Invasive Mold Infections: A Rare but Deadly Fungal Disease


Infectious Disease Physician
Sultanah Bahiyah Hospital

Fungi are found naturally in our environment. There are many different types of fungi, over 2 million species however about 600 fungi have caused diseases.

Invasive fungal infections typically manifest as a severe and aggressive form of the disease, leading to corresponding to high prevalence and death rates if left untreated.

These infections include invasive mold infections.

  • Usually caused by Aspergillus (giving rise to invasive aspergillosis) but can also be caused by other rarer molds such as Mucormycetes (giving rise to mucormycosis).
  • These molds produce spores; most of us encounter these spores every day without getting ill, but people with compromised immune systems may develop complications as a result of these spores.
  • Despite invasive aspergillosis and mucormycosis being relatively uncommon, invasive mold infections are often life threatening. If left untreated, the mortality rates can reach 100%!
  • Various parts of the world reported superinfections of invasive aspergillosis and mucormycosis in patients with COVID-19, which are associated with increased risk of death. COVID-19 likely increases the risk for fungal infections because it weakens the immune system or due to certain therapies used for treatment such as steroids.
  • There are no specific symptoms, as symptoms can vary depending on the type of infection. This makes diagnosis an infection a challenging and sometimes complicated task!
Invasive Aspergillosis
Aspergillosis and how it affects our lungs. Click on the image for a larger, more detailed version.
  • Invasive aspergillosis is uncommon and occurs primarily in immunocompromised people.
  • Commonly seen in people that have undergone stem cell and other organ transplants (especially lung transplant), as well as in patients with blood-related cancers such as acute leukemia.
  • Typically affects the lungs, but it can also spread to other parts of the body.
  • Mucormycosis is rare and estimated to affect approximately 10,000 cases worldwide, barring India. If India is included the numbers rise to 910,000 cases annually!
  • Typically occurs in the sinuses of the nose or lungs; however it can spread to the brain and other organs as well.
  • Typical pneumonia symptoms including fever, chest pain, cough, coughing up blood, and shortness of breath
  • Sinus infection, which may be painful
  • Pain, tenderness, swelling and pressure around the eyes, cheeks, nose or forehead
  • One-sided facial swelling
  • Headaches
  • Nasal or sinus congestion
  • Black lesions on nasal bridge
  • When performing activities that involve close contact with soil and dust, such as yard work or gardening, take care to wear shoes, long pants, and long-sleeved shirts
  • Whenever possible, avoid dusty areas like construction or excavation sites; wear a N95 mask when you have to visit these areas
  • Keep your house dry and mold-free
  • Avoid staying in a moldy home (even while it is being cleaned)

#YouMatter Promotes Mental Health Awareness and Creates Safe Space


In conjunction with World Mental Health Month in October, Suria KLCC together with The Body Shop invites the public to be part of the change in temoving the stigma of mental health problems. Also coming onboard this year is the is Mental Illness Awareness & Support Association (MIASA).

The campaign with the tagline #YouMatter will run until 10 November 2022.


A safe space is available Suria KLCC for people to come together and converse about mental health without the fear of receiving judgment and being stigmatized by the rest of society.

This safe space, called Safe Space @ Suria KLCC, will be open for the duration of this campaign.


  • Located at Level 1, Ampang Mall (you can’t miss it)
  • Will be opened throughout the campaign (until 10 November 2022)
  • 10 am to 10 pm daily
  • Participate in workshops, talks, and panel discussions with mental health professionals
  • Talk to the stationed mental health volunteer for more information

The calm room in Safe Space @ KLCC allows one to de-stim and find peace of mind.

“The last two years marked a turbulent and uncertain time for all,” says Andrew Brien, the Executive Director of Suria KLCC Sdn Bhd. “With the pandemic in the rear-view mirror, there’s no better time to reconnect and focus on recovery.”

He adds: “The Safe Space @ Suria KLCC is a welcoming space where the community can come together to share and learn. After all, a problem shared is a problem halved—we want people to leave the space feeling better and with more insight about themselves or others.”


YAM Tengku Puteri Raja Tengku Puteri Iman Afzan Al-Sultan Abdullah, the Founder and President of the Green Ribbon Group, emphasizes that Safe Space and similar efforts are needed to show our support for those with mental health problems as well as to highlight an ongoing commitment towards doing more for the cause.

She adds that for this year, the focus is on the mental health of youth. “The focus on youth mental health this year is especially timely for the Green Ribbon Group. We are very fortunate to be able to pilot programmes in secondary schools and universities that focus on mental health literacy, self-management and peer support. This has always been a dream of mine—to reach out to our youth and empower them to prioritise their mental health.”

Founder and President of MIASA, Anita Abu Bakar shares a similar sentiment. “Looking after each other should be everyone’s responsibility and not just the health sector alone,” she says. “This is why we should strive to prioritise community-based mental health support—so that the burden of care can be shifted from being shouldered solely by our incredible frontliners to being shouldered by all of us. Through efforts like this, it is our sincere hope that the scale of our response to the issues surrounding community mental health can begin to match the scale of the challenge itself.”

For more information on MIASA, you can visit (link opens in a new tab), while more information on the Green Ribbon Group can be found by visiting (link also opens in a new tab).

See the map below if you’re unsure as to where KLCC Suria is.

How Intraocular Lens Can Help People with Cataract and Presbyopia


Consultant Ophthalmologist
Gleneagles Hospital Kuala Lumpur

Dr Cheong Fook Meng shares that it is normal to develop cataracts as you age.

However, this condition can also be caused by eye injuries as well as certain diseases or medications.

As one’s cataract progresses, the lens in their eyes gradually become hard and cloudy, allowing less light to pass through. This leads to diminished vision and even complete blindness in severe cases.


“Presbyopia is another condition that occurs naturally as a person ages; your eyes gradually lose the ability to focus on nearby objects,” says Dr Cheong.

With presbyopia, the lens inside the eye progressively loses its flexibility, making it harder for the affected eye to focus the light reflected from objects.

A common sign that someone may have developed this condition is having to hold reading materials at arm’s length to make out what they are reading.


“This surgical treatment allows the removal of the eye’s cloudy natural lens and replacing it with an intraocular lens,” explains Dr Cheong.

The intraocular lens is clear, made to fit one’s eye shape and personalised according to the patient’s condition and needs.

Intraocular lens (labelled as lens in the image). Click to view a larger version of this image.
  • Monofocal lenses correct a single range of vision, usually to see distant objects. Additional issues will need to be fixed through other means.
  • Toric lenses are suitable for patients who also have astigmatism but, similar to monofocal lenses, they restore vision for only one area of focus.
  • Multifocal lenses are designed to provide clear vision for distant and near vision.

Extended depth-of-focus intraocular lens delivers an enhanced range of vision with a reduced frequency of glares and halos, regardless of the lighting conditions.

During the day or when driving at night, these lenses deliver great vision and clarity.

For presbyopia

Extended depth-of-focus intraocular lens can be used to correct presbyopia, by creating a single elongated focal point to enhance one’s range of distance for which their eye can see an object clearly.

For cataract

While all lenses can fix cataracts, extended depth-of-focus intraocular lens may improve one’s quality of life.

They provide distant, intermediate (at arm’s length, such as for reading a newspaper or working on a laptop) and functional near vision (up close, such as for reading books and mobile phone screen), with minimum visual disturbances.

They may even decrease a patient’s need to wear glasses after their cataracts have been removed.

Important Things That You Should Know About Silent Heart Attacks


Consultant Cardiologist
Sunway Medical Centre

Dr Patrick Tiau reveals that silent heart attacks, also known as silent myocardial infarction, account for 45% of heart attacks.

These heart attacks are “silent” because they occur without the usual, recognizable symptoms of a heart attack.

  • Chest pain (often described as heavy or pressure sensation)
  • Radiating pain in the arm, neck, or jaw
  • Sudden shortness of breath
  • Sweating
  • Dizziness
Because of this, many people may not know that they have experienced one until days or even weeks after.

However, Dr Patrick shares that there are some early warning signs to look out for.


It’s good to consult a doctor when you have concerns, especially if you experience these signs and fall under the high-risk below (see below).

  • Feeling tired
  • Indigestion
  • Nausea
  • Sweating.

Dr Patrick says, “We have come across many patients who have dismissed the early warning symptoms as simply feeling tired, indigestion, nausea or sweating. By the time they seek out medical treatment for these symptoms, they are shocked to learn that what they are experiencing is actually due to a reduced blood flow to their heart, and that has caused them to have a silent heart attack.”

Silent heart attacks can lead to more serious health complications if left untreated over an extended period of time, such as an increased risk of another, potentially more deadly heart attack.

  • Age. The risk increases as we grow older.
  • Gender. Men are more at risk than women. However, women are more prone to a higher risk of complications after experiencing one, especially if they are diabetic.
  • Family history. The risk is higher for people with a family history of heart diseases.
  • Smoking. Chemicals in cigarettes stimulate one’s heartbeat and can dramatically increase one’s risk of heart attack.
  • High cholesterol. Individuals with elevated cholesterol levels can lead to formation of atherosclerotic plaque in the blood vessel and reduce blood flow to the heart.
  • High blood pressure: Having high blood pressure puts extra strain on the heart muscle. Over time, this causes the heart muscle to stiffen, thicken, and perform less optimally.
  • Individuals that are overweight or obese, especially when their weight tends to sit at the waist, are more at risk even if they do not have any other risk factors.
  • Physical inactivity. Doing regular exercise helps protect the heart by keeping under control other risk factors such as cholesterol, blood pressure, diabetes, and obesity.

“Undeniably our heart health is essential to allowing us to have a well-balanced and fulfilling life,” he says. “The heart itself is the first and last sign of life that is responsible for, quite literally, keeping us going. In combatting heart attacks, the most important thing to remember is that prevention is definitely better than cure.”


Make the necessary small changes to daily lifestyle to reduce one’s risk factors. These changes include:

  • Regularly monitor blood pressure and cholesterol
  • Get sufficient exercise
  • Quit smoking
  • Eat a balanced diet of fruit, vegetables, lean meats and whole grains
  • Ensure that one’s blood pressure, cholesterol and blood sugar are well-controlled
  • Inform a doctor as soon as possible about any unusual symptoms that may indicate a silent heart attack

Once you go home from the hospital, it is essential that you keep taking your medications as prescribed. “This will ensure your heart health is kept in check, possibly for the rest of your life,” says Dr Patrick.

Consider joining a support group. Dr Patrick acknowledges that heart attack survivors may start to develop feelings of shock, sadness, and anxiety. This is normal, and these feelings can be managed with the right support.

“Some people find it helpful to join a support group where they can talk with others that have gone through a similar experience, or seek out companionship and encouragement through avenues such as the gym, or yoga classes,” he advises.

A Man’s Swimmer Problems

A Man's Swimmer Problems

May 8, 2022   Return


Man’s Health and Fertility with

Dr Agilan Arjunan

Consultant Gynaecologist & Fertility Specialist KL Fertility Centre


According to the Guinness Book of World Records, Moulay Ismail ibn Sharif who ruled Morocco during the 17th century likely fathered 1,042 children during his lifetime. Some historians believed that the number might be as high as 1,171!

These days, it may not be possible to have this many children, even if the man is crazy enough to want to, as there are reports that, overall, the sperm count for men in America, Europe, Australia and New Zealand has dropped by more than 50% in less than 40 years. However, we have yet to find out the exact reason(s) for this fall. It is speculated that perhaps it is due to exposure to chemicals or pollutants, smoking, stress, obesity or maybe even all of them.

This month, we join fertility specialist Dr Agilan Arjunan in looking at what men can do to ensure that their fertility is still up there to create that little bundle of joy with their beloved partner.

Reference: Kelland, K. (2017). Sperm count dropping in Western world. Scientific American. Retrieved from article/sperm-count-dropping-in-western-world/


Too much! “The heavier you are, the more fat you will have stored in your body,” says Dr Agilan. As a result, there is more testosterone, the male sex hormone, converted to oestrogen, the female sex hormone in the fat. This will significantly affect sperm production, which is driven by a cascade of hormones that include testosterone.

Too hot! Another issue that comes with having excess weight is that it causes the temperature in the testicles to increase. Optimal sperm production requires a temperature that is slightly lower than that of the rest of the body, which is why nature has designed a man’s testicles to dangle between the legs instead of being an internal organ. The hotter it gets inside the testicles, the lower is the rate of sperm production.


“So … eat less?”

Not just that. To maintain a healthy weight, total energy obtained through food should be equal to total energy used by the body. So, there are two components to consider here: eating healthy, balanced meals and being physically active on a regular basis.


“How can I eat less? I’ll starve!”

We don’t have space in this article to fully dwell on the principles of healthy eating, but you can consult a dietitian for more advice. Basically, you should eat foods from all food groups, according to the recommended portion size based on your age, sex, current body weight, level of physical activity and any existing health condition you may have.

Some hunger is inevitable at the early stages of your new diet, but you will survive and adapt. Hang in there – over time, you will feel healthier, happier, and sexier!


“I’m already hungry and now you want me to exercise? Are you joking?!!”

Daily physical activity is important, as it strengthens the muscles and keeps the body working in good condition (all these are great for many things, including making babies). It also burns away any unused calories from your meals, ensuring that you do not gain weight. Furthermore, exercise is a great stress reliever. The gains far outweigh any momentary discomfort you may experience when you begin your new exercise routine.


If you like your alcohol, brace yourself as there is no way to break it gently: abstaining from alcohol is always better when it comes to trying for a baby. Even moderate consumption of alcohol can affect fertility in a significant manner.

Alcohol affects both sperm count and quality. This is because it can disrupt the ideal conditions in the testicles needed for optimal sperm production. Over time, it can even cause the cells in the testicles responsible for sperm production (Sertoli cells) to deteriorate. Alcohol may also affect the production and regulation of hormones that regulate sperm production.

All in all, drinking is not a good thing when it comes to ensuring that a man’s swimmers are in good condition and numbers!

“Sober up, huh? You think that’s simple? HAH!”

Don’t be so pessimistic! These days there are programmes to help people quit drinking successfully. A psychiatrist specializing in treating addictions will be the best person to turn to, but if one is not available near you, you can try asking a family medicine specialist for help. There are also many support groups available both in real life and online.


“It’s been known for many years that smoking can reduce both sperm count and the quality of the sperm produced by the man,” Dr Agilan points out, adding that the sperm count is especially affected by this habit.

It is found that the tobacco in cigarette contains substances that can negatively affect the ability of a man to produce normal amounts of sperm.

In the sperm cells that are produced, it is found that many have lower motility than sperm cells produced by non-smokers – which is to say, these sperm cells are less capable of traveling along the woman’s womb to successfully reach the egg cell.

“Hmm, so I should quit. That’s hard, right?

These days it’s easier to quit compared to the past, thanks to a combination of nicotine replacement therapy and counselling. You can consult your neighborhood pharmacist for more information.

“Wait … if the problem is nicotine, I can then vape instead, right?”

Dr Agilan points out that research on vaping is still at early stages, and it’s likely that other chemicals present in vape juices may also affect sperm count and quality. Why risk the chance? 


There is evidence that high levels of stress can affect sperm production, according to Dr Agilan. Furthermore, stress also makes it hard for couples to experience the mood to make babies!

When you are stressed, the body reacts as if you were in danger and releases stress hormones, which trigger the fight-or-flight response. You will feel your heart beating faster, your breathing will become shallower and you feel tensed up. The fight-or-flight response also closes off other functions that the body considers to be of lesser importance when dealing with the stress, and one of these functions is reproduction. Therefore, the more stress you experience, the more your sperm count may be affected.

Stress can come from a variety of external sources outside the bedroom – work, family finances, relationship woes, health issues. However, it can also come from the bedroom.

Dr Agilan cautions against what is called “medicalizing” the process of making babies. This occurs when couples are so determined to have a baby that each planned sexual encounter ends up becoming a stressful chore.


Calm down! Challenges and frustrations are inevitable parts and parcels of life. Often, stress relief can be obtained by stepping back for a while to focus on relaxation activities such as exercise, yoga, keeping a journal or anything else that can bring you a sense of peace.

But do reach out for help when you need to!

There are counsellors, hotlines and support groups out there that can help, and some of them offer free support. If trying to have a child is causing you and your partner undue stress, it may be time to seek a fertility specialist for advice.


It’s well known that boxers are supposed to be the underpants of choice as the tighter briefs- style underpants can elevate the temperature around the testicles and affect sperm production. Interestingly, there are studies which conclude there isn’t any significant difference in sperm production and quality among men who wear either type of underpants. However, Dr Agilan believes that there is no harm in choosing to wear boxers over briefs – anything that can increase the odds of success can be a good thing!

What happens if a man is born with low or zero sperm count? Dr Agilan will focus on such a situation in the next column, so don’t miss it! HT

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May 8, 2022   Return







Heart disease is the primary cause of sudden death among men in Malaysia. According to Dr Tee Chee Hian, sudden death can be caused by a variety of heart problems such as arrythmia (having an irregular heartbeat), congenital heart disease, or more commonly, coronary artery disease.


Know the signs and symptoms

Catching heart disease early may help prevent sudden death. Dr Tee says that men experiencing symptoms such as palpitations, fainting episodes, lethargy, shortness of breath on exertion, chest pain, postprandial angina (chest discomfort after meals), or reduced exercise tolerance should see their doctor immediately, as these may be signs of heart issues.

Men should also get screened regularly for the common risk factors of heart disease such as dyslipidaemia (abnormal cholesterol levels), hypertension, and diabetes.


Keep a heart-healthy lifestyle

Lifestyle changes that include quitting smoking, having a balanced diet with more vegetables and fruits, and doing exercises that promote cardiovascular fitness like running, jogging, and cycling can help lower the risk of heart disease.



Dato’ Dr Selvalingam Sothilingam notes that prostate cancer is the 3rd most common cancer in Malaysian men. It is often diagnosed in the late stages, due to the asymptomatic nature of the disease in its early stages.


Get screened

“The most common age for diagnosis of prostate cancer is men in their 60’s and 70’s. However, we have also detected cancer cases in men as early as in their 50’s. Early diagnosis is key as it is potentially treatable if detected at an early stage,” Dr Selvalingam explains.

Men that have a family history of prostate and/or breast cancer should get screened for prostate cancer from the age of 45.


The right diet may lower risk of prostate cancer

Dr Selvalingam shares that frequent consumption of foods such as cooked tomatoes, soya products, green tea, vegetables, and fruits may lower a person’s risk of prostate cancer.

On the other hand, having a diet high in red meats and processed foods as well as low in fibre may increase the risk of prostate cancer.

Just Guy Things

Just Guy Things

April 28, 2022   Return

Ask people what defines a man and, chances are, the first thing that crosses the mind are those body parts down below. There are at least 174 ways to describe the penis using the English language, and at least 100 for the testicles. We said ‘at least’, because there is no doubt that more slangs and creative euphemisms are created for those body parts with each passing year.

We may talk and think quite a lot about those body parts, but just how well do you really know the male reproductive system? Our grandparents often tell us that to truly know something is to love it, so guys, if you really want to love those parts down below, let’s take a while to know them better.

Here are the Guy Bits

Comedians and other people who think they are so funny often describe men as simple, uncomplicated creatures. Well, compared to the fairer sex, there may be some truth to that. For one, biology has decided that the human male reproductive system is less complex than the female reproductive system!

You are no doubt familiar with the penis and scrotum as they are the visible components of the male reproductive system. Hidden from view and less well-known are structures inside the body, such as testes and prostate gland 

The structures of the male reproductive system serve three important functions – to let you look like and function as a man, allow you to make babies and get rid of urine. 

The testicles produce sperm cells, which are then sent to the epididymis to mature. The prostate gland (which technically is part of the exocrine system) produces a fluid that make up a big part of the semen. This fluid serves to nourish sperm cells, so that they function properly to allow the conception of new life.

The testicles also produce and release male sex hormones such as testosterone. These hormones play key roles in the regulation of many important functions to give men their distinctive characteristics (facial hair, huskier voice, etc) and maintain the function of their reproductive system.

The penis also helps to expel urine, which contains excess water and unwanted waste products.

What Can Go Wrong?

Men are naturally concerned about the possibility of things not working properly, especially when it comes to making babies. However, let’s not overlook the dreaded ‘C’ word – cancer. Find out more in the next article.

Reference: WebMD. Available at

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Grief to the Prostate

Grief to the Prostate

April 28, 2022   Return

E_Dr Sulaiman

Dr Sulaiman Tamanang   Consultant Radiologist and Nuclear Medicine Physician, The National Cancer Society of Malaysia

Prostate cancer may not be the most common cancer among men in Malaysia – that would be lung cancer – but it is nonetheless common in men over 50, according to Dr Sulaiman Tamanang, a consultant radiologist and nuclear medicine physician. To date, we have not identified the actual cause(s) of prostate cancer.

No early symptoms

When it comes to prostate cancer, there are usually no specific symptoms during its early stages. 

Symptoms usually show during advanced stages

Symptoms may occur at later stages, and even then, things are complicated by the fact that these symptoms may be the same as those of other conditions, such as benign prostatic hyperplasia (BPH, swelling of the prostate glands).

Therefore, see a doctor as soon as symptoms occur

Some symptoms to watch out for are:

  • Urinary problems – blood in the urine, difficulty in urinating, weak urine flow, frequent need to urinate (especially at night), pain or burning sensation while urinating.
  • Problems achieving or maintaining an erection.
  • Pain in the hips, back, chest and other areas; this may be a sign that the cancer has spread to the bones.

Even better, go for screenings

Dr Sulaiman recommends every man over 50 to take the prostate-specific antigen (PSA) test once a year. Getting screened is just a matter of having some blood taken to be tested in the laboratory. This test is available at most medical establishments, and can be requested as an add-on to standard health screening packages.

“While this screening is not 100% accurate, it gives us some indication that there may be something wrong,” Dr Sulaiman explains. Therefore, this screening can be a good way to detect prostate cancer at an early stage.


Early is better

Just like with other types of cancer, early detection often means an improved chance of recovery and a lower possibility of the cancer returning (recurrence).

Treatment options

There are usually three options available – surgery, hormone therapy and chemotherapy.

For a patient of advanced age, however, Dr Sulaiman says that a “wait and see” approach is usually adopted. This is because at that age, there are other diseases that will pose a bigger threat to the man’s health. 

Prostate surgery

For early stage prostate cancer, it is usually recommended to have the affected prostate removed via surgery. Parts of the surrounding tissues (including lymph nodes) may also be removed, so that they can be examined to determine whether the cancer cells have spread.

“There may be side effects,” explains Dr Sulaiman, “such as poor urine stream and dry ejaculation (no ejaculate is released during orgasm). However, not everyone will experience them, and we have means (medication, therapy, etc) to address them when they occur.”

Hormone therapy

Hormone therapy is usually offered to patients whose cancer has reached an advanced stage, or if the patient is unable to undergo surgery for medical reasons.

Dr Sulaiman explains that, in a patient with prostate cancer, the testosterone hormone can stimulate cancer cells to grow. Hormone therapy acts to either reduce the amount of testosterone produced in the body, or to stop testosterone from reaching the cancer cells.

As a result, the cancer cells grow slower or, in some cases, the tumour may shrink in size. However, hormone therapy will not cure prostate cancer.

Hormone therapy may cause side effects due to the changes in testosterone level in the body, such as decreased libido, erectile dysfunction and growth of breast tissue (gynaecomastia).


Chemotherapy is usually a “second resort” treatment, given when the patient does not respond favourably to hormone treatment, or when their cancer has spread to other parts of the body.

This therapy involves the use of drugs to kill the cancer cells in the body. Depending on the severity of the cancer, the patient may be offered a combination of different drugs. These drugs will help to slow the growth and spread of the tumour(s), and in the process give the patient more time and improve his quality of life. However, they will not cure the cancer.

Chemotherapy has side effects, caused by the fact that the drugs cannot tell healthy cells apart from cancer cells. Healthy cells will also be affected by the drugs, leading to side effects such as changes in physical appearance (loss of hair, nails, bloating, skin blotching, etc), nausea, fatigue and weakened immune system (which may increase the risk of infections). The good news is that these side effects will eventually go away once treatment is over. 

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A Tumour in the Testicle

A Tumour in the Testicle

April 28, 2022   Return

Assoc Prof Dr Christopher Ho Chee Kong   Consultant Urologist and Sexual Medicine Consultant, Beacon International Specialist Centre

Testicular cancer is not very common, but when it does occur, it commonly occurs among men between their 20s and 40s. It can occur at a later age, but that is even rarer. Usually only one testicle is affected, but the cancer may spread to the other testicle and other parts of the body if left untreated.


Risk factors

Consultant urologist and sexual medicine consultant Assoc Prof Dr Christopher Ho points out that we have yet to discover the exact causes of testicular cancer, but among young men, the risk increases if they have a history of undescended testicle (cryptorchidism).

We can’t rely on symptoms to tell us that something is wrong.

Dr Ho explains that, in many cases, most men with early stage testicular cancer do not experience any pain or discomfort. It is only when the cancer has reached an advanced stage that symptoms may be felt. These symptoms include bone pain and jaundice.

Therefore, self-examination is the best “screening” method.

Dr Ho recommends checking one’s testicles in front of a mirror regularly (at least once a month). Some things to watch out for are:

  • Appearance of mysterious lumps, nodules or other masses
  • Unusual swelling or enlargement of the testicles

It is best to perform this self-examination after having a warm bath, as the heat from the bath would relax the skin of the scrotum, making it easier to detect any signs of abnormalities.

If you detect any abnormalities, see a doctor as soon as possible. If the cancer is diagnosed at an earlier stage, your chances of recovery are significantly higher.

Diagnosing testicular cancer

The doctor will perform some tests to determine whether you have testicular cancer. First, the doctor will physically examine your affected testicle.

Next, an ultrasound test is performed. Dr Ho says that this method allows the doctor to “look” into your testicle to locate and determine the size of the unusual mass. This test is about 90% accurate.

If the presence of a lump is confirmed, the doctor usually recommends the removal of the entire affected testicle. The procedure is called radical inguinal orchiectomy.

According to Dr Ho, this is both a treatment and diagnostic procedure, as the removed testicle will be sent to a laboratory to determine whether the lump is cancerous and, if it is, the type and stage of the cancer.

If you are uncomfortable about your appearance down below after the surgery, Dr Ho mentions that reconstructive surgery is available. This procedure implants a prosthesis into the scrotum, and the prosthesis feels just like a real testicle.

After the surgery

Next, your doctor will determine whether the cancer cells in your testicle have spread to other parts of the body. This is usually done via a computerized tomography (CT) scan. A series of X-ray images of your abdomen, chest and pelvis will be taken. These images will then be analysed for the presence of tumours.

A blood test may also be performed, to check for elevated levels of substances called tumour markers. If the test comes back with abnormally high levels of these substances, there may still be cancer cells in your body.

Follow-up treatments – radiation therapy or chemotherapy, or both – will then be prescribed, based on the stage of your cancer.

Radiation therapy

This is one possible treatment for certain types of testicular cancer (seminoma type). There is a risk of infertility associated with this therapy, so if you wish to have children in the future, you can freeze your sperm first. You can discuss your options with a fertility specialist.


For advanced stage testicular cancer, in which the cancer has spread to other parts of the body, chemotherapy will be prescribed. Just as with the chemotherapy drugs used to treat prostate cancer, the chemotherapy drugs for testicular cancer can cause side effects. You will be monitored closely for these side effects, and dosage would be adjusted to reduce their severity. Once treatment is complete, the side effects will go away.

Recovery rate

Dr Ho delivers the good news: compared to other types of cancer, testicular cancer (even at its advanced stage) has a good recovery rate.

For early stage cancer, the cure rate is more than 90%. Even for advanced stage cancer, the survival rate is still pretty good, about 70%. Of course, this is provided that the patient receives proper treatment.

Therefore, if you suspect that there is something abnormal happening to your testicles, it is definitely a good idea to see a doctor as soon as possible!

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Caffeine for the Hair, Sir?

Caffeine for the Hair, Sir?

April 28, 2022   Return

Hair loss has long been the bane of many men’s existence. Millions of men worldwide are affected by male pattern hair loss, a condition caused by an inherent sensitivity to dihydrotestosterone (DHT), a substance produced in the body from the male sex hormone testosterone. Male pattern hair loss can be passed from father and son – bad news indeed for men whose fathers exhibit this condition.

As much as men may not like to admit it, hair loss can leave a serious dent on one’s self esteem. Various inventive combing techniques (called, imaginatively enough, comb overs) have been invented over the years to hide a bald patch, while those with enough budget blow thousands of Ringgit on hair transplant. All to assure the man that he still looks youthful and attractive!

Interestingly, there may be a solution to hair loss – a solution that is already a big part of our daily lives: caffeine. Yes, the same substance that gives our coffee its ‘kick’.

Hold On to Your Cup of Joe

Don’t go washing your hair with espresso just yet, though, as the amount of caffeine consumed by even the heaviest coffee drinkers is not enough to do the trick.

According to Dr Adolf Klenk, a leading German researcher of caffeine and its effects on hair loss, you will need to consume 40-50 cups of coffee to provide the dose of caffeine needed to make its way up to the hair root. Even if someone is foolhardy enough to drink this much coffee, he will most likely end up with a bigger problem than hair loss. After all, caffeine is a drug-like substance, and it would be extremely toxic when consumed in extremely high amounts.

Fortunately, caffeine can be used as an active ingredient in shampoos, hair gels and other hair care products without causing health problems!


Caffeine Control

Dr Klenk, who was recently in Malaysia, explains that research on caffeine indicates that it can control the effects of DHT and therefore prevent premature hair loss in men. “Caffeine can also protect hair roots against hereditary hair loss in men and support hair for healthy growth,” he adds.

The Center for Cosmetologic Research, Catholic University of Sacred Heart in Rome performed an application test on 30 male subjects, aged from 18 to 55 with male pattern baldness. They found that caffeine shampoo, when used over 6 months, can:

  • Decrease hair pulled out by 7% after 3 months, 14% after 6 months.
  • Significantly improves strength of hair.
  • Reduce intensity of hair loss.
  • Reduce typical scalp problems such as itch, dryness and tension.

The same centre conducted another research, this time using caffeine liquid hair wash, on men with alopecia (a type of hair loss caused by the cells of the immune system attacking one’s own hair follicles) over 2-4 months. They found that the caffeine liquid hair wash brought about the following benefits:

  • Decreases hair loss by 8% after 2 months, 15% after 4 months.
  • Reduces premature hair loss by 43%.
  • Improves hair structure by 53%.
  • Improves scalp condition by 12%.
  • Reduces balding by 43%.

These are just some of the more recent research on the potential benefits of caffeine in controlling and reversing hair loss. Therefore, if you are worried about losing your hair, or if you are already losing your hair, it may be worth discussing with a dermatologist or hair restoration expert about using caffeine hair care products.

Don’t forget the B’s

While good nutrition will not bring back your lost locks, B vitamins can help with the formation and growth of new hair follicles. Therefore, it may be worthwhile to load your daily diet with food rich in these vitamins to complement your efforts to prevent or reduce hair loss. Good options are chicken, fish, eggs and dark leafy vegetables such as spinach. Supplements may also be helpful.

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