Why are there no free cancer screening for men?

Pat Custard · 05-06-2014 10:26pm #1

In so many places, there are free breast exams (don't get me wrong), it's a great initiative.

There are also free smear tests available from so many GPs.

Why are there no free initiatives available for prostate and testicular cancer? Why is there so little publicity into these cancers?

Why can't men go to these free breast clinics too? Men CAN and have gotten breast cancer. Especially more, "well-endowed", men who are over weight / have men boobs.

Curious what people think.

run_Forrest_run · 05-06-2014 11:11pm

Pat Custard wrote: »

In so many places, there are free breast exams (don't get me wrong), it's a great initiative.

There are also free smear tests available from so many GPs.

Why are there no free initiatives available for prostate and testicular cancer? Why is there so little publicity into these cancers?

Why can't men go to these free breast clinics too? Men CAN and have gotten breast cancer. Especially more, "well-endowed", men who are over weight / have men boobs.

Curious what people think.

some very good questions here, worth asking the right people (politicians and cancer charities).
We're always told men don't talk enough or don't go to their GP etc but perhaps if there was a screening programme it would get the ball rolling...pardon the pun

06-06-2014 12:58am

It's fairly simple, men don't matter as much.

Lou.m · 06-06-2014 1:26am

This would be a GREAT idea.

endacl · 06-06-2014 1:35am

Well, for testicular cancer there is. To put it crudely, nobody knows yer bollix like you know yer bollix. Have a regular rummage. If you notice anything that shouldn't be there to be noticed, go to your doctor. Most effective screening possible, if lads would bother.

A prostate check is included in any regular health check. Again, fairly straightforward. Doctor pulls on a latex glove and lubes up....

So, for the 'male' cancers, there are regular and extremely effective screening measures available. The problem is, men tend not to bother with them.

The 'female' cancers require X-rays and cell samples, and a specialist lab, to be tested for effectively.

Lads. We have it easy if we'd only bother. Our health is about more than an excuse to grow a daft moustache once a year.

Let's not play the victim here.

Pawwed Rig · 06-06-2014 9:48am

endacl wrote: »

A prostate check is included in any regular health check. Again, fairly straightforward. Doctor pulls on a latex glove and lubes up....

So, for the 'male' cancers, there are regular and extremely effective screening measures available. The problem is, men tend not to bother with them.

Prostate check has never been once mentioned by my doctor.
Is there a such thing as a regular health check? Doctors don't really like to do them once never mind regularly.

Watch the generalisations. Alot of men are very concerned about their health. Saying 'men tend not to bother' is not true.

endacl · 06-06-2014 10:13am

Pawwed Rig wrote: »

Prostate check has never been once mentioned by my doctor.
Is there a such thing as a regular health check? Doctors don't really like to do them once never mind regularly.

Watch the generalisations. Alot of men are very concerned about their health. Saying 'men tend not to bother' is not true.

Of course there's such a thing as a regular health check. It's when you put 'go to doctor for annual NCT' into your diary. You ask for the prostate exam to be included if the doctor doesn't suggest it. Mine started to bring it up at 35. TBH, it wasn't something I'd been thinking of myself.

So, in response. Yes. There is such a thing. You just have to take the personal responsibility to organise it for yourself.

Doctors don't really like to do them? Not in my experience. In fact, initially it was my doctor's idea, and is his policy to suggest it to patients of a certain age. I realise this is anecdotal and I may have the only doctor in the country who does this, but I doubt it...

'Watch the generalisations'? I'm speaking generally about a large population: men. Half the adult population of the state. How else do you propose I talk about such a large population? Individually? That would be a long post. Making general statements about a large group of people is what generalising is. Do you also have a problem with the OP's generalising? All women get something that all men don't?

A lot of men are concerned about their health. Of course they are. We tend, generally! As a population, to take post crisis steps to deal with health problems. A far larger proportion of women take pro active steps to address health matters than men do. This is a recognised tendency.

The main point I was making is that it is a far simpler proposition for 'male' cancers to be detected early as they can be caught either in the shower, or at a regular health check. Which doctors are very happy to do. I'm not sure where you got that bit...

Pawwed Rig · 06-06-2014 10:26am

endacl wrote: »

Of course there's such a thing as a regular health check. It's when you put 'go to doctor for annual NCT' into your diary. You ask for the prostate exam to be included if the doctor doesn't suggest it. Mine started to bring it up at 35. TBH, it wasn't something I'd been thinking of myself.

So, in response. Yes. There is such a thing. You just have to take the personal responsibility to organise it for yourself.

It is not free though which is the point of the OP.

No problem with the OP as there is a free programme for cancer screening for women so it is a fact not a generalisation. Women get free cervical cancer screening http://www.cervicalcheck.ie/ and women over the age of 50 get free breast checks http://www.breastcheck.ie/.

Can you point to a FREE screening programme for any male cancer?

These free tests were introduced so women would be encouraged to get screened so why are there no similar initiatives for men?

endacl · 06-06-2014 10:42am

Pawwed Rig wrote: »

It is not free though which is the point of the OP.

No problem with the OP as there is a free programme for cancer screening for women so it is a fact not a generalisation. Women get free cervical cancer screening http://www.cervicalcheck.ie/ and women over the age of 50 get free breast checks http://www.breastcheck.ie/.

Can you point to a FREE screening programme for any male cancer?

These free tests were introduced so women would be encouraged to get screened so why are there no similar initiatives for men?

Can I point to a free screening programme for an male cancer? Yes I can. Self examination for testicular cancer is recommended as a highly effective method of early detection. That's about as free as it gets.

I'm not going into the prostate stuff again. I made the point.

Look. The fact is that to screen for cervical cancer, for example, cell samples need to be sent to a lab to be tested. If abnormalities are found, a woman has to have a biopsy taken in a colcoscopy. It's a more complicated process than checking for the early signs of cancer in men.

I don't disagree with the OP. I simply pointed out that national screening programmes are not as necessary for men as they are for women. That's a simple fact of biology.

I'm not entirely sure what your issue is.

Maguined · 06-06-2014 10:54am

There is also the issue of HPV vaccinations. It is only offered for girls which while makes sense for the female specific cancers it ignores anal cancer.

HPV is the cause for 70% of cervical cancers, 60% of vaginal cancers, and 40% of vulvar cancers but it is also responsible for 80% of anal cancers. According to HSE statistics men make up 66.6% of colorectal cancers so thats basically a lot of boys being ignored when the evidence and the solution is already available.

runawaybishop · 06-06-2014 11:00am

endacl wrote: »

Can I point to a free screening programme for an male cancer? Yes I can. Self examination for testicular cancer is recommended as a highly effective method of early detection. That's about as free as it gets.

I'm not going into the prostate stuff again. I made the point.

Look. The fact is that to screen for cervical cancer, for example, cell samples need to be sent to a lab to be tested. If abnormalities are found, a woman has to have a biopsy taken in a colcoscopy. It's a more complicated process than checking for the early signs of cancer in men.

I don't disagree with the OP. I simply pointed out that national screening programmes are not as necessary for men as they are for women. That's a simple fact of biology.

I'm not entirely sure what your issue is.

That's not free screening of the same type that is offered to women who can also do a self examination of their breasts.

Men get cancer more than woman do and prostrate cancer is the most common cancer affecting only men (skin being no1) and there is no free screening offered - more men are affected by prostate cancer than woman are affected by breast cancer. Why the disparity in services offered?

endacl · 06-06-2014 11:01am

Maguined wrote: »

There is also the issue of HPV vaccinations. It is only offered for girls which while makes sense for the female specific cancers it ignores anal cancer.

HPV is the cause for 70% of cervical cancers, 60% of vaginal cancers, and 40% of vulvar cancers but it is also responsible for 80% of anal cancers. According to HSE statistics men make up 66.6% of colorectal cancers so thats basically a lot of boys being ignored when the evidence and the solution is already available.

Now that's a fair point, and one I wasn't aware of.

SpaceTime · 06-06-2014 11:03am

Maguined wrote: »

There is also the issue of HPV vaccinations. It is only offered for girls which while makes sense for the female specific cancers it ignores anal cancer.

HPV is the cause for 70% of cervical cancers, 60% of vaginal cancers, and 40% of vulvar cancers but it is also responsible for 80% of anal cancers. According to HSE statistics men make up 66.6% of colorectal cancers so thats basically a lot of boys being ignored when the evidence and the solution is already available.

It would also give herd immunity too by actually making the whole population immune to HPV.

ancapailldorcha · 06-06-2014 11:42am

SpaceTime wrote: »

It would also give herd immunity too by actually making the whole population immune to HPV.

It's also been linked to some penile cancers as well. I read that years ago in a virology journal so I'm not sure where we are presently.

Different Source:

Cancer Research UK wrote:

Human papilloma virus (HPV)
HPV is a common infection and is passed from one person to another by sexual contact. Around 8 out of 10 people (80%) in the UK will be infected with the HPV virus at some time during their lifetime. For most people the virus causes no harm and goes away without treatment. But men with human papilloma virus have an increased risk of developing cancer of the penis. A number of research studies have tried to establish the link between penile cancer and HPV. These studies show that the number of men with penile cancer who have evidence of HPV infection is around 5 out of 10 (47%). HPV also increases the risk of cervical, anal, vulval and vaginal cancers.

HPV is commonly called the ‘wart virus’ because some types cause genital warts. There are over 100 types of HPV and each one has a number. The main types of HPV found in men with penile cancer are HPV 16 and 18, although other types may also be related too. HPV 16 and 18 do not usually cause genital warts but there is evidence that men with a history of genital warts have an increased risk of penile cancer.

In a Danish study, men who had never used condoms had more than double the risk of penile cancer compared to men who had used condoms. This may be because condoms reduce the risk of HPV infection. Men who have two or more sexual partners before the age of 20 have a 4 to 5 increased risk of penile cancer. This may also be due to HPV infection.

Circumcision seems to reduce the risk of HPV infection of the penis.

Mikros · 06-06-2014 11:50am

The benefit of large scale prostrate cancer screening is at best negligible, and at worst can result in more harm at a population level. While prostrate cancer is the most common non skin cancer for men, it is quiet rare before 50 years of age and 70% of deaths occur after 75 years of age. Most prostrate cancers are actually fairly benign and progress so slowly that they will remain asymptomatic for the man's lifetime.

Men with prostrate cancer detected at a screening can potentially fall into 1 of 3 categories: those whose cancer will result in death despite early detection, those who will have good outcomes anyway in the absence of screening, and those for whom early diagnosis and treatment improves survival.

The last category is where screening is of benefit. Two major clinical trials in the US and Europe suggest the number of men who avoid dying of prostate cancer because of screening after 10 to 14 years is, at best, very small, in the region of 1 in 1000. Other studies show no significant improvement in outcomes at all.

Population screening for prostate cancer therefore will detect a lot of otherwise benign cancers. In addition there is a significant number of false positive results from the screening. The resulting treatments carries it's own risks and harms, as well as causing a lot of unnecessary stress and upset for the patient.

All this has to be weighed up in considering the cost of a prostrate cancer screening programme. As it stands the benefits are very marginal when considering the costs which is why there is no programme. There is not an unlimited pot of gold so money has to be targeted at what will give the best cost-benefit outcome. Testicular cancer screening can easily be done by self examination and putting resources in raising awareness etc. might be far more effective in improving men's health.

SpaceTime · 06-06-2014 2:28pm

ancapailldorcha wrote: »

It's also been linked to some penile cancers as well. I read that years ago in a virology journal so I'm not sure where we are presently.

Different Source:

Just seems nuts we're not vaccinated. It's not a big deal and it's non invasive.

I wouldn't mind getting that vaccine myself as an adult male. Wonder if it's available?

I think though the biggest issue with men's health is guys don't go when they do find something is a problem. That can range from minor annoying easily fixed issues to lumps that might be cancer.

I think maybe we're a little too shy about that area in general.

iptba · 06-06-2014 3:03pm

Mikros wrote: »

All this has to be weighed up in considering the cost of a prostrate cancer screening programme. As it stands the benefits are very marginal when considering the costs which is why there is no programme. There is not an unlimited pot of gold so money has to be targeted at what will give the best cost-benefit outcome.

I've heard the same argument made about breast screening programs (in medical journals), but that because they have such momentum due to all the advocates for breast cancer, breast screening will remain.

ancapailldorcha · 06-06-2014 3:08pm

SpaceTime wrote: »

Just seems nuts we're not vaccinated. It's not a big deal and it's non invasive.

I wouldn't mind getting that vaccine myself as an adult male. Wonder if it's available?

I think though the biggest issue with men's health is guys don't go when they do find something is a problem. That can range from minor annoying easily fixed issues to lumps that might be cancer.

I think maybe we're a little too shy about that area in general.

I would think that it'd be at your own expense. It's not cheap either.

Boots UK wrote:

You will need to have a total of three vaccinations, which in total cost £297. After the first vaccination you will need to return to Boots after one month for the second vaccination and then again after six months for the third and final vaccination.

We're not great at talking, either about personal issues or about issues affect men as a whole. Women are much better at this. Remember that "Turn Facebook pink" silliness? Replace pink with purple or even red and I doubt that that would have spread as far and/or as rapidly.

spurious · 06-06-2014 3:11pm

I have a friend in Australia who had a blood test which showed up prostate problems. I don't know if that is available here or whether it's an early detection method.

Mikros · 06-06-2014 3:28pm

iptba wrote: »

I've heard the same argument made about breast screening programs (in medical journals), but that because they have such momentum due to all the advocates for breast cancer, breast screening will remain.

Yeah, absolutely. It's the case for all screening programmes. Though for breast cancer screening the relative risk reduction for mortality for women aged 50 - 70 who are screened versus those who are not is 20% URL="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61611-0/abstract"]source[/URL. There is always going to be contention and uncertainty, but the figures are a lot stronger than for prostrate cancer - mainly because of the (typically) later onset for prostrate cancer and the speed of progression.

I don't think there is any argument that women's health advocacy groups are a lot stronger than men's, and that likely has some influence. But the idea that screening programmes can actually do more harm than good (at a population level) is rarely understood in the wider public.

Mikros · 06-06-2014 3:35pm

spurious wrote: »

I have a friend in Australia who had a blood test which showed up prostate problems. I don't know if that is available here or whether it's an early detection method.

That's a PSA blood test (Prostate-Specific Antigen). It used to be recommended for males over 50 years of age, or earlier if there was a family history of prostate cancer, but the thinking has shifted recently in some quarters. The risks of over-diagnosis have to be weighed up against the possible benefits. It is available in Ireland of course, and would be used as a screening / early detection method.

Bafucin · 07-06-2014 5:19am

SpaceTime wrote: »

Just seems nuts we're not vaccinated. It's not a big deal and it's non invasive.

I wouldn't mind getting that vaccine myself as an adult male. Wonder if it's available?

I think though the biggest issue with men's health is guys don't go when they do find something is a problem. That can range from minor annoying easily fixed issues to lumps that might be cancer.

I think maybe we're a little too shy about that area in general.

There is no push to get women vaccinated etc either. Women pushed for it. Men don't tend to.

Yes why shy about our health and talking seriously about it.

The health service is not going to push for anything that will cost at the moment anyway.

Women are not afraid to look silly.

Women will do walks for prostate cancer at the drop of a hat wear a daffodil etc. Lads don't.

Pawwed Rig · 07-06-2014 7:05am

Bafucin wrote: »

There is no push to get women vaccinated etc either. Women pushed for it. Men don't tend to.

Yes why shy about our health and talking seriously about it.

The health service is not going to push for anything that will cost at the moment anyway.

Women are not afraid to look silly.

Women will do walks for prostate cancer at the drop of a hat wear a daffodil etc. Lads don't.

Mod note - One of the rules of this forum is that generalisations are not allowed as they are just trolling material. Your post falls below that standard. Please read TGC charter.

anothernight · 07-06-2014 3:11pm

runawaybishop wrote: »

That's not free screening of the same type that is offered to women who can also do a self examination of their breasts.

As an aside, this is no longer recommended by the WHO and the CDC (amongst others) as a screening method, due to a very high number of false positives, as well as the fact that once a woman can find a cancerous lump, the cancer is usually quite advanced*. It is therefore not a good comparison to testicular self-examination.

http://www.who.int/cancer/detection/breastcancer/en/index3.html
http://www.cdc.gov/cancer/breast/basic_info/screening.htm

*Anecdotally, I only know two people who found their breast cancer by self examination. By the time they found it, it was too late for them. An early mammogram would likely have saved them, but they weren't old enough to be included in the national screening programme of Brazil, where they lived.

eviltwin · 07-06-2014 5:47pm

Pat Custard wrote: »

In so many places, there are free breast exams (don't get me wrong), it's a great initiative.

There are also free smear tests available from so many GPs.

Why are there no free initiatives available for prostate and testicular cancer? Why is there so little publicity into these cancers?

Why can't men go to these free breast clinics too? Men CAN and have gotten breast cancer. Especially more, "well-endowed", men who are over weight / have men boobs.

Curious what people think.

Those free breast checks are only for women between the ages of 50-64, everyone else has to pay for them.

entropi · 08-06-2014 8:37pm

Mikros wrote: »

That's a PSA blood test (Prostate-Specific Antigen). It used to be recommended for males over 50 years of age, or earlier if there was a family history of prostate cancer, but the thinking has shifted recently in some quarters. The risks of over-diagnosis have to be weighed up against the possible benefits. It is available in Ireland of course, and would be used as a screening / early detection method.

If I'm not mistaken, men ages 40+ are now being asked to take a test like this or to have a physical prostate exam, maybe they've brought the age profile 10 years lower? either way, earlier detection (especially in families prone to cancerous death or detection & treatment) can be a very good thing.

If I'm not mistaken, I seen an advert in the cinema of all places recently enough talking about the dangers of testicular cancer, and that men should at the very least perform self checks and if worried, visit their doc. Although a self check is not a golden standard at all, it will at least help more men take hold of their health and promote even an annual visit to their doctor for a check up.

A program like the one proposed by the thread title would help alright, it might not be a feasible one considering the HSE are already tightening the purse strings and are cutting whatever available costs they can.

Azwaldo55 · 08-06-2014 10:25pm

It is assumed men should suffer quietly and not complain. Women and children first and all that.

Fighting Irish · 08-06-2014 10:54pm

Deleted User wrote: »

It's fairly simple, men don't matter as much.

i think it's, women think they're important

A Neurotic · 08-06-2014 11:36pm

Cancer is a word which encompasses loads of different diseases. Breast and cervical cancer are completely different diseases to prostate and testicular cancers. Some diseases are more suitable for public screening measures than others. The disease criteria for a public screening program to be worthwhile are outlined nicely here: http://www.patient.co.uk/doctor/screening-programmes-in-the-uk

Rather than there being a global radical feminist conspiracy (orchestrated by overwhelmingly male governments) to deny men healthcare, I think it's probably more likely that "male" cancers don't fit these criteria as well as "female" ones.

Sauve · 08-06-2014 11:47pm

Fighting Irish wrote: »

i think it's, women think they're important

Mod

If you have nothing constructive to add to a discussion, then please don't post. Generalising an entire gender is not acceptable around here.

iptba · 09-06-2014 5:04pm

A Neurotic wrote: »

Rather than there being a global radical feminist conspiracy (orchestrated by overwhelmingly male governments) to deny men healthcare

Just because individual males are in positions of power doesn't mean they run things for the benefit of men as a whole. One obvious example is conscription, where women have been protected from having to fight in numerous wars.

In Ireland we have a (statutory) Women's Health Council:

The Women's Health Council is a statutory body set up in 1997 (under statutory instrument No. 278 of 1997) to advise the Minister for Health and Children on all aspects of women's health. Its mission is to inform and influence the development of health policy to ensure the maximum health and social gain for women in Ireland. The membership of the Women's Health Council is representative of a wide range of expertise and interest in women's health.

Background

In 1995 the Department of Health held a nation-wide consultation with women aimed at defining a framework for women's health policy. Out of this process came the Women's Health Plan. The Plan recommended the setting up of the Women's Health Council, a permanent body to ensure effective and appropriate policy for women's health care. The work of the Women's Health Council is guided by three principles:

Equity based on diversity - the need to develop flexible and accessible services which respond equitably to the diverse needs and situations of women

Quality in the provision and delivery of health services to all women throughout their lives.

Relevance to women's health needs.

Mission Statement

The Women's Health Council exists to influence the development of Health Policy at regional, national and international levels in order to ensure the maximum health and social gain for women.

http://www.activelink.ie/content/irish-links/health/womens-health-council

There are lots of active groups looking out for women's interests.

There is no Men's Health Council. It is quite conceivable that in such a scenario, initiatives aimed at helping men's health could be neglected, I believe.

Why are there no free cancer screening for men?

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