Men’s health in the spotlight

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Contribution from Brunei Cancer Center, Pantai Jerudong Specialist Center

Once again, November is approaching and men’s health is in the spotlight with International Men’s Day falling on November 19th. The Movember campaign began in 2003 with the dual goals of raising funds and raising awareness for prostate cancer, before incorporating testicular cancer awareness. from 2007.

The campaign encourages men to grow mustaches during the month of November. It quickly became an international campaign and its success led to the creation of the Movember Foundation.

In 2014, the foundation raised €71.7 million worldwide and paved the way for an extraordinary global public health awareness initiative. The main objective of this campaign was to raise awareness and support men with prostate cancer, testicular cancer, mental health issues and suicide prevention.

WHY IS MEN’S HEALTH IMPORTANT?

All over the world, women live longer than men. The average longevity for women is 82.2 years and 77.2 years for men, a difference of five years. Several factors contribute to men’s poor health, including lack of awareness of various health issues and reluctance to seek medical help.

Men also do not openly discuss their health issues with others and more often engage in risky activities. The majority of men simply don’t know what they can do to improve their health and live healthier, happier lives.

The Pantai Jerudong Specialized Center. PHOTO: PJSC

Brunei Cancer Center (TBCC) at Pantai Jerudong Specialist Center is a comprehensive cancer center with state-of-the-art facilities for the holistic management of cancer patients which includes cancer screening and early detection, advanced nuclear imaging , including PET scans, DOTA scans, chemotherapy including immunotherapy and targeted therapy and radiotherapy like EBRT and SBRT.

BURDEN OF MALE CANCER IN BRUNEI

According to Brunei Darussalam Cancer Registry (BDCR) statistics, a total of 682 new cases of cancer were diagnosed in 2021, of which 278 (41%) were male. It is estimated that one in four men in Brunei will develop cancer in their lifetime.

The Sultanate saw a 22.8% increase in the number of new cancer patients diagnosed over five years between 2015 and 2019, compared to 2010-2014. If this gradual trend continues, cancer cases are expected to increase an alarming 108% between 2020 and 2040.

These disturbing statistics could be attributed to several factors, including changing lifestyles, smoking habits, consumption of toxic substances including alcohol and caffeinated beverages, lack of physical activity and growing morbid obesity. The most common cancer among men in Brunei is colorectal cancer, followed by lung cancer and prostate cancer.

Other specific male cancers are testicular cancer and penile cancer.

PROSTATE CANCER

The prostate is a walnut-sized gland located below the bladder and surrounding the urethra. Its main function is to produce sperm and transport sperm.

Prostate cancer is the third most common cancer in Brunei men, followed by colorectal and lung cancer.

Common symptoms of prostate cancer are difficulty urinating, inability to completely empty the bladder, drops of urine after urinating, blood in the urine, and difficulty maintaining an erection.

Sometimes prostate cancer produces no symptoms until it is quite advanced.

Early diagnosis of prostate cancer leads to better outcomes and better survival. It is therefore important to undergo optimal screening for prostate cancer.

SCREENING FOR PROSTATE CANCER

Screening is a methodology applied for the early detection of cancer before the onset of signs and symptoms. Routine screening guidelines for prostate cancer are a combination of a simple blood test called PSA and a clinical prostate exam (digital rectal exam) based on the patient’s risk category.

Screening is recommended for men over 50 or earlier if there is a family history of prostate cancer or those with genetic mutations like BRCA. If prostate cancer is suspected, a prostate biopsy guided by transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI) is considered to confirm the diagnosis.

STAGE AND TREATMENT OF PROSTATE CANCER

After diagnosis of prostate cancer, other tests like PSMA-PET scan are done to find out if the cancer has spread to other parts of the body.

It is similar to most cancer management strategies that involve trimodal treatment including chemotherapy, radiation therapy, and surgery.

The management of prostate cancer also involves a trimodal approach depending on the stage of the disease. The treatment is very effective in early-stage versus late-stage cancers. Some patients with early-stage, low-grade prostate cancer may be kept on active surveillance or on a wait-and-see approach.

TESTICLE CANCER

Unlike prostate cancer, which is a disease of aging men, testicular cancer occurs in younger people between the ages of 15 and 40.

Patients usually complain of painless swelling, changes in size or texture of one of the testicles. Sometimes this can produce a dull, aching pain.

Common risk factors for developing testicular cancer are undescended testicles, family history, and abnormal testicular development. The majority of testicular cancers are called germ cell cancers, which can be seminomas or non-seminomatous germ cell tumors (NSGCT).

Testicular cancers are managed using a trimodal approach including surgery, chemotherapy and radiotherapy depending on the stage and risk stratification of the disease.

The good news is that the treatment is very effective with good cure rates of almost 99% five-year early stage survival rate and 75% five-year survival rate in advanced stage testicular cancers .

TESTICLE CANCER SCREENING

Men at increased risk of developing testicular cancer should perform periodic testicular self-exams and seek medical attention if they find anything abnormal.

COLORECTAL AND LUNG CANCER

Colorectal cancer and lung cancer are the other common cancers seen in the Sultanate, which are directly linked to lifestyle factors such as smoking, high fat diet and obesity. Effective screening with fecal occult blood and colonoscopy for colorectal cancer and low dose CT scan screening for lung cancer are available to individuals for the purpose of early detection.

MEN AND MENTAL HEALTH

With the pandemic causing several changes in the way society works and lives, more and more men around the world are experiencing work pressure, stress and isolation which in due course can lead to health issues mental health, including depression and suicidal tendencies. Most men do not openly discuss their mental health and whereabouts, and how they feel due to social stigma which can be life threatening without medical intervention.

HOW CAN WE PROMOTE MEN’S HEALTH AWARENESS

Let’s join hands in November/November to reach out and promote men’s health awareness. They can be men from our house, including fathers, brothers, sons or the uncle of our neighbours. It’s never too late to seek medical help and get tested.

Early cancer detection is the key to successful cancer treatment and cure. Encourage men to talk about their mental and physical health with family and friends.

Sometimes listening to other people’s problems can make a big difference. Promoting healthy lifestyle activities such as physical activity, weight control, balanced diet, and abstinence from smoking can help reduce the threat of cancer in the abode of peace.

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