If men’s cancers are so prevalent, why do we hear less about them?

Men have lower five-year cancer-survival rates, so they need to be proactive, like Willie Penrose

Tue, Jun 10, 2014, 01:00

Men are more likely to die of cancer, and have lower five-year survival rates than women. According to figures produced by the National Cancer Registry, men have a one in seven, or 14 per cent, chance of dying of cancer. The equivalent figure for women is 11.2 per cent. Yet men’s cancers get relatively little attention.

The number of men who will have invasive cancers is projected to double by 2035 as the male population gets older and lives longer.

A recent report by the Irish Cancer Society, in conjunction with the National Cancer Registry and the Institute of Technology Carlow, found elevated levels of certain types of cancer among men. The Excess Burden of Cancer Among Men study concluded that lifestyle plays a major part in incidences of cancer among men.

Men are three times more likely than women to be diagnosed with bladder cancer, twice as likely to get stomach cancer and 1.64 times more likely to get lung cancer, mostly due to lifestyle issues.

Research carried out by the World Health Organisation Cancer Mortality Database has shown that 29-38 per cent of all cancers in men in Europe are attributable to smoking, compared with 2-10 per cent of women’s cancers. Similarly, 10 per cent of cancers in men are attributable to alcohol consumption, compared with 3 per cent in women. Lack of exercise and poor diet are also risk factors.

Traditionally, men are reluctant to go to the doctor. A recent pan-European report, entitled State of Men’s Health in Europe, found that men’s infrequent use of health services can lead to high levels of potentially preventable health problems, and means that when they do become ill, their treatment options are limited.

Similarly, cancer-survival rates among Irish men are also lower than those of Irish women, according to the National Cancer Registry. Men and women have similar rates of survival at one year, but differ widely for five-year diagnosis.

The reasons for that is unclear but doctors believe women may have a biological advantage over men in terms of being more robust in coping with their cancer.

Diagnosis

Labour TD Willie Penrose had been in junior ministerial office for only three months, in May 2011, when he was diagnosed with prostate cancer. Like many people who are given a cancer diagnosis, he knew the news was bad when his doctor asked to see him in person. His immediate reaction was to ask how severe the cancer was.

The doctor discussed a number of options, of which one was surgery. Another was radiation treatment which would involve 37 sessions of concentrated radiotherapy, and hormone treatment.

The other option was brachytherapy, a relatively new process in which pellets are injected into the affected area of the prostate. It is a less-invasive process than surgery and was first introduced into Ireland in 2002.

Compounding the cancer diagnosis was another problem: Penrose weighed 24 stone. He started to pile on the weight after entering politics in 1992 as part of the Spring tide.

He gave up exercising, and the notorious political lifestyle of late meetings and eating on the move caused him to pile on the pounds. His weight meant that the surgery could be tricky and that he might not heal as well as expected, with incontinence a lifelong issue.

Having weighed up the options and spoken to other patients, he chose brachytherapy. He had it done in the Mater hospital in September 2011 and was discharged after 24 hours.

In November 2011, Penrose resigned as junior minister for housing as a result of the closure of Mullingar barracks. He now says that he went back to work too quickly after diagnosis and the stress of the barracks closure did not help his recovery.

Lose weight

Amid the political turmoil and hectic life, he resolved to lose weight, having being told he was in real danger of contracting type 2 diabetes as a result of his diet and lifestyle. “I knew I would have been healthier if I was mobile and able to move around easily,” he says.

He lost almost 10 stone, which he attributes to 80 per cent diet and 20 per cent exercise. Now, he says, he is full of vigour.

“Once I spoke publicly about my prostate cancer, people from all over the country rang me up asking for advice,” he says. “I know that prostate cancer is highly curable once it is tackled in time. If you are diagnosed with prostate cancer, speak to other people who have been through the same experience.

“Rather than be dismissive, which, very often, I was, listen to their advice. They will help you cope with the diagnosis and assist in terms of deciding the treatment.”

Penrose has told his story in Man To Man: Irish Stories of Hope in Prostate Cancer.

The book, which is produced by the Irish Cancer Society, tells the stories of 11 Irish men who contracted prostate cancer. Prostate and testicular cancers are the cancers unique to men and both are very curable if caught in time.

Every year in Ireland, more than 3,000 men are diagnosed with prostate cancer and, after skin cancer, prostate cancer is the leading cause of cancer in men. In Ireland, about 17,000 men are living with prostate cancer and about 500 men die of it each year. Five-year survival rates for prostate cancer are over 90 per cent.

Penrose says that he would recommend to other men to take the PSA (prostate-specific antigen) as he did in 2010 when prompted by his GP. Though not in itself a definite indicator of prostate cancer, elevated levels can be an indicator that cancerous cells are present in the prostate.

Penrose says he was positive about his diagnosis from the beginning and has made a “great recovery”.

I remember thinking that, if I was to get cancer, this was the one to get. It was a bit of a consolation at the time. Other people are fighting other more aggressive forms of cancer every day, and they need to be tackled. They are also winning.”

Donal Buggy, head of services at the Irish Cancer Society, says identifying lifestyle choices is the key to understanding men’s cancers. “In order to effect change, we need to understand what works in relation to behaviour change and healthy lifestyle options in men, with a particular emphasis on understanding what works for men living in lower socioeconomic groups,” he says.

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