Comic books to educate young men about testicular cancer

Comic books may help to educate young men and their partners about testicular cancer and its early symptoms and encourage them to do more self-screening, according to Ryerson University School of Fashion professor and comic book artist David Brame.

Brame is the lead author of the study, Ain't Nothing Comic About It! Educating Young Men about Testicular Cancer: A Resource Development Project. The report also involved Dr. Peter Chung and Dr. Joyce Nyhof-Young of the Department of Radiation Oncology at Princess Margaret Hospital, and David Kolin, a medical student at the University of Toronto.

"Existing pamphlets about testicular cancer are usually written by healthcare providers, which means they may contain jargon that isn't readily understood by the average person," Brame explained. "Most pamphlets circulated at hospitals are also directed at patients, and do not reach the broader population."

According to the Canadian and American Cancer Societies, an estimated 8,900 North American men are diagnosed with testicular cancer each year and about 450 will die from the disease. The most common form of cancer in men aged 15 to 34, testicular cancer is often curable, especially if detected early. Many men, however, are unaware of the disease and do not self-screen appropriately, which can lead to later diagnoses of more advanced disease.

Brame and his research team found that illustrated resources on testicular cancer were lacking. To fill the information gap, the researchers explored comic books as a vehicle to reach out to this young group. The genre's target audience - men aged 18 to 39 - was a good fit. Comic books are already used to discuss other conditions, including HIV, hepatitis B, asthma, leukemia and swine flu. The researchers conducted a literature review and analyzed earlier interviews from 40 testicular cancer patients at Princess Margaret Hospital. The latter data was used by Dr. Nyhof-Young to determine information needs and to generate true-to-life stories. From there, Brame spent a number of weeks drawing and finessing the artwork.

In the end, two comic books were developed. The first, A Courageous Journey, follows a young man through diagnosis and treatment. It also addresses the many social, economic and psychological issues that patients may face along the way. The second comic book , Testicular Cancer: Screening and Diagnosis, describes the symptoms, how to perform a self-examination and the importance of seeking prompt medical treatment if worrisome changes are noticed.

Both comic books were field-tested with healthcare providers, high school students, and testicular cancer patients and their families.

The researchers found that preliminary feedback from the students was positive. While survey responses indicated that students' knowledge of testicular cancer and self-examinations increased considerably after reading the comic books, neither resource significantly impacted whether they would or would not self-screen in the future. The researchers also plan to survey the other groups in the future.

This feedback, Brame says, demonstrates the challenges that health professionals experience in connecting with and changing the behaviors of 15- to 25-year-old males. But, he notes, the students' responses will prove valuable as the team redevelops the resources - a process that is already underway.

"We have to find ways to give educational materials a mainstream look, rather than using familiar hospital templates. This will increase audience receptivity to the messages. And with more literacy and education, a disease is less likely to run unchecked."