symptoms
Most people are aware of testicular diseases, particularly testicular cancer. However, being aware of a disease and knowing the disease are two very different things. In both our research and review of the literature, we discovered that men did indeed hear about testicular cancer, the most common cancer in men younger than 45 years. However, men rarely checked their testicles and did not know what to look for while doing so. In fact, one man said that checking his testicles felt 'like trying to find a lump in a bag of lumps'.
Men tend to ignore testicular symptoms like pain, lumps, and bumps until these symptoms become unbearable. This is mainly due to embarrassment and the fear of a potential cancer diagnosis. In one of our studies, one testicular cancer survivor said: "I went along for several months with desperate pain and the fear of actually dying…It was easier at times just to block it out and fear of actually being told there was something wrong with you, when instinctively deep down within yourself, you knew there was something going wrong…I just kept thinking things would go away, but they didn't."
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From RTÉ Radio 1's Ray D'Arcy Show, interview with Cavan footballer Oisin Kiernan about his diagnosis with testicular cancer at the age of 25
Luckily, testicular symptoms are rarely caused by testicular cancer. Non-cancerous conditions like testicular torsion (twisting of the testicle), epididymo-orchitis (infection in the testicle), and varicocele (swollen veins in the testicle) are more common than testicular cancer and can cause similar symptoms. If detected early, men with testicular diseases endure less treatments and lower financial costs.
We found that men are quite interested in learning more about testicular diseases. They preferred educational strategies that are brief, visually stimulating, innovative, positively worded, and delivered frequently using light and simple language.
Based on these preferences, we developed E-MAT, a 3-level educational game delivered using a virtual reality (VR) headset with voiceover and two controllers. E-MAT stands for Enhancing Men's Awareness of Testicular Diseases and the game takes place in a virtual apartment.
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From RTÉ One's Second Captains in 2015, Tipperary hurler Noel McGrath takes about his battle with testicular cancer
Level 1 takes place in the bathroom during a hot shower, the best time for men to feel their testicles. Men are shown two walnuts hanging side by side and are informed about the normal look and feel of the testicles, particularly that testicles are oval shaped rather than round shaped, one testicle tends to lie more horizontally than the other, and the two testicles are usually not identical. Changes like pain, swelling, and lumps then start appearing consecutively on the walnuts. Men are required to find these changes to progress to Level 2.
Level 2 takes place in the bedroom. Here, men are shown a 3D model of a testicle and are required to click on the different anatomical structures to learn about common testicular diseases. During Level 2, symptoms seen in Level 1 are linked to testicular diseases like testicular torsion, epididymo-orchitis, and cancer.
After identifying all testicular diseases, men enter the final level (Level 3) which takes place in the kitchen-dining area. Here, the key messages from Levels 1 and 2 are summarised. A poster of a fingerprint is used to inform men that their testicles are unique, hence the importance of knowing how their own testicles look and feel. The second poster is an infographic showing men the technique to feel their testicles. The final item is a first aid kit to remind men about the importance of seeking help for testicular symptoms and the urgency of sudden and severe pain.
Men tend to ignore testicular symptoms like pain, lumps, and bumps until these symptoms become unbearable
We tested the game with university students and staff on two occasions who described E-MAT as user friendly, engaging, and suitable for men from various socioeconomic and educational backgrounds. The game was effective in increasing men's knowledge of testicular diseases and their knowledge about the importance of checking with a healthcare professional for symptoms of concern.
Men who play field games, like hurling, are at risk for testicular trauma and diseases. When struck, the sliotar can reach a speed of 160 km/h, which poses significant injury risks. For this reason, we sought and secured funding from the Health Research Board to test the game in GAA clubs, with a particular focus on "Healthy Clubs".
In total, 74 players and coaches aged 18 to 50 years from nine GAA clubs in Co Cork participated in the study. Preliminary results from this study show that E-MAT is indeed effective, and that GAA players and coaches are satisfied with their engagement with the game Our plan is to apply for further funding to deliver and test it nationally, and ultimately make E-MAT publicly and freely available.
Some tips to keep testicles healthy:
(1) Be aware of how your own testicles normally look and feel by checking them, preferably during a hot shower or bath
(2) Talk to a healthcare professional, like your GP, if you felt any lumps and bumps
(3) Visit the A&E if you felt any sudden and sharp pain in one or both testicles
(4) Remember, testicular lumps, bumps, and pain are not only symptoms of cancer. They can occur because of torsion or infections, including sexually transmitted infections
The views expressed here are those of the author and do not represent or reflect the views of RTÉ
