(236) Evaluating the Social Media Landscape Surrounding Men’s Health Conditions in Testicular Cancer Patients
Authors: Zhu M , Loloi J , Babar M , Wysocki M , Winokur N , Bernstein A , Matulewicz R 
Published: February 2024

Abstract

Introduction
Forms of sexual dysfunction remain some of the most common concerns amongst testicular cancer survivors. While it is commonly reported, discussions surrounding male sexual dysfunction among patients with testicular cancer in public social media forums are understudied.

Objective
We sought to evaluate themes and tones on Reddit, a large social media platform, regarding men’s health conditions in patients with testicular cancer.

Methods
We retrospectively analyzed discussion posts on Reddit using qualitative analysis and natural language processing-based sentiment analysis. Using the Reddit application programming interface (API), 1000 posts from April to June 2023 were extracted from the subreddit r/testicularcancer, which is dedicated to discussions related to testicular cancer and has &gt;5,900 active members. Men’s health issues were defined to include erectile dysfunction, low libido, testicular discomfort, or ejaculatory dysfunction (e.g., delayed or premature ejaculation, anejaculation, painful ejaculation). Qualitative analysis was performed to determine overall themes within discussion posts. Sentiment analysis was performed using the validated tool VADER, which is specifically attuned to sentiments expressed on social media platforms and assigns a score for each post that can be interpreted as having a positive (score of 1), neutral (score of 0), or negative (score of -1) sentiment.

Results
A total of 148 posts were randomly selected for thematic and sentiment analysis. Notable discussion themes from the posts include discussing treatment options (e.g., chemotherapy vs. surgery vs. observation) offered by the physician (24.3%); asking about side effects of treatment (17.6%); discussing a patient’s personal journey with testicular cancer (33.1%); asking for advice from the online community (68.9%); and discussing various emotions (frustration, anxiety, stress, etc.) (28.4%). Fifteen (10.1%) posts mentioned a men’s health issue within the text body. Of these 15 posts, 7 discussed low libido, 4 discussed testicular pain or discomfort, 3 highlighted ejaculatory dysfunction, and 1 highlighted a physiologic effect of low testosterone levels. The mean (SD) VADER score was 0.1 (0.9); most posts (75; 51.0%) had a positive sentiment while 62 (42.2%) had a negative sentiment. Posts discussing men’s health issues did not have a significantly stronger positive or negative tone than other posts (p = 0.83).

Conclusions
On Reddit, the slim majority of posts had positive sentiment and patients seemed to prioritize discussing their journey with testicular cancer and its various treatment options along with asking for community advice and second opinions. Upon initial analysis, a smaller but notable percentage of posts mentioned a men’s health issue, indicating that men’s health issues may be underdiscussed on social media venues despite its prevalence in this particularly vulnerable patient population. A variety of reasons may explain this, including stigma involving discussing sexual dysfunction in public forums and a lack of prioritization and focus on men’s health issues in the context of living with cancer.

Disclosure
No.