Testicular Cancer and White Males

The health disparity I chose to discuss is testicular cancer in white males.  Being a 21 year-old, white male, this is a topic not only of interest but a topic of concern.  This is because testicular cancer is the most common form of cancer in males 20-34 years of age and is 5 times more prevalent in white males than in black men and 3 times more than Asian and Native American men.  The causes of testicular cancer are relatively unknown but there are agreed upon risk factors that may increase a males risk for cancer development.  These risk factors include specific medical conditions that some patients suffer from in addition to the cancer, family history and genetics but most men
with testicular cancer do not have a family history, and a man’s occupation.  It has been shown that social determinants such as income and education may have an impact on testicular cancer development because higher rates of the cancer are seen in men that have high income and educational levels.  In addition, conditions a male faces before and after birth can play a role in potential testicular cancer development.  Conditions such as weight at birth, age of the mother during pregnancy, number of pregnancies, and hormone levels caused by natural or artifical hormones.

Biologically, there are no identifying markers that can be used to classify an individual into a specific race.  Instead, race is a socially constructed idea that is used to group those that have similar appearances.  When it comes to genetics, people of a similar ancestral background would share similar genes, such as the Pima Indian example from the lecture, but this doesn’t necessarily classify them as a separate race from other people.  Therefore, when it comes to trying to determine an individual’s health based on their race it would be better to look at the person’s social setting, where they live and how much money they make, rather than making a general assumption based on what they look like.

Sources:

http://www.cancer.org/Cancer/TesticularCancer/DetailedGuide/testicular-cancer-risk-factors

http://www.health.ny.gov/statistics/cancer/registry/abouts/testis.htm

http://www.cdc.gov/cancer/npcr/training/nets/module10/nets10_3.pdf (Graph)

6 thoughts on “Testicular Cancer and White Males

  1. Nice explanation of genetics, health and race. There are many factors that go into the assessment of an individual’s health. Though I agree that race is a social construct, and there is no current definitive biological evidence to prove the contrary, these “similar appearances” are biological adaptations for beneficial survival. At one point in the evolutionary chain a group of individuals would have acquired these outward appearances for the well-being of themselves and their species. The question I have though is if there are outward appearances of biological genetic adaptations, which we classify as race, then is there not a high probability that there are internal, unseen adaptations that also occurred between different individuals? I agree that a social setting is essential to the evaluation of the person as a whole, this is one aspect I failed to thoroughly discuss in my post. I believe we should avoid any assumptions based strictly on race as an external condition, rather we should identify the unforeseen biological changes that I mentioned in addition to the whole assessment. We should still collect racial categories in clinical investigation, not for simply the reason of grouping individuals, but to help in the identification of disease patterns. When disease occurs in a population its cause was influenced by several factors including the genetic and social conditions, but sometimes treatment varies. Why do some populations respond to a pharmaceutical drug differently than others? Minute genetic variations have developed in individuals, which cannot be identified externally. This treatment variation may have been influenced by social factors, no doubt, but there are also instances of physiological response differences.

  2. I too enjoyed your explanation about the difference between perceived race and actual genetic variations based on ancestry. It helped explain the fact that someone who looks to be a certain race could really have a genetic makeup that may not be in fitting with what is socially perceived, because it has more to do with your ancestry, than your appearance. I agree that many and probably most correlations between race and disease have to do more with social statistics than with what the person looks like. But I would also include emotional and physical stress, as well as past history, in your list of social setting, location, and income. I think that racial categories have become a bit of standardized statistic among clinical studies, and that this probably happened long before geneticists discovered the fact that genetically there is really no such thing as race. To be honest, I think it is only helpful to the extent that it may help some from a similar background determine their risk for a certain disease, particularly if they suffer from a family history. If one wanted to discuss racialized health disparities in a more constructive manner, one would have to add in a lot more statistics, like the ones you outlined in your post. That way we are seeing the overall, sweeping social patterns that are found in clinical studies, instead of focusing on race, which is essentially a meaningless categorization based on socially or self identified parameters.

  3. Being a 21 year old white male also, your topic really interested me. It definitely made me more aware of the chances of getting cancer. You did a really good job looking through the relationship between race, genetics, and health. Looking into family history made sense, but I would have never have thought about occupation. I thought the fact that cancer rates were higher in higher income, higher educated individuals was really interesting and I would have never suspected that.

    You make a really good point about race being largely socially based, which I agree with. But I also think that it is at least partially determined by genetics. It is a genetic difference that makes ones skin darker or that forms some of their physical features. I believe that there could be some correlation between race and predispositions to some diseases. There could definitely be a link between the genetics that make the protein that determines hair color and the genetics that make proteins for disease prevention. However, I think that genetics may only play a small part in health. Socio-economic setting has a much bigger impact on an individuals health, such as living conditions, or access to health care.

  4. I also like your description of the relationship between ancestry and racial categories. While race is entirely a social construct and does not have a scientific basis, individuals we would consider to be of the same race are more likely than individuals not of the same race to share a common ancestry and have more similar genetic predispositions to certain diseases. In response to Aaron’s comment about the similar appearances being biological adaptations, what if the difference is merely a result of genetic drift? While the increased melanin of darker-skinned races does provide a significant advantage, I cannot think of any other difference in appearance that is advantageous one way or another. In regards to testicular cancer, I am not sure what causes whites to be so much more susceptible than other groups. I would say that between social determinants and genetic predisposition, social determinants probably play the larger role, although some level of genetic predisposition is probably playing some role as well. The Y chromosome is 4.8 times more likely to mutate than other chromosomes (Graves, J. A. M. (2006). “Sex chromosome specialization and degeneration in mammals) Since cancer requires several mutations to occur beforehand(proto-oncogene mutation, loss of function in both copies of tumor suppressor genes and in mismatch-repair genes), I would imagine that the increased mutation rate of the Y chromosome is responsible for the high incidence of testicular cancer. It is also possible that the increased mutation rate makes the Y chromosome more sensitive to social determinants and environmental factors, which could be responsible for the large difference in testicular cancer rates between different social groups. Overall, I agree that racial categories should be kept track of in order to locate trends, but I do not think it matters much overall.

  5. Although I would also say that race is a social construct I do not think that it should be over looked when doing a health evaluation of an individual because the impact of race on health is very far reaching. The treatment one recieves may result in excess levels of stress hormones which can often lead to poor health. While I do agree that high levels of wealth can postively affect health, if that person is from a lower class background their health may not experience a significant positive affect. I think that many of the factors you suggested to look into were great the one I had not thought of myself was parity (number of pregnancies).

    As far as clinical studies are concerned I would say that race is very important. The experiences (enivronmental factors) that come along with can greatly affect one’s health. For example discrimination can cause high stress levels, resulting in the body releasing catecholamines sending the body into a fight or flight response. This puts extra strain on the body and should not be constantly occuring. Economically race is statisically correlated with occupation, thus income, and residence. These things can determine the type of diet an individual has. If someone falls into the blue-collar manual labor occupation they may not have a very high income to live in an area where there many grocery stores that offer a wide variety of fresh fruits and vegatables. Without the foods that have high levels of nutrients they are susceptible to disease.

  6. Your post was very interesting, and you made some great points about one’s social race versus their biological race. One would naturally think that cancer is something can be traced in your family history, and I without a doubt thought that about testicular cancer. When you stated factors such as high income and educational levels as an major variable in the equation it surprised me. Even the conditions before and after birth have an effect on the development of the cancer. The actual testing itself, Categorizing white males as men who are more susceptible to testicular cancer could be skewed as well. If this test only tested American men, than wouldn’t it make sense that as a social grouping there are more “white men” in the U.S. than any other race? Therefore, it automatically gives a bigger pool of people in higher income and educational levels as well as different physical conditions they have experienced throughout their life. Racial categories can definitely be important if it targets a specific category such as Irish Americans, than maybe that finding would be more conclusive than just white males. It’s also a difficult task to understand different racial pools because of how big the U.S. is as a country. I would say that males would probably have a different environment(even the weather) and social setting from someone that lived in the Atlanta to another that lived in Portland.

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