Rizal Faisal
Men need to acknowledge vulnerability and remove the stigma surrounding their mental health.
This was one of the key focusses of discussion during a forum held by Pantai Jerudong Specialist Centre (PJSC) this month to mark Movember, a men’s health awareness campaign at the Baiduri Community Space at the Baiduri Bank headquarters.
The forum featured The Brunei Cancer Centre (TBCC) doctors, Consultant Medical Oncologist Dr Ravi Sekhar Patnaik and Senior Consultant Radiation Oncologist and Head of Radiotherapy Dr Jacob Samuel Justin, as well as Ministry of Health (MoH) Clinical Psychologist Haji Mohamad Danial Azizi bin Haji Mahadi and cancer patient Aaron John Ho Junjie. It discussed issues leading up to inadequate men’s health and the readily available state-of-the-art facilities for holistic management of cancer patients at TBCC, PJSC.
The forum discussed factors that contribute to men’s poor health including limited awareness of 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 are just not aware of what they can do to improve their health and live healthier, happier lives,” the panel discussed.
The panel shared statistics from the Brunei Darussalam Cancer Registry (BDCR), Non-Communicable Diseases (NCD) Prevention Unit, MoH, which recorded 682 new cancer cases diagnosed in 2021, of which 278 (41 per cent) were males. It is estimated that one in four males in Brunei will develop cancer in their lifetime.
Records also show that the Sultanate has seen a 22.8 per cent increase in the number of new cancer patients diagnosed over five years from 2015-2019, compared to 2010-2014. If this progressive trend continues, cancer cases are projected to rise by an alarming 108 per cent between 2020 to 2040.
The panel stressed that these worrisome statistics could be attributed to several factors including changing lifestyles, smoking habits, consumption of toxic substances including alcohol and caffeine-containing drinks, lack of physical activity and growing morbid obesity.
Over the last 10 years there were 824 cases for colorectal cancer, followed by 620 cases for lung cancer and 453 cases for prostate cancer recorded in Brunei Darussalam.
“Other male specific cancers are testicular cancer and penile cancer,” the panellist doctors shared.
They underlined that screening is a methodology applied for early detection of cancer before the onset of signs and symptoms. In Brunei Darussalam, the MoH has provided three screening programmes specifically for cancer cases, which are for cervical cancer (cervix), breast cancer and colon cancer.
Routine screening guidelines for prostate cancer is a combination of simple blood test called PSA and clinical examination of the prostate gland (digital rectal examination) based on the risk category of the patients.
The discussions brought awareness that screening is recommended for men over 50 or earlier if there is history of prostate cancer in the family or those harbouring genetic mutations like BRCA. If prostate cancer is suspected, a transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI) guided prostatic biopsy is considered to confirm the diagnosis.
After the diagnosis of prostate cancer, further advanced tests like PSMA-PET scan is done as required by an oncologist.
Prostate cancer management also involves tri-modality approach depending on the stage of the disease. Treatment is highly effective in early-stage cancers compared to advanced stage. For some patients in the early stage, low grade prostate cancer can be kept under active surveillance or wait and watch approach.
Unlike prostate cancer, which is a disease of the ageing men, testicular cancer occurs in younger aged individuals, between the 15-35 years age group.
Patients usually complain of painless swelling, it changes in size or texture of one of the testis. Sometimes it can produce a dull aching pain.
Common risk factors for developing testicular cancer are undescended testis, family history and abnormal development of testis. A majority of testicular cancers are called germ cell cancers which can be seminoma or non-seminomatous germ cell tumours (NSGCT).
Testicular cancers are managed with a tri-modality approach comprising surgery, chemotherapy and radiotherapy based on the stage and risk stratification of the disease.
The good news is treatment is highly effective with good cure rates of nearly 99 per cent five-year survival rate in early stage and 75 per cent five-year survival rate in advanced stage testicular cancers.
Men with increased risk of developing testicular cancer should do periodic self-examination of the testis and seek medical help if they find anything abnormal.
Colorectal cancer and lung cancer are the other common cancers.
