There’s hardly a man in South Africa who doesn’t know November is Men’s Health Month. Most men’s partners – and their scratched cheeks – are also aware that the prickly new moustache on their beau’s upper lip signifies an awareness of three major conditions affecting men’s health: prostate cancer, testicular cancer, and mental health.
We talked to Dr Kgomotso Mathabe, a urologist at the Steve Biko Academic Hospital and the University of Pretoria in Tshwane to find out about men’s health conditions.
The most common men-only health condition is prostate cancer. This is “typically a disease of older men,” says Dr Mathabe, and there are a variety of treatment options available. With prostate cancer, she says, “diagnosis is not the end of the road, it is not a death sentence, it’s the beginning of a conversation. Like with HIV, with screening and good treatment options, these days we speak of living with prostate cancer rather than dying from it.”
The question most men dread comes next: who should screen for prostate cancer and what does testing entail? Dr Mathabe is reassuring on this note, too. Whereas men used to be advised to have an annual test from age 50-55 onwards, urologists now want to screen men for prostate cancer from age 40. But it’s not necessary to screen every year, depending on your risk profile.
“Screening is very important because this condition shows no symptoms until a late stage, by which time the cancer is far advanced or may have spread,” says Dr Mathabe.
If your ears pricked up at “risk profile”, here’s what that means: Prostate cancer has an earlier onset and is more aggressive in African men, and about 10% of prostate cancers are familial so that you are at greater risk if your male relatives have or had prostate cancer. A link with breast cancer has been established – the BRCA gene is responsible for both breast and prostate cancers – so you’ll be asked about the women in your family and their cancer history, too.
Now it’s time for the notorious doctor’s DRE – that’s digital rectal examination, in case you were wondering, and it’s marginally less stressful than beef with a West Coast rapper.
“This is 30 seconds of discomfort for a potentially life-saving diagnosis so that you can be around to see your children and grandchildren grow up. Women endure all sorts of diagnostic tests too. So please take a deep breath and get through it,” advises Dr Mathabe.
After that, you will do a blood test called a PSA – “depending on these results we can determine the risk of prostate cancer,” says Dr Mathabe. If your results suggest a risk, there are other investigations, such as MRIs or prostate biopsies. “We go in looking for something to TREAT,” stresses Dr Mathabe. “Because if we find cancer, we have options. We can do surgery – either open or laparoscopic or robotic – to remove the prostate or parts thereof.”
“If cancer has spread to other parts of the body – and usually with prostate cancer it’s to the bones – then we will need treatment that will also attack cancer elsewhere. This can include tablets or injections, chemotherapy, or androgen deprivation therapy, where testosterone levels are manipulated.”
While prostate cancer is a disease of old men, testicular cancer is prevalent between 15 and 35, says Dr Mathabe. “The typical presentation is as a lump in one of the testes. That’s why boys and men must know how to do a monthly self-examination of their testes, just like women do with their breasts,” Dr Mathabe says. “By the time symptoms are bad enough for a doctor to pick up, the situation is serious. That’s why education is vital.”
Testicular cancer, unlike prostate cancer, is more common in Caucasian men but can affect everybody. “It’s rare cancer, accounting for 1%-2% of all cancers in young men,” says Dr Mathabe. “It’s also very treatable. It’s an amazing success story of modern chemotherapy.”
“Men are famous for their aversion to doctors,” says Dr Mathabe, shaking her head, but she acknowledges it’s a concern. “Mental health conditions have become aggravated due to the Covid-19 lockdown, which has unmasked us. Men who were on the brink may have been pushed over that brink. From a urological perspective, men’s stress often manifests in erectile dysfunction. In that way, urology provides us with a beautiful opportunity to refer men on to the appropriate mental health specialist.”
The strongest thing you can do is defy the voices telling you to need to cope alone, and seek help when you need it. Profmed actively endorses this preventative approach to maintaining mental health. So be the best man you can be, by taking care of your physical and mental health.