Article: Why are men so reluctant to seek medical help?

The_Conductor

http://news.bbc.co.uk/2/hi/uk_news/magazine/8154200.stm

When doctors first examined former footballer John Hartson last week, he was already in the advanced stages of testicular cancer, which had spread to his brain and lungs. Why do men commonly get medical help later than women?

John Hartson went into Swansea's Singleton Hospital a week ago and doctors quickly established that he had testicular cancer which had spread to other parts of his body. Within days he'd had emergency brain surgery.

It's not clear whether the former Celtic and West Ham hero had ignored warning signs - sometimes testicular cancer has no symptoms.

Cycling legend Lance Armstrong, who has sent Hartson his best wishes, admitted he delayed going to a doctor for months before he was given a similar diagnosis in 1996.

A survey last month for the Everyman Male Cancer Campaign suggested that nearly twice as many men as women had not visited their GP in the past year.

Evidence suggests fewer men go to dentists or ask the pharmacist for advice and information, or attend contraception clinics, although men are more likely to end up in hospital because they delay for so long.

Even male cancer helplines are used more by women, speaking on behalf of partners, fathers or sons. And the fact that more women get skin cancer than men but more men die from it, indicates how late men are going to doctors.

Men are slowly getting better at it, says Mike Shallcross, associate editor of Men's Health magazine, but the contrast is made between men's attitude to testicular lumps and women checking their breasts for potential tumours.

"There's that fear when you find a lump on your testicle of thinking 'If I go to the doctor he'll just lop it off', which is the standard treatment, but you can get by perfectly with the one. But in the vast majority of cases, it's not cancer at all and you've done the right thing and got a weight off your mind."

This kind of comparison can be misleading, however, because women need to be more vigilant, he says, Breast cancer is much more common, with about 45,000 new cases a year compared with 2,000 new cases of testicular cancer, which makes up only 1-2% of male cancers and has a very high survival rate.

"Men could learn from women about attitudes to health. I would characterise it as the way they treat their cars. Women drive very carefully and make sure they take it into the garage at the right time but men just put their foot down until it's knackered."

Embarrassment and inexperience were the reason Martin Carter, 37, waited nine months to get his testicle checked after it became swollen and hard.

He finally got it seen when it swelled to four times its normal size and he had severe back pain and was losing weight. By then the cancer had spread to his lungs and abdomen and was pushing against his spine.

"I was only 20 and quite shy," he says. "Even though I was close to my family and friends, I just felt too embarrassed to tell anyone. I felt awkward.

"I thought it was something sexual, something I'd caught, and that made it even harder to talk about it. Back then testicular cancer wasn't so well known, there were no awareness campaigns like now.

"Also, I didn't know where to start. I was young and had hardly been to my doctor and when I had been, it was with a parent. That lack of experience meant I didn't know where to start when it came to seeing my GP."

Gender divide

He had his testicle removed, along with the tumours in his lungs and abdomen, and underwent chemotherapy. The treatment was successful but 14 years later, in 2006, his remaining testicle showed signs of cancer.

He got it checked straight away and was told the cancer had returned. But because he acted immediately it hadn't spread anywhere else and he only needed to have the testicle removed.

Martin's experience underlines the cultural reasons behind the gender divide in the self-diagnosis of cancer, says Professor Colin Cooper, head of the Everyman Centre, Europe's first research centre dedicated to male cancer.

"Historically women have always been the custodians of health in the family," he says. "They have cervical screening and breast screening and they take the kids to the GP. But men don't do any of that and tend to be much more reluctant to go when they have symptoms."

It could also be argued that women use the NHS at an earlier age, because of contraception or child birth, and they are generally more in tune with changes in their bodies.

Cancer survival rates in the UK are among the lowest in Europe because the British - both sexes - are for some reason less inclined to go to a doctor and cancer is diagnosed late, says the professor.

Celebrity Jade Goody, who died earlier this year after cervical cancer spread, ignored a letter saying a cervical smear test had indicated abnormalities. But generally women are better than men at acting.

"Men tend not to talk about health," he says. "Eight years ago we did a survey which found that men like to talk about sport, women, cars. Even politics is more popular than health issues. It has slightly opened up since but there's still a problem."

That's why men are going to doctors with very advanced cancer, he says, and John Hartson's survival prospects, although still quite good at about 60:40, would have been 99:1 had he been diagnosed earlier.

Men have a reluctance to ask for help or admit they have a problem about anything, says Peter Baker of Men's Health Forum, but basing primary health care around office opening hours hardly helps men who are in full-time work.

However, testicular cancer is not the major issue facing men because it's rare and the clear-up rate is high.

"Campaigns have worked because doctors are seeing testicular tumours at an earlier stage. If I was to pick one issue above all others, I would say obesity and we should do much more about alerting men to the dangers of being overweight."

Men are generally in poorer health, he says, with a worse diet. They are more likely to smoke and be alcoholics. They do more physical activity but the majority don't do enough to make any difference to their health.

"Taking risks and thinking nothing bad will happen is even seen as part and parcel of being a man," he says.

Health education should equip men with an understanding of what taking these risks means and how it affects their health, but it needs to be done in a humorous way to have any impact.

This should entail going to the workplace, the pub, the sports venues, and using humour to break down barriers, says Mr Baker.

A recent successful campaign was based on a Haynes car repair manual, with a man's body illustrated as a car engine.

cocoa

The end doesn't make that much sense without the rest :

They do more physical activity but the majority don't do enough to make any difference to their health.

"Taking risks and thinking nothing bad will happen is even seen as part and parcel of being a man," he says.

Health education should equip men with an understanding of what taking these risks means and how it affects their health, but it needs to be done in a humorous way to have any impact.

This should entail going to the workplace, the pub, the sports venues, and using humour to break down barriers, says Mr Baker.

A recent successful campaign was based on a Haynes car repair manual, with a man's body illustrated as a car engine.

Thanks for that, it was an interesting read.

I think sometimes people expect a bit too much from their doctor. While it would be fantastic if my doctor carefully questioned, looking for anything I was embarrassed about or forgot to say, it really doesn't seem like too much to ask that I take the responsibility on myself, and carefully make a list of anything and everything I want to discuss with my doctor and bring this along with me. This is really in response to some of the comments after the article, while some doctors are better than others, there's a lot you can do to get the best out of yours.

DrIndy

This summarises the most important thing this forum is for.

I'm a guy and a doctor. We are diabolical for seeking help when worried. Why should we be any more embarrassed about our balls when women happily go to have cervical smears (and this is a very personal examination) or their breasts which actually take longer to do than a testicular exam. Testicular cancer is the most survivable cancer in existence with the minimum of surgery and fantastic cure rates on chemotherapy if caught early. It is in fact better than cervical cancer to have - but women know they need a smear done and are happy to put up with the mild indignity (if you know your doctor - its a mild indignity).

Thoughts folks.......

DazMarz

It's defo just an embarrassment issue, I reckon. Lads seem to reckon that the GP has never seen a penis or testicles before and that theirs is somehow unique! I imagine every GP has seen all shapes, sizes, colours...and yours will be nothing more than #1,203,473 in the list of penises your GP will have seen.

Doctors are there to help, advise and cure. They do not judge, tease or condemn. They are there to make sure you are as healthy as possible and that you can live life as best as you can.

I still find it a bit embarrassing to visit my GP for my physical. But I still force myself to go, and once it's over, I realise it's not all that bad. Same as donating blood. I have cold sweats and my stomach is in knots beforehand, but after I wonder why I was so scared!

We build things up too much in our own minds and believe that we're going in to see Dr. Mengele or Dr. Lecter instead of our friendly GP. It's all psychological!!!

The_Conductor

I don't think its an embarassment issue to be honest- more a lack of willingness to accept our own mortality- or acknowledge that anything could possibly be wrong. I suspect that the way most of us refuse to acknowledge we're lost when out driving and stop to ask for directions- is related. Guys are far more likely to keep anything that they suspect may be wrong to themselves- whereas women are far more likely to sit down and discuss things among themselves. Further- women are incredibly active at organising themselves and campaigning on behalf of womens health and other issues- and men see themselves as too 'macho' to admit they may have anything wrong (though thankfully this is changing). I really don't think the almost 4 years extra longevity women have over men on average, is largely down to genetics- its a reflection of the extra care women take of themselves. I know this is a massive generalisation.

DrIndy

You may well be onto something though. I had a young fella come in to me with a hamstring injury and right at the end (after I told him to whip his trousers off - but keep the undies) to examine him properly, he told me he and his mate has just been "broke" a few weeks previously and was worried about this rash between his legs (which was jock itch).

He thought he had an STD, was worried ****less but did not go to a doctor. After he sussed me out as "cool" with everything and about to leave, he confessed about this for reassurance.

Young women (of the same category as above) by converse turn up all the time with lower tummy pain +/- genital pain. I tell them I think it might be an STD and need to do an internal exam. Undies whipped off straight away, no questions asked (and with a female nurse!!) I do a pelvic exam. Women expect this is going to happen, men seem surprised. I always give a very clear talk to them that their partner MUST also be checked out - or they will just be back again seeing me. How many men go about with pain when peeing or discharge and ulcers on their penis and do nothing?

Why?

sam34

DrIndy wrote: »

Thoughts folks.......

DrIndy wrote: »

but women know they need a smear done and are happy to put up with the mild indignity

ahem. mild indignity??

DrIndy wrote: »

I'm a guy

ah, that explains it!

Will

Fear, well for me it was, and maybe too proud to admit that something maybe wrong with them? Found a lump few weeks back, spent 2 weeks worrying about it. Finally just blurted it out and went to my GP. Thankfully nothing, but in my mind i was thinking "if i ignore it long enough it will go away".

Dunno, conditioning us when we are young to be "manly"? I remember getting a belt of a fairly haggard and splintery hurl in my leg during a match once. Loads of splinters, blood and pain. Was told to just grin and deal with it. Was maybe 11 or 12, all I wanted to do was cry but was afraid to show weakness. Most of the lads when they got a belt of a hurl too were told the same and rarely a squeak out of em.

Stheno

DrIndy wrote: »

This summarises the most important thing this forum is for.

I'm a guy and a doctor. We are diabolical for seeking help when worried. Why should we be any more embarrassed about our balls when women happily go to have cervical smears (and this is a very personal examination) or their breasts which actually take longer to do than a testicular exam.

I'd agree with this, my bf put up with a pain in his back for six months before he had to go to the doctor to get an unrelated prescription renewed.

It's almost as if men are afraid to face up to any health issues, I know with the bf that he was worried that the back pain was serious and tbh didn't want to know it it was.

Routine preventative maintenance in terms of health checks are normal for women, plus any woman who is sexually active will have regular appointments for contraception/smears etc so it's a fact of life for women

Men don't have the same need in a way so can choose to ignore things.

The_Conductor

nouggatti wrote: »

Men don't have the same need in a way so can choose to ignore things.

Thats just it though- men do have the same need- but choose to ignore it......... Ignoring something does not mean it will go away- if its something serious very often- something that may be reasonably easy to treat in early stages becomes something different altogether......

Routine preventative health checks should be the norm for men, in the same manner as they are for women.

Women are great at campaigning for what they conceive to be their health issues- but they can be to the detriment of other conditions (e.g. Breast cancer gets massive publicity- as its seen to be a major killer of women. This in turn generates a complacency among women towards other cancers (in Ireland lung cancer killed more than breast cancer in each of the past 3 years- and heart disease almost 16 times more........)). Lung cancer and heart disease are viewed as 'less sexy' than breast cancer- and get lost in the static- when not only are they major health issues for both sexes, but they are far bigger killers than some illnesses/diseases at the fore.

The health system can be such though that even when men know they have a pre-disposition towards a particular illness or condition- the facilities for monitoring or testing- simply are not available. Look at the sad position we are in regarding colonoscopys- even for younger people who have IBD. Its simply not available.......

It is also the case that as women campaign for women's health matters- money is invested in those issues they campaign on behalf of- often it might be hypothesised to the detriment of those illnesses/diseases/conditions- that aren't flavour of the month........

Condo131

I can't fathom it either and I'm a guy. I suppose it depends on what you're used to.

I used to work for a company that offered periodic medicals and availed of that. After I left, I opted to have an annual 'M.O.T.' done by my G.P.

I've always taken the view that "Your health is your wealth", coupled with a running maxim, "Use it or lose it"

The strategy paid off; a few years ago, my G.P. recommended a PSA check because of my age. To cut a long story short, I was diagnosed with what was termed 'advanced prostate cancer' - I had no symptoms lads!

However the early diagnosis proved critical and, two years (almost) post surgery, I'm more or less back to normal.

I like the car maintenance analogy in the BBC article, and often use something similar when talking to men about getting medical checkups, particularly if they have some symptoms of an ailment, or something that is troubling them: "If your timing belt was causing bother, you'd get it sorted. It'd be expensive and cost a couple of hundred. However if you ignore it and it breaks, it'll cost you a couple of grand, or the car might even not be worth repairing" It can be something similar with your health.

So if what's under YOUR bonnet is acting up....do yourself, AND your loved ones, a big, big favour........check it out!

Cancer doesn't have to be a death sentence - you CAN take MY WORD for it!

iptba

Will wrote: »

Dunno, conditioning us when we are young to be "manly"? I remember getting a belt of a fairly haggard and splintery hurl in my leg during a match once. Loads of splinters, blood and pain. Was told to just grin and deal with it. Was maybe 11 or 12, all I wanted to do was cry but was afraid to show weakness. Most of the lads when they got a belt of a hurl too were told the same and rarely a squeak out of em.

Yes, I think it's a factor.

Possibly one of the worst things (or certainly not a desirable trait) for a man to be seen as is a wimp.

Condo131

iptba wrote: »

Possibly one of the worst things (or certainly not a desirable trait) for a man to be seen as is a wimp.

I tend to agree somewhat, but you'd imagine that common sense might come in somewhere - unfortunately, I find that common sense is very rare!

However I think there are several other attitudes involved, the first of which involves your idea:
1. Men don't want to go to their doctor and find that their fears are unfounded and therefore appear a wimp in front of them.
2. Men, far more so than women, seem to have a difficulty/embarrassment when referring to/talking about their own body parts.
3. They fear that something might be wrong but, if it's not named, it's not happening. Now that, or similar, is VERY common.

On the latter I know several men who ignored symptoms for far too long and, unfortunately, got into very *serious* trouble. :(:( What do you say to these people? You can't call them wimps when you *know* what they're facing, but you'd love to ask them "What the %*@# were you thinking?" - but you just can't.

This year approx. 28,000 people in ireland will be diagnosed with some form of Cancer. What makes YOU think that YOU won't be one of those and not see your G.P. for a checkup?

krudler

DrIndy wrote: »

This summarises the most important thing this forum is for.

I'm a guy and a doctor. We are diabolical for seeking help when worried. Why should we be any more embarrassed about our balls when women happily go to have cervical smears (and this is a very personal examination) or their breasts which actually take longer to do than a testicular exam. Testicular cancer is the most survivable cancer in existence with the minimum of surgery and fantastic cure rates on chemotherapy if caught early. It is in fact better than cervical cancer to have - but women know they need a smear done and are happy to put up with the mild indignity (if you know your doctor - its a mild indignity).

Thoughts folks.......

I used to be like this, had a benign cyst once that took ages for me to get checked out, as a doctor this must happen a lot, the "hand on door query" cos I've done it myself, guy goes to doc for some random thing like a cold or backpain or something easy to treat, then as he's leaving "oh yeah while I'm here, bit of pain when I pee" my own doc says this happens all the time, its a guy thing and most of us are of the "if I ignore that massive red lump it'll go away on its own" school of thought

Mrmoe

Another artcile from the bbc echoing what has been mentioned here already
http://news.bbc.co.uk/2/hi/health/8588686.stm

Women are more likely than men to complain about their health even when they are in better shape, according to government statistics.
UK researchers looked at links between how healthy people thought they were, and their death rate.
They found women were more likely than men to say they were in poor health, but less likely to die over the following 5 years.
Doctors are concerned about men's apparent lack of awareness of health.
The analysis used data from three studies across England and Wales, Northern Ireland and Scotland.
It looked at how those aged 35-74 at the time of the 2001 Census rated their health, and their mortality from 2001 to 2006.




It found there was generally a strong association between those reporting that their health was only poor or fair, and subsequent deaths.
Women were more likely to report poorer health than men, but this was not reflected in subsequent mortality rates.
Doctors and campaigners are concerned about men's apparent lack of awareness about health problems and reluctance to go to the doctor.
Commenting on the study, Steve Field, Chairman of the Royal College of General Practitioners, said women are better at disclosing how they feel about their health.
Steps should be taken to encourage men to report health problems earlier, he said.
"The message for the health system is that it should try harder to make it easier for men to access healthcare through suitable hours, venues and phone or computer consultations.
"If men have got concerns about their health, they should come and talk to their GP," he added.
'Extremely worrying'
Peter Baker, Chief Executive of the Men's Health Forum, said the findings were consistent with previous research which showed men are less likely than women to acknowledge health problems to themselves or others.
He pointed out that studies have shown that men who develop diseases like cancer and diabetes tend to be diagnosed later than women.
Mr Baker said: "Men are less aware of their symptoms than women, and are more reluctant to seek help.
"They delay going to the doctor which means their symptoms are more advanced and harder to treat.
"This is extremely worrying. Forty percent of men die before the age of 75."

Caoimhín

Im sure my shoulder has been broken for about a week now but there is now way im going to sit in the A&E for 10 hours.

Dr Galen

if you really have a broken shoulder you really need to go get it checked.

star-pants

Aye I have to agree, a good few guys that I know would be more 'ah sure I'm grand'.

I remember I arrived home & my dad had fallen (ladder collapsed under him) and he wasn't sure if he'd passed out or not, big cut above his eyebrow n his fingers were all swollen up. My mother was trying to convince him to go into hospital and he was 'ah I'll be fine in a minute, just a bang'. He'd a facecloth to his head.
I gave out to him and sat him down and cleaned the wound and put on paper stitches, it was deep cuz I could see muscle or whatever is in there. So I forced him to go in, even if he insisted on driving in himself, I said I'd go with him just in case.
Turns out he needed a few stitches, they did an xray of his hand but he'd just badly mashed/bruised them.

But still like that, was nearly beating him with a stick to get him to go.
It's funny because he slipped a disc/put his back out about 18/19 years ago lifting my brother out of the cot, and he has to go to the chiropractor every so often. If his back is reallly at him, he'll pick up the phone and get it sorted. Because he knows how much it will restrict him.

So I think sometimes it's more of a case of 'can I work through this?' and if it's yes they leave it, if it's no, they might go get checked.

It's so so SOoooooo important to get things sorted though. My cousins gfs dad had bad constipation/pain back in Sept 09, went to doc, went to hosp, they sent him home told him to eat more spinach. Within a month or so, he'd lost 3stone and was still not good. Back in and they did nothing. His sister organised a colonoscopy and they found bowel cancer. And the man is practically on his deathbed now. If something is wrong and you're not satisfied with the doctor that sees you, INSIST on getting another opinion or more tests or whatever. Because if they'd copped on and caught it back in Sept/early Oct, it would have been treatable (they've said that). Very very sad.

My dad had a swollen.. thingy and my mother told him to go up to the doc, insisted, cuz he's 52, you don't mess around with that type of thing. Turns out he'd just pulled it or something but still, better safe than sorry.

I'm not one to go up to the doctor myself unless it's something that I know feels wrong, or if I'm *really* sick, but if it's something that's not quite right, damn it, get it checked out, 50-60 quid for peace of mind is better than not & ending up much worse off.

I think it's good to have more of an awareness etc about encouraging men (and anyone) to seek medical help if it's needed.

iptba

I don't think the mocking with terms like "man-flu" helps.

irlforum

Hi there,
I am somebody that's concerned about my health - I've been unwell for a long time due to a mental issue (not an extreme one but chronic which caused huge problems in my life) that I've had and because of that my life has been a mess. Now that I am well (only in the last few weeks) I am trying to organise and sort everything out in my life - for what's it worth to anyone that may be familiar with the myer briggs personality scale or types I am an INTJ - may give a doctor reading this for example more insight into what I am looking for as a person.

Anyways to get to the point I have smoked over the last 10 years quite abit and have had a poor diet with little to no fitness either. When I was at my doctor last I mentioned the possibility of an annual check. I assumed this would be a fairly normal thing to ask about - she didn't seem to think so though. She said some people do it and if it makes you feel happy it's fine.
I asked her for a general check up thinking this was a normal thing and she really wanted to know why - she was looking for my reasoning behind this - I suppose in hindsight this was normal enough. I had not fully formulated why at that stage so had no answer prepared but thought about it since. I would like to get an overall picture of my general health - I would like to be able to rule out cancer in areas of my body including lung, prostate, bowel etc. There are I'm sure many other things which I have not researched as of yet or come across. One other thing that would concern me is cholesterol.

Doctors or people in the know - Is it possible to get all these things tested for and ruled out quite easily so I can resume my life afterwards with little need to worry about these things anymore? Then perhaps continue on a more general annual check or something?

This has been an interesting thread and I definitely fit into the category of males that put off seeing their doctors. Just after reading this article I rang my doctor to make an appointment as I have been off work the last two days with a stomach ulcer - I have been concerned about pains in other areas of my stomach than usual and also gas being generated very mildly from one of my organs which for me seems a little unusal. I was putting it off entirely waiting for it all to go away.

pickarooney

I think the cost has a lot to do with it and men don't seem to prioritise doctors' fees over computer parts or beer when it comes to budgeting.

It may also be a cultural thing, but in France, where doctor's visits are free or close to it, men seem to have no hesitation whatsoever in going to the doctor or taking pills when there's anything even remotely wrong with them. I'd go so far as to say they take the piss in terms of heading down to the GP with every sniffle, headache or itch.

I spent most of my childhood between doctors and hospitals but thankfully have grown out of all of that and am rarely sick or injured enough to need medical intervention, but I think I'm fairly well able to decide for myself when something does or doesn't require a doctor's visit.

Cicero

I used NEVER go to the doctor- if I had the flu/chest infection etc, I would just sit it out at home or keep going if I could...had some illness last year in which I was hospitalised and found the doctors and my own GP very helpful...I'm not a fan of tablets at all, but realised that sometimes, you do need a bit of help....it would probably encourage me to go more now if I were sick again...only for that though, I'd probably still be somone who avoids doctors..

fonecrusher1

Why are men so reluctant to seek medical help? Answer: Because GP's charge too much.

iptba

fonecrusher1 wrote: »

Why are men so reluctant to seek medical help? Answer: Because GP's charge too much.

One could do a study on this involving people who had access to free health care and then didn’t. For example, in the college I went to, there was free health care on campus. So look at the rates of attending and in particular whether there was a bigger drop in the males. If we had men's studies departments, this whole issue might be looked at from different angles.

sam34

fonecrusher1 wrote: »

Why are men so reluctant to seek medical help? Answer: Because GP's charge too much.

women are charged the same, yet it doesnt stop them from going

fonecrusher1

sam34 wrote: »

women are charged the same, yet it doesnt stop them from going

True, but its a contributing factor to the general problem of people who do not have a medical card avoiding GP visits because of the ridiculous consultation fee.
Personally i would only go to my GP if i had a pretty serious health issue, otherwise i would get advise in a pharmacy.

iptba

There are differences in spending patterns between men and women so a price could have a more pronounced difference for one gender over another.

Dr Galen

iptba wrote: »

There are differences in spending patterns between men and women so a price could have a more pronounced difference for one gender over another.

true
but with a caveat, that being that for anyone, health should be the top of your priorities.

Dr Galen

fonecrusher1 wrote: »

Why are men so reluctant to seek medical help? Answer: Because GP's charge too much.

i had to get a plumber recently. His callout fee was twice that of my GP.

fonecrusher1

Dr Galen wrote: »

i had to get a plumber recently. His callout fee was twice that of my GP.

Whats your point & what does plumbing have to do with this topic?

Cicero

fonecrusher1 wrote: »

Whats your point & what does plumbing have to do with this topic?

Illustrating your original point that GP's charge too much?

Stheno

sam34 wrote: »

women are charged the same, yet it doesnt stop them from going

And that goes back to my original point that in many cases women have to got to gp's to have pill prescrtions renewed etc.

And when you got to a gp for that you have a basic health check and get asked about smears etc, so you are more likely to be aware of the need to have them.

Iderown

I'm an old guy but I simply cannot bring myself to trust doctors. When I was a few days old I was tied down and had a sensitive part of my anatomy mutilated off by a "doctor". I'm sure this could not happen nowadays. Could it?