Editorial: A hairy way for men to learn about health issues they like to ignore

The Canadian Movember group is raising money to change the face of male health and well-being, through improved understanding and treatment. “Movember,” because as part of the fund-raising effort, men are asked to grow a moustache this month, and show their support.

While the campaign is broad based, there are four main focal points: Prostate cancer, testicular cancer, mental health and suicide.

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These are all challenges that men are prone to face, and that tend not to receive the attention they merit.

Male wellbeing is a difficult topic to discuss, in part because men are supposed to be the strong silent types; in part because they often find it difficult to come forward and ask for help.

We see that, for instance, in the fact that some men only seek medical care when it is too late in the disease process.

Men also tend to be less knowledgeable about personal health.

Women are encouraged to practice breast self-examination. Men are rarely encouraged to examine their testicles for cancer.

Again, suicide rates across the country are three times higher in men than women. And men are also vastly over-represented in opioid deaths.

Nation-wide, of the 16,364 illicit drug deaths between January 2016 and March 2020, 75 per cent were men.

Part of the reason for this gender imbalance is that men are more likely to work in dangerous occupations, such as forestry or construction. The injuries they suffer may be treated with opioid pain killers that can later lead to addiction.

Risky male lifestyles, like smoking or alcohol abuse, help explain why, worldwide, women outlive men by six years.

The objective of the Movember movement is to bring these issues out in the open, recognizing that awareness is the first step toward progress.

There are many gender-related burdens that affect men and women differently. Some are obvious (e.g. childbearing), some are subtle (opioid-related deaths).

But to address them effectively, we have to understand the whole picture.

Beginning with the opioid crisis, we need a better grasp of why men suffer a far higher death rate.

Some of the causes are employment-based. But that cannot be the whole story. There are other factors at work.

Moving on, every year 23,000 Canadian men will be diagnosed with prostate cancer, and 4,200 will die.

In comparison, 26,900 women will be diagnosed with breast cancer, and 5,000 will die.

These figures are roughly similar, yet the financial resources devoted to breast cancer research are more than twice that for prostate cancer.

Thanks to this higher level of support, treatment of breast cancer has improved markedly. In years gone by, the standard surgical procedure was radical mastectomy, meaning the entire breast and surrounding muscle tissue was removed.

That left women often unable to perform every-day tasks, and raising an arm can be impossible. Research, including important studies conducted in Canada, established that lumpectomy (where only the tumour is removed) followed by radiation is as successful, less disfiguring and preserves freedom of movement.

By comparison, while gains have also been made in the treatment of prostate cancer, radical prostatectomy remains one of the standard remedies for this disease. That means the entire prostate gland is removed, often resulting in damage to surrounding nerve systems.

That in turn can lead to long-term side effects like impotence and incontinence.

With more equitable research funding, these side effects might be eliminated, or at least mitigated.

Beyond question there remain numerous instances of injustice where biases against women live on.

But it is also time to recognize that gender imbalance is not a one-sided affair.

We need more research funding directed at male disorders like prostate and testicular cancer.

Our public health staff must recognize that men are predominantly the victims of illicit drug overdose and suicide. Focused efforts are required to address some of the causes, loneliness and despair among them.

And our economic planners must direct more attention to the decades-long erosion of blue-collar jobs. Some of this is unavoidable, caused by automation and the flight of companies abroad to low-wage destinations.

But new industries and growth sectors can partner with training institutes to create sustainable blue-collar employment.

Here too, the first step toward a solution is recognition of the problem.

Perhaps through Movember we can give voice to these needs.

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