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Men, it's time to take Movember seriously

The month that trains the spotlight on men's health issues needs more recognition. Hear it from UAE-based experts - and even a cancer survivor - about why ignorance is not always bliss

When 'stashes are back in fashion and phrases like 'mo bros' find renewed currency, you know Movember is back in town. The penultimate month of the year often sees various establishments around the country offering men a creative variety of discounts and privileges, all in a bid to encourage more dialogue about a subject that many are still wont to keep mum about: their health.
As far as medical checkups go, the findings - both anecdotal and statistical - aren't very healthy. Men, it turns out, are far more likely to 'do anything and everything' to avoid a visit to the doc than women. According to a 2016 survey of 500 males by US-based Cleveland Clinic, 60 per cent of respondents don't go to the doctor, while more than half (53 per cent) admit their health is not a talking point in conversations. With several other studies reporting similar findings, you can be sure if you know any males who don't need to be nagged, dragged to or tricked into seeing a physician, you're associating with the minority.
From the standard 'too busy' liners to misguided notions that 'real men tough it out', the reasons for the stance are often as questionable as they are varied. But the message of the month from experts and survivors alike is the same: ignorance - at least where health is concerned - is not bliss.
'No shame in illness'
UAE-based expat Abdullah (name changed) used to fall into the 'tough it out' camp until testicular cancer changed the course of his life forever. It all started with a "weird feeling" in the infected area, says the 56-year-old. He felt two tiny lumps, the size of chickpeas, in the area - yet chose to do no more about it, except ask a pharmacist for a painkiller, which he used whenever he felt any pain.
For almost a year, he refused medical tests - until the painkillers could no longer help him and he was forced to schedule an appointment with a doc. To his shock, the lumps had "evolved to the size of an orange" by then, which his doctors (after multiple tests) told him could only be resolved through surgery: the infected area had to be removed.
The distressing report pushed the Jordanian to seek opinions from doctors in several different countries, including his own - yet, all of them reverted with the same conclusion. Having finally run out of options, Abdullah did as the doctors advised, but post-surgery tests discovered that the cancer cells had already spread. Seven rounds of chemotherapy later, he received the all-clear from his doctors, who have recommended regular checkups every six months - ones he intends to keep.
Abdullah says that while the experience was taxing, he definitely learnt a lot more than he bargained for by avoiding those initial trips to the doc. "This journey really changed me," he says, reasserting what medical practitioners have been telling us all along: the earlier you catch the cancer, the higher your chances of a cure. "No matter how small a matter you think it may be, if you notice anything odd about your body, consult a doctor - because you could save a lot. I lost a part of my body due to a lack of knowledge about my illness," he continues. "Nobody likes to go to a hospital - myself included - and, as men, we usually prefer to get over a problem without seeking medical help. But that's the worst thing we could do for ourselves."
The other thing he's learnt? Talking about men's health can only help. A lot of people may feel embarrassment or shame when in such a situation, he notes. After all, who wants to admit they have testicular cancer? "Of all the cases I know similar to mine, 60-70 per cent of men were ashamed of their condition - but illness is nothing to be ashamed of," says Abdullah. In his own case, friends, relatives and societies like the Sharjah-based nonprofit Friends of Cancer Patients chose to be very supportive, while also respecting his privacy. "I've no history of cancer in my family - yet I got diagnosed with it. It's important that we raise our awareness about these matters."

From left to right: Dr Waleed Hassen, Dr Basel Altrabulsi, and Dr Prakash S Pania
Masculinity matters
Interestingly, masculinity seems to be a key factor that crops up in every study that's ever explored the causes for why men seem so 'allergic' to medical checkups. For all the challenging of traditional gender stereotypes in recent years, machoism and bravado still continue to be markers of masculinity that seem to be deeply embedded in the male psyche. There's nothing wrong with that, of course - until such notions begin to interfere with good medical advice. So, while there's a time and a place for keeping your chin up and powering through, when it comes to health matters, there's more to be said for brain over brawn.
On another level, there's also the genuine discomfort or vulnerability that many men will attest to with some of the physical exams involved. For instance, one of the major illnesses that Movember asks men to screen for is prostate cancer - the third most common cancer in the UAE. Dr Waleed Hassen, staff physician at Cleveland Clinic Abu Dhabi and chairman of the Middle East NCCN Prostate Cancer Guideline Committee, notes that "over 50 per cent of men present themselves with more advanced stages of prostate cancer" in the UAE. "This is, in all likelihood, due to the lack of education and PSA screening rather than any inherent differences in the disease here compared to other parts of the world," he says.
But while the screening for this could be as simple as a blood test, at times, it calls for a digital rectal exam too - which can, understandably, evoke a 'hell no' reaction from most. American singer and prostate cancer survivor Harry Belafonte probably summed it up best when he said, "The prostate is something that attacks that central part of the male body that men are very preoccupied with. Somehow, any disorder there means your life is over, you can't be a man anymore, you are now something less." However, the activist is also quick to add, "If you're going to have [prostate cancer], you're going to have it. It's what you do about it that makes the difference - how you conduct your life."
The situation is not without sympathy. The modern-day male is under tremendous stress, notes Dr Prakash S Pania, consultant endocrinologist at Aster Jubilee Medical Complex. "He's meeting deadlines, paying EMIs, often staying away from home, and running from pillar to post in order to secure a stable and secure future for his family. In doing so, he tends to neglect his own health, often 'sacrificing' his regular checkups in the interest of time or money. Many a time, he knows he might be suffering from a certain medical disorder but feigns ignorance, hoping the problem will miraculously disappear instead."
It's perceptions like these that make Dr Pania believe more awareness campaigns are in order. "Unlike the breast awareness campaign in October, which has achieved global recognition, the Movember movement to highlight men's issues is still in its nascent stage and requires more support."

Wellness advocate Rob Donker
'Listen to your body'
Movember is not only about getting yourself checked once you've crossed a certain age. Reportedly, one of the most common excuses men offer when declining to visit a doctor is that they 'feel' perfectly fine. Wellness advocate and owner of several health and fitness businesses in Dubai Rob Donker acknowledges that while he is proud of the super-healthy and fit lifestyle he leads, it does tend to "bring out the Neanderthal" in him, because he "waits for something to happen" before he schedules a doctor's appointment. "It's probably our masculine pride that makes us like to think we're indestructible," he says, sportingly.
However, he is also quick to note that health and fitness, while two peas in a pod, are not synonymns. "Fitness alone cannot be a marker for health," he says. "There are several factors that contribute to health: are you putting the right things into your body? Managing stress properly? Taking care of your mental health? Moving daily? There must be a balance."
A firm believer in listening to the body, he says, "If people listened to their bodies properly, they'd be able to alleviate a lot of problems. It works with physical pain - the body's way of signalling something is wrong - and it works with food. All of us have a natural barometer for what we know is good and bad for us. We know - but we do not act accordingly."
A straw poll of men we spoke to saw many confess to avoiding checkups because they didn't want to hear any bad news. Says Rob, "I'd recommend that people follow what the medical industry says is the right time to get tested. If you're looking after your health properly - your movement, nutrition and stress management - you could do these tests without nervousness or worry."
Chief medical officer at the National Reference Laboratory in Dubai Dr Basel Altrabulsi also makes a good point when he says, "Many illnesses and health conditions, such as high blood pressure, diabetes, and prostate and colon cancer, lie dormant or appear without symptoms in their early stages. Based on the patient's history, a physical examination and diagnostic tests, doctors can identify symptoms or test results that one could never discover alone."
(With additional reporting inputs by Hisham Salah.)
karen@khaleejtimes.com