November is nearly over and millions of men will shave off their moustache much to the relief of their women. It all sounds so great. Men getting together to share and help each other. It's the male Pink Ribbon!
But I ask what is this awareness all focused on? It's focused on looking out for trouble. Get that PSA Test. Find out if you have it. Find out how best to treat it.
What younger man has ever had a conversation with his doctor about how to live so as not to get prostate cancer? Do men talk to each other about how to live so as not to get it? Never!
As with breast cancer the conversation is all about early detection and then treatment. The research is confined to finding a "cure". The "Cures" are all invasive, dangerous and unpleasant. And and also expensive and disabling.
The research is confined to "Cures" or more detection. In breast cancer there is a strong known linkage between obesity and cancer. Does this exist for men? We don't know but is this the kind of research that is going on? I doubt it because there is no pill or treatment that we all pay for if this is true. Research tends to be biased to the $ result.
And what about advice when you are diagnosed?
What doctor tells a man with a high PSA that only 1 in 15 diagnoses has a cancer that will kill you? The usual message is that you cannot take the risk and must decide on treatment. What doctor sits down with you and discusses what you can do to reduce your risks now you have it? Each specialty will advocate for their own treatment option. Who advocates for wait and see? There is no money in wait and see, so it is unlikely that no one will advise that.
Cancer is not just a lottery. In many cases how we live, what we eat has a bearing on whether we get cancer or not. Where is the research on that?
Now that Movember has started the "Awareness" please let's have a real conversation.
Why do men get prostate cancer? What are the key behaviours that we can modify to reduce our risks? What can we test years before the PSA to see our deep risk? If we have prostate cancer what are the real risks of dying? When we know that we can then evaluate the real risks of the treatments on offer. I know that with a 1 in 15 chance of having a fatal variety, I would wait and watch before I would endure any of the current options. I also know that aged 63, I am entering the zone where cancer moves very slowly. Most men over 80 have it and die of something else.
Does early detection have any bearing on mortality? We know it has none for breast cancer. What are the risks of treatment? We know they are significant.
If you care about prostate cancer, please have a deeper conversation and please be aware of so much more than I need to test for it.