Society has come a long way over recent decades with a great change in the way we view men and their health. In the past, it may have felt unmanly or taboo for men to share their feelings and seek professional help for their ailments or emotional state. Thankfully, this outdated way of thinking has changed, in large part thanks to the funds and awareness raised by the Movember Foundation.
It all started with two mates: Travis Garone and Luke Slattery, having a quiet drink at a pub in Melbourne back in 2003. An idea for bringing the moustache back into fashion by raising money to grow one was sparked and the pair recruited 30 blokes to participate. Since then, the Movember Foundation has expanded to 21 countries around the world and has raised over $730 million. The funds raised have gone toward the prevention of four major men's health issues (prostate cancer, testicular cancer, mental health and suicide) in the charity’s quest to reduce the number of men dying prematurely by 25% by 2030.
November is as good a time as any to check-in with yourself and others around you, and think about what you can do to minimise the risk of these four major health issues: prostate cancer, testicular cancer, mental health and suicide. In October 2019, Movember research found that 74% of men in Australia did not seek medical help when they had a health concern (1). Sometimes a 'she'll be right' attitude' might come at a fatal price. Let's reverse this by starting to educate ourselves on these morbidities; how to detect them, and where to seek help.
Prostate cancer is the most commonly diagnosed cancer among men; taking the lives of around 3,500 men annually (Prostate Cancer Foundation of Australia, 2019). It is, therefore, no surprise that the Movember Foundation chose first to support the Prostate Cancer Foundation of Australia.
What is it prostate cancer?
The prostate gland is located inside the body directly below the bladder and plays a vital role in the reproductive system of males. Its most important function is the production of a fluid that, together with sperm cells and other fluids, makes up semen. The muscles of the prostate also allow for ejaculation.
Over the years, the cells of the prostate start to divide, causing the prostate to enlarge. This is known as 'benign prostatic hyperplasia' (BPH). As hyperplasia continues, the prostate begins pressing against the urethra, which explains why older men sometimes have trouble passing urine. Prostate cancer arises from a bit of a stuff up in hyperplasia where one of the dividing cells acquires a dangerous mutation. Essentially, this single mutation sets the stage for the development of a cluster of mutated cells with the ability to duck and dodge any of the body's defence mechanisms in place to protect it. If the tumour stays contained in one location and can be well-differentiated, then the prognosis is pretty good. On the contrary, if the tumour cells keep rapidly dividing and metastasize (escape the prostate and move somewhere else), then some serious issues may arise.
How to prevent it
The American Cancer Society (2) explains that improving your diet and increasing overall physical activity may lower your risk of developing prostate cancer. Although evidence is inconclusive, including more fruits and vegetables in your diet whilst reducing refined carbohydrates such as white bread, pastries, white rice, refined pasta and sweets, as well as reducing total and saturated fats, and cooked meats, may protect the prostate and slow the progression of cancer (3) among a host of other health benefits.
When and where to seek help
Although most common amongst older men, if you're passing blood in your urine, have erectile dysfunction, experience general pain around the pelvis and bones, and/or have difficulty or pain when urinating, it might be time for a check-up. Your GP can perform a simple blood test known as a Prostate Specific Antigen (PSA) test to see if you have elevated levels of the PSA protein in your blood. Alternatively, or alongside the PSA test, you might require a physical examination involving your GP assessing the size of your prostate. Keep in mind that general practitioners are trained professionals who have seen it all before, so as uncomfortable as this might be, it might just save your life. More information can be found on the Prostate Cancer Foundation of Australia website.
Research from the Movember Foundation indicates that the mortality rate for testicular cancer is 1 in 20 men, with a higher prevalence in young men (4). The Foundation aims to halve this number, and the number of men facing ongoing side effects from treatment, by 2030. Recent statistics from the Cancer Council have shown a 50% increase in the incidence of testicular cancer over the last 30 years without any explanation (5).
What is testicular cancer?
As you may or may not know, the testicles' primary role is to produce two things: mature spermatozoa (sperm) and testosterone. Sperm goes through a maturation process in order to gain motility and fertility known as 'spermatogenesis', beginning in specialised cells called germ cells. It is in the germ cells where the majority of testicular cancers start their development into a potentially invasive tumour capable of entering the bloodstream or lymph and spreading elsewhere. Despite having an unknown cause, it partly overlaps with that of other developmental disorders of the male reproductive system (6), which might explain some of the following risk factors suggested by the Cancer Council (2019):
o Undescended testicles early in life
o HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome)
o Some congenital defects (see your GP about what they might be)
o Previous testicular cancer
o Intratubular germ cell neoplasia (ITGCN) - abnormal germ cells with a 50% chance of developing into cancer
o Family history of a brother or father with testicular cancer
Although the list above is relatively extensive, none of the following myths is associated with cancer:
o That time in high school cricket when one of your mates bowled a ball straight into your crotch (or anything else involving mechanical trauma to the testicles!)
o Wearing skinny jeans
o Having a vasectomy
o Having sex
How to prevent it
Since most of the risk factors are unmodifiable, testicular cancer cannot be prevented. There is great news in that the prognosis is usually very positive, especially when detected early. To help you look for signs of change, you need to check your testicles regularly.
You can find out how to check your testicles here.
This self-assessment should be done monthly to ensure you are aware of what your testicles normally feel like so that if something doesn't feel right, you can schedule a visit to the doctor. Just because something doesn't feel right, it does not mean it is cancerous. Getting it checked by a medical professional is the best course of action. Have a look at this Nuts & Bolts resource provided by the Movember Foundation to learn more about keeping your testicles healthy.
When and where to seek help
If you notice some painless swelling of the testicle, a nodule/s, dull ache or heavy sensation in the lower abdomen (7), then get it looked at right away. These symptoms are not exclusive to testicular cancer, however. If your GP is concerned, they will refer you to the hospital to have an x-ray, urine test and/or blood test to investigate the symptoms further.
Mental Health & Suicide
Evidently, the 'she'll be right' attitude associated with toxic hegemonic masculinity is far from ideal for men's health. It is estimated that one man takes his own life every minute around the world. This is not OK and the Movember Foundation is focused on reducing these rates by 25% by 2030. We explore the issue more and what you can do to help yourself or one of your mates.
What is it?
Two of the most prominent mental health issues around the globe are depression and anxiety. Both are clinical conditions that are preventable, however, sadly they lead to an alarming number of suicides.
Feeling emotional whilst watching a sad movie is a completely normal response to a sad event. Sadness is not to be confused with depression though, which persists for far longer. The most widely accepted theory for depression is the 'monoamine hypothesis of depression' that predicts a chemical deficiency of three neurotransmitters in the central nervous system:
1. Serotonin - known as the 'happy hormone' and involved in sleep regulation. About 90% of serotonin (or 5-Hydroxytryptophan) is produced in the gut which is why a happy gut helps with your mood (more on this later).
2. Norepinephrine (AKA noradrenaline) - contributes to judgement, motivation and intelligence.
3. Dopamine - the 'reward hormone' which, when depleted, is responsible for low motivation and disinterest in the things that usually excite you.
Overall, depression is an internal physical depletion of these neurotransmitters whereas anxiety comes from an often-unknown underlying trigger. Notably, these conditions go hand in hand, making it an even tougher battle.
Anxiety or panic is a normal phenomenon that is genetically ingrained in us as a protective mechanism. It is that feeling you get when you walk through a spider's web, shout out and start shaking your arms around, swiping at the air, before evading the situation as quickly as possible. You got away from the spider’s web without being bitten thanks to the large surge in another neurotransmitter: epinephrine (AKA adrenaline), which was released from your adrenal glands that sit on top of the kidneys. Again, this is a completely normal response to a somewhat frightful event. Clinical anxiety, or panic disorder, however, is when you get feelings of anxiety in the absence of a fearful event. About 20% of blokes don’t need the explanation because that's how many men experience it (Beyond Blue, 2019). For the other 80%, it's important to know how to prevent it and how to help someone around you who might be experiencing anxiety.
How to prevent it
Although depression has been found to be genetic in some cases and is closely linked with anxiety, they're both largely preventable – or at least manageable, with the right tools. Whether you're someone who falls under this category or not, it is important to stay in check with your mental health by doing the following:
1. Staying active - getting outdoors and participating in physical activities contributes to a healthy mind. Evidence suggests that the frequency of exercise is more important than duration and intensity (8). In other words, do what you enjoy and repeat it often.
2. Eating a balanced diet - read Food and Your Mood for a run-down on good foods to focus on. As a short introduction, the article explains that following a Mediterranean diet high in plant-based foods, moderate in oily fish and poultry, and low in red meat, dairy, alcohol and sweets, favours healthy gut and brain chemistry. The gut has a brain of its own and works in tandem with our actual brain, having a positive effect on our mental health.
3. Keep an open line of communication with those you trust. Good places to chat are in the car, in the kitchen, with your partner in bed, over a quiet drink or with a trained professional in their office. The earlier you talk about what's going on, the less it will build up, resulting in a lowered risk of depression and anxiety.
When and where to seek help
Neuroscience Research Australia (9) lists the following symptoms of depression to be aware of:
o Not wanting to go out or take part in activities that were previously enjoyable
o Withdrawing from social contact with friends and family
o Difficulties in concentrating or sleeping
o Feeling overwhelmed, guilty or frustrated
o Experiencing negative thoughts
o Feeling continuously sick, tired or run down
Anxiety and depression can be completely different for everyone. Beyond Blue (10) lists common symptoms of anxiety to look out for:
o Physical: panic attacks, hot and cold flushes, racing heart, tightening of the chest, quick breathing, restlessness, or feeling tense, wound up and edgy
o Psychological: excessive fear, worry, catastrophising, or obsessive thinking
o Behavioural: avoidance of situations that make you feel anxious, which can impact on your study, work or social life
If any of these sound familiar either for yourself or someone you know, have a chat. If you feel as though you cannot talk to any of your family or friends, then go to your GP. They will be able to point you in the right direction for help. Often, this will involve a referral to a psychologist who can help you work through what you’re feeling in a safe and calm environment.
November and every other month of the year is a time to look after yourself. Men's health has taken leaps and bounds in the right direction, but there is still work to be done. Eating well, exercising often, and maintaining healthy relationships with your friends, family and yourself, are huge steps in the right direction. For my information on men's health and what you can do to help yourself and your mates, click on the following links:
If you want to raise money and awareness for the Movember Foundation, you can grow a mo, commit to a fundraising challenge or join a team, host a get-together, and/or use the power of social media to spread the message.
1. The Movember Foundation. (2019, October 28 ). 3 in 4 Australian men don’t always go to a GP when they have a health problem.
T. A. (2019). Can Prostate Cancer Be Prevented? https://www.cancer.org/cancer/prostate-cancer/causes-risks-prevention/prevention.html
Lin, P., W. Aronson, & S.J. Freedland. (2015). Nutrition, dietary interventions and prostate cancer: the latest evidence. BMC Medicine.
Foundation, T. M. (2019). Testicular Cancer. https://au.movember.com/about/testicular-cancer.
Council, C. (2019, November 13). Testicular Cancer. https://www.cancer.org.au/about-cancer/types-of-cancer/testicular-cancer.html
Meyts, E., N.E. Skakkebaek, & J. Toppari. (2018). Testicular Cancer Pathogenesis, Diagnosis and Endocrine Aspects. Endotext.
Sachdeva, K. (2019, September 11). Testicular Cancer. https://emedicine.medscape.com/article/279007-overview.
Craft, L., & Perna, F. (2004). The Benefits of Exercise for the Clinically Depressed. The Primary Care Companion To The Journal Of Clinical Psychiatry..
NeuRA. (2019). Depression Health Information. https://www.neura.edu.au/health/depression/?gclid=CjwKCAiA8K7uBRBBEiwACOm4d8uSz21MqjnQPu9HXuhHxZclry3UAb55o_fKEISdbkUN0eJehIbMUhoCsA0QAvD_BwE.
Bie, B. (2019). Signs and symptoms. https://www.beyondblue.org.au/the-facts/anxiety/signs-and-symptoms?gclid=Cj0KCQiAk7TuBRDQARIsAMRrfUbTgoBlLl1q8uQQWCOtCmguCk_IO3hzDj7DAxaISMWq2T-lsyx5yyIaAnMaEALw_wcB.