Photo by Robert Hood / Fred Hutch News Service
(Editor's note: We're bringing back this piece from November 2014 for Men's Health Awareness Month.)
Ask a man about the relationship he has with his PCP and he may think you’re talking about pest control products, not primary care physician. For whatever reason, many men loathe going to the doctor — often to their detriment.
“I allowed a mole to progress to a stage 3 malignant melanoma before I saw a doctor on my wife's strong recommendation,” said Bruce Hyland, a 64-year-old marketing communications consultant from Rochester, New York. “They ended up taking a huge steak out of me and I had to follow up with X-rays, blood tests, etc., for five years.”
Hyland is hardly an anomaly. According to the U.S. Agency for Healthcare Research and Quality, men are 24 percent less likely than women to have visited a doctor within the past year. And many are quick to proffer excuses. Seeing a doctor is a waste of time, they’ll say. It’s invasive. It’s scary.
Big hairy deal, counter the folks at Movember, a global organization that’s trying to change the face of men’s health, both literally and figuratively, by encouraging men to grow mustaches — or “mo’s” — during November to raise awareness and funds for men’s health research.
Photo courtesy of Bruce Hyland
Why dudes won’t go to the doctor
Hyland, who was diagnosed with melanoma at 33, said a combination of factors kept him from consulting with a doctor about his “mole-run-amok”: an inability to focus on his own health, a lack of awareness about skin cancer and its signs, an assumption that he would simply get better on his own and his role as a provider.
“I didn’t want to be ‘out of commission’ and unable to do the things that needed doing,” he said. “I felt like I couldn’t afford to step out of the flow because I’d lose my place and my ‘standing.’”
Dave Brewer, a 56-year-old marketing manager from Seattle, said he, too, has never been big on doctor visits.
“I used to go in my 20s when I was sick or had an ache or pain but by the time I’d see them, I’d be better or they wouldn’t find anything,” he said. “When that happens a couple times, you get frustrated and think, ‘Why should I take time off from work?’”
These are common refrains, said Dr. Jonathan Bricker, a public health psychologist at Fred Hutchinson Cancer Research Center. But behind them are the true culprits that keep guys from going to the doctor: the traditional masculine qualities of self-sufficiency and bravery.
“You’re socialized as a man to take care of yourself, to do things on your own, to be independent,” he said. “And you’re also encouraged to be brave and to take risks which can often come with a reward. These qualities can be helpful to men if they’re investing in the stock market or climbing a mountain or fighting for their country but they’re inconsistent with seeing a doctor.”
Bricker said men (and even women) who have these qualities face a psychological barrier when it comes to seeking out health care.
“You tend to neglect aches and pains,” he said. “You think you can tough it out, that you can be brave and you’ll be able to get through things on your own.”
Unfortunately, white-coat avoidance comes with a cost.
Half of men in the U.S. will be diagnosed with cancer in their lifetime, according to the American Cancer Society, and one in four will die from it. Compared to women, men are 28 percent more likely to be hospitalized for congestive heart failure, 32 percent more likely to end up in the hospital for long-term complications from diabetes and 24 percent more likely to be admitted for pneumonia that could have been prevented by getting an immunization.
And it doesn’t stop there. According to the Centers for Disease Control and Prevention, nearly 17 percent of men smoke and almost 35 percent are obese. Nearly 32 percent of men over 20 have hypertension and more than 12 percent are in fair or poor health. As for the life expectancy for men, it’s a little over 76 years, a full 5 years less than the life expectancy for women.
“The consequences for bravery and self-sufficiency are severe,” said Bricker, who researches smoking cessation at Fred Hutch. "You can end up delaying health care and getting in to see a physician either too late or when you need more treatment. And then there are consequences — for you, for your family, and for the health care system because now you have to do more extensive treatment, which is clearly not as cost effective as preventative care.”
Saving men’s health one hairy lip at a time
Founded in 2003, the global Movember movement was created to help get the word out about men’s health issues — particularly prostate and testicular cancer and mental health and suicide prevention — in an easy, fun and quintessentially male way.
Each November, men sign on to become “Mo Bros” and grow mustaches, essentially becoming walking billboards that get other men talking and taking action: going to the doctor, becoming more aware of the health issues they face and/or donating money to research.
As of November 2017, Movember has raised $769 million, funding more than 1,200 men's health projects in 21 countries. And the campaign seems to work. In 2013, 62 percent of the movement's participants either saw (or made an appointment to see) a medical professional to get baseline numbers on their blood pressure, cholesterol, weight and waistline. Organizers hope that number will continue to grow so by the year 2030, 25 percent fewer men will die prematurely.
“When you grow a mustache, you want people to ask, ‘Why are you doing this?’” he said. “And it’s even better if it doesn’t look like something you’ve had for 15 to 20 years, if it looks bad. My own attempt at growing a mustache has been a real conversation starter.”
Movember hasn’t just been a conversation starter for the researcher, though.
Nelson has received several grants over the years, including a $1.5 million award from the Prostate Cancer Foundation and Movember in 2013 to help Nelson and his investigating partners at the University of Washington, Johns Hopkins University and Baylor College of Medicine develop new treatments for advanced prostate cancer.
“Advanced prostate cancer is a deadly disease where we have almost no cures,” he said. “Once it spreads out of the prostate and into the bones and other sites we can often temporize it for years by cutting off the fuel supply — testosterone — but eventually these cancers all resist treatment. We’re trying to understand how they resist and develop new therapies that target these resistant pathways.”
Nelson said he and his collaborators have identified several interesting targets and are now evaluating new drugs to see if they can improve outcomes.
As for Movember, Nelson said that while most of the mustaches will disappear at the end of the month, he hopes the message of men’s health will continue year-round.
“It really shouldn’t stop after the month is over,” he said. “The whole idea is to get the message out that awareness and screening are important for various cancers such as prostate cancer and to encourage men to go in and get their regular health checkups and not minimize symptoms that could be due to more rare cancers such as testicular cancer. Women are used to visiting their physician regularly and to discussing health issues with their friends, but men generally don’t do that. But it’s important that they get screened for cholesterol, for blood pressure and for other things. That’s the point of Movember. It starts here, but it needs to carry on.”
Diane Mapes is a staff writer at Fred Hutchinson Cancer Research Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she blogs at doublewhammied.com and tweets @double_whammied. Email her at firstname.lastname@example.org.
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