In Australia, men have a life expectancy that is four years less than our female counterparts. We have strokes, heart attacks and certain types of cancers in higher numbers, more frequently suffer from substance abuse problems and are, on average, less able to handle stress. But when was the last time you went to the doctor? And why is it that we’re so reluctant to even have a check-up, let alone get an opinion on a particular problem that arises? Only one in four men has seen their doctor in the past 12 months. Think of all the niggling issues that are being tolerated by men of all stripes – strange aches and pains, changes in bowel or bladder habits, sudden weight gain or loss, fatigue, stress and anxiety, even depression. Declining to consult with a doctor is leading to alarmingly high rates of mostly preventable disease. If we don’t like the statistics, we need to contribute to real change by taking control of our bodies and our livelihoods.
This guide provides an outline of the top diseases affecting men today, and the basic things we can do to help prevent, identify and treat these conditions.
Ischemic heart disease
Ischemic heart disease (IHD) is the leading cause of death among Australian men every year, accounting for an alarming 16.9% of all male deaths. Almost twice as many men die from IHD in Australia than women (although heart disease is also the top killer of Australian women). Ischemia is characterised by an inadequate blood supply, in this case to the heart. The arteries around the heart gradually narrow, increasing blood pressure and stressing the cardiovascular system, ultimately leading to blockages. Most people don’t know they have IHD until it’s too late, although a specialist can identify the early stages with a few simple tests. An annual health check can identify any new risk factors you may have, such as high blood pressure and increased cholesterol levels, and a management plan may be put in place accordingly.
Once you’ve developed heart disease, cure is not an option, and an individual treatment and management plan will need to be adhered to in the long-term. If you’re diagnosed only after a heart attack, more invasive procedures may be required, such as bypass surgery or angioplasty. The Heart Foundation stresses that these procedures are not a cure for heart disease and that ongoing treatment and prevention need to be carried out after surgery.
Fortunately, many conditions that lead to heart disease can be prevented by making lifestyle changes.
These changes can also help reduce the risk of other lifestyle diseases such as bowel and lung cancer, stroke and type 2 diabetes. The Heart Foundation recommends that we all:
- Quit smoking
- Eat a diet high in fibre, fruits and vegetables and low in saturated fats, sugar and salt
- Exercise regularly
- Monitor and manage our blood pressure and cholesterol levels
- Try relaxation or leisure activities such as walking, cooking, reading and socialising to reduce stress
Prostate cancer is among the top five causes of death among Australian men. Every year, 20,000 are diagnosed and 3,300 will lose their lives.
The prostate is a lesser-known reproductive organ. Located below the bladder and palpable from the rectum, its main function is to produce fluid which protects and nourishes the sperm. The cancer occurs when some cells of the prostate reproduce far more rapidly than a normal prostate does, causing a swelling or tumour. Prostate cancer cells have the ability to metastasise to other areas of the body, most commonly the bones and lymph nodes. Early detection for prostate cancer is considered critical as once these cells metastasise, a complete recovery is rare. The good news is, if diagnosed early, prostate cancer has one of the highest five-year survival rates of all cancers. 92% will survive after an early diagnosis. This is why regular testing for prostate cancer is recommended for men over the age of 50.
The biggest risk factor of prostate cancer is age: the risk of being diagnosed with the disease increases significantly after the age of 50. The second risk factor is family history. If you’ve had someone in the family diagnosed with prostate cancer, you’re twice as likely to develop the disease. Perhaps the most alarming aspect of prostate cancer is that some men don’t get much warning – prostate cancer can occasionally develop asymptomatically. This is because the growth is not large enough to place pressure on the urethra, the tube that carries urine from your bladder to the outside world, so the usual changes we might expect to take place are absent.
Just as many men die from prostate cancer each year as women die from breast cancer, but notably missing is the sense of camaraderie and the associated support groups. Charity organisations like Movember do some incredible work in this field, and thankfully awareness is increasing. And just like breast cancer, there is a huge genetic component at play. Since you won’t know your risk without genetic testing, you should at least familiarise yourself with the early warning signs. If you’re suddenly waking in the night to urinate, find yourself needing to go with little warning, have difficulty starting to urinate or notice changes in your flow (particularly the presence of blood), experience pain or discomfort when urinating, or develop erectile problems, don’t take a wait-and-see approach. Book an appointment with your GP at your earliest possible availability. Chances are that tests will indicate a benign enlargement of the prostate (which has other implications), but you should not take any chances.
Depression and anxiety
Suicide accounts for slightly more than one-quarter of all male deaths in the 20-24 year old age group and is a leading cause of male death. Australian men take their lives at four times the rate women do. Why is this? Some believe that the resilient Australian male stereotype compels us to keep our more intense thoughts and feelings to ourselves, leading to an unhealthy internalisation of problems. We shouldn’t be so uncomfortable: 48% of men have had a mental health condition in their lifetime. It is not a sign of weakness – merely an indication that our lives and our bodies are complex, and occasionally we need some help to get through.
Suicide, by its very nature, is a preventable cause of death. Anxiety and depression, often precursors to suicidal thoughts, can be treated with the right professional help. The most important things about depression and anxiety are to recognise the signs and symptoms and talk them over with your GP. They’re trained to be discreet about matters pertaining to mental health.
Signs and symptoms of depression include:
- Increased intake of alcohol and drugs
- Withdrawing from close family and friends
- Feeling irritable, miserable and disappointed for more than two weeks
- Heavily fatigued
- Sleep problems
- Change in appetite
Signs and symptoms of anxiety include:
- A racing heart
- Tightening of the chest
- Snowballing worries
- Having trouble sleeping
Not-for-profit mental health awareness foundation Beyond Blue has a handy anxiety and depression checklist to measure your level of mental health. Your results are confidential, and at the end of the test you are able to print your results to hand to your GP or treating specialist.
Please remember, you are not alone: one in five men experiences mental illness in any given year. If you feel that you require urgent attention, please call Lifeline on 13 11 14. Their trained Telephone Crisis Supporters are ready to take calls 24 hours a day, seven days a week.
Testicular cancer occurs in the scrotum, often as a painless lump, and will affect less than 0.5% of men. Although this number makes it one of the rarer types of disease, it is significant because it happens to be the second most commonly diagnosed cancer in young men aged 18-39. There is an excellent cure rate in cases that are caught early, so ensure that if a lump in the testes, or any of these less-common symptoms present, you seek medical advice without delay:
- An odd feeling of heaviness in the scrotum
- Any change in the shape or size of the scrotum
- A new feeling or sense of “unevenness”
- Aches or pains in the lower abdomen, testicles or scrotum
- In advanced testicular cancer, back pain, respiratory problems and nipple tenderness may present
These symptoms are also indicative of other testicular conditions, and should not automatically strike fear if they present. The important part is having any testicular abnormality seen to, because even benign conditions may need specialised treatment. Factors increasing the likelihood of developing testicular cancer include a family history (father or brother previously diagnosed) and, for unknown reasons, undescended testes in infancy.
Lung cancer is responsible for more deaths than breast, prostate and ovarian cancers combined, and is diagnosed in men at a rate that is 50% above that of women. A tumour forms somewhere within the lung and continues to grow unabated until it is removed surgically or treated with radiation or chemotherapy. The trouble with lung cancer is that the tumour needs to be quite large before its symptoms are obvious, which makes early diagnosis problematic.
Smoking is certainly the largest contributing factor to rates of lung cancer, but being a non-smoker is not a guarantee against a diagnosis. Exposure to other carcinogens, such as asbestos, radiation, air pollution and traffic fumes, or to metal smelters, also increase your risk of developing lung cancer. In some sufferers, no cause can be identified. Be aware that if you experience any of the following, you should seek a thorough examination:
- Chest pain and breathlessness
- A new dry cough or a change in a chronic cough; a vocal change
- Recurring pneumonia or bronchitis
- Presence of blood in the saliva or phlegm
- Difficulty swallowing
- Abdominal and joint pain
The Final Word
When it comes to your health, be your own advocate. Get the medical attention that you would want your partner, your parents and your children to have. There are people who love you, rely on you, and want the very best for your future, and would expect that you’d visit a medical clinic if something didn’t feel right. You can’t control everything, but you can acknowledge that the first step to being in charge is information – getting it, talking about it, and knowing what to do with it.
NEVER ignore a persistent health problem – it could be the difference between life and death. And most importantly, talk. Talk to your partner, your children, your friends, and importantly, your doctor. If there are a few life lessons to be learnt from women (and if we’re being honest there’s more than a few), it’s that they are far better at identifying and seeking assistance, and they ultimately live longer.