‘Movember’: A call to action for men’s health

When it comes to health, men can often be their own worst enemies. Research consistently shows that men tend to ignore warning signs, delay doctor visits, and avoid preventive care. However, there is a growing movement aimed at changing these behaviours; Movember.

Every November, men around the world grow moustaches to raise awareness for critical health issues that affect them, particularly prostate cancer, testicular cancer, and mental health. Movember is more than just about facial hair; it serves as a powerful call to action for men to take their health seriously. 

The harsh reality of cancer 

Cancer does not discriminate, and men are at a higher risk for some of the most common forms of cancer. According to the American Cancer Society, men are more likely than women to be diagnosed with certain types of cancer, including prostate cancer, testicular cancer, and lung cancer.

In adults, factors such as sexual hormones, dietary habits, exposure to carcinogens, smoking, and alcohol consumption contribute to the higher incidence of cancer among men globally. Each year, approximately 7.4 million cancers are diagnosed in men, compared to 6.6 million diagnosed in women.

Men’s experiences battling cancer

Sam Kyeza, 69, was declared free from prostate cancer in July 2021. He decided to go to the hospital after his uncle, who started the Prostate Gland Initiative, informed him that all men over 45 years of age should have their prostate gland regularly checked to avoid late-stage prostate cancer.

In December 2019, he visited Mengo Hospital in Kampala to undergo the necessary tests.

"I frequently felt the urge to urinate, especially at night. My sleep patterns were interrupted because I woke up many times during the night. Additionally, my libido had decreased, which were some of the signs the doctor had discussed. I was advised to undergo a prostate biopsy test which confirmed that I had prostate cancer," he says.

Kyeza was also instructed to get an MRI scan to check if the cancer had spread to other parts of his body. When he took the results to Dr Fred Okuku, an oncologist at the Uganda Cancer Institute (UCI), he learnt that he was fortunate because the cancer had been detected early and was treatable.

"The doctors informed me that because my cancer was detected early, I would not require surgery. Instead, my treatment plan included eight injections of hormonal therapy, each scheduled three months apart. Throughout the treatment, I was still able to work without any disruption to my job. My family, including my wife and children, was very supportive, and my colleagues from the Prostate Gland Initiative provided invaluable assistance," Kyeza says.

By July 2020, he had completed the hormonal therapy and was recommended to start radiotherapy, which he underwent for three weeks, five days a week. 

"I continued going for reviews until July 2021, when the doctor told me that there were no more cancer cells in my body after examination," he says.

He urges men; "If you screen late, there is a chance you will end up bedridden. This can affect your family, especially as the breadwinner. However, if you know about it early, you have better chances of beating the disease." 

Prostate cancer

Prostate cancer is one of the most common cancers among men worldwide, with one in eight men being diagnosed in their lifetime. It occurs when abnormal cells in the prostate gland grow and divide uncontrollably, eventually forming a tumour.

Common symptoms of prostate cancer may include frequent urge to urinate, especially at night, a feeling of not fully emptying the bladder and blood in urine or semen. 

Dr Job Kuteesa, a urologist at C-Care Hospital in Kampala, says early-stage prostate cancer often shows no symptoms. This is why it is critical for men over 50 (or younger if there is a family history) to discuss screening options with their doctors. Screening methods may include the PSA blood test or a digital rectal exam.

Prostate cancer has a high survival rate when detected early, yet many men do not realise how essential regular screening can be. Dr Kuteesa advises all men over 40 to get a PSA test to help with the early detection of prostate cancer or an enlarged prostate.

"Talk to a general practitioner about your symptoms, even if they do not seem concerning," he suggests. "Having an enlarged prostate is not thought to increase the risk of developing prostate cancer, but it is important to identify any underlying causes of your symptoms that can be treated. If you find it difficult to pass urine, seek medical help immediately," he warns.

Treatment options for prostate cancer vary depending on the stage of the disease and may be tailored to the individual. Potential treatments include surgery for partial or complete removal of the prostate, radiotherapy, hormone therapy, chemotherapy, or active surveillance.

Testicular cancer

Testicular cancer, while less common, is the most prevalent cancer among men aged 15 to 35. Unlike prostate cancer, testicular cancer typically shows symptoms that should not be ignored. The most common symptom is a lump or swelling in the testicle.

Dr. Kuteesa states, “If caught early, the cure rate for testicular cancer is more than 95 percent, making it one of the most treatable cancers. Yet, many men still avoid seeking help, often dismissing their symptoms or feeling embarrassed to discuss them.”

Lung cancer

Lung cancer is the leading cause of cancer deaths among men, often because the disease is advanced by the time symptoms appear. While smoking is the most significant risk factor, it is important to note that non-smokers can also develop lung cancer.

Understanding your family history and risk factors is crucial. If you smoke, consider undergoing screening tests, such as low-dose CT scans, especially if you have been a smoker for an extended period.

During this awareness month, it is important to educate men about the significance of regular screenings, early detection, and self-exams, such as those for testicular cancer. This knowledge empowers men to seek medical advice and take proactive steps regarding their health. 

According to the GLOBOCAN cancer observatory, the incidence of oesophageal and liver cancers is also rising among men, with prevalence rates of 9.6 percent and 7.3 percent, respectively. These increases are attributed to lifestyle factors such as excessive alcohol consumption, smoking, HPV, and genetic predispositions.

Mental health

Movember also addresses mental health and suicide prevention. Men are often less likely to discuss their mental health struggles, which can lead to higher rates of depression, anxiety, and suicide. The Uganda National Institute of Public Health (UNIPH) reports that men have an 18 percent higher risk of suicide compared to women.

Derrick Kizza Mbuga, the executive director of Mental Health Uganda, says various calamities such as Covid-19, landslides, cattle rustling, and insecurity in regions such as Northern Uganda have contributed to the increase in suicide rates.

He notes that; "A total of 15 attempted suicides were registered through the organization’s hotline in the last quarter of 2023, and three individuals died before they could be rescued. Karamoja, Kapchorwa, and Busoga have the highest incidence of suicide cases, primarily due to poverty." 

This month, we should aim to break down the stigma surrounding men's mental health by encouraging open conversations and providing resources for those in need.

ACTION

“No man should feel embarrassed to discuss his health concerns,” says Dr Job Kuteesa, a urologist. “Urological cancers are not just physical challenges; they affect every aspect of a man’s life. But, with early detection, treatment, and support, men can lead full, meaningful lives,” he adds