‘Movember’: Spotlight on men’s health

Rizal Faisal

Men around the world commemorated ‘Movember’ by growing a moustache in the month of November – with women also stepping up to support the movement – to raise awareness and funds for men’s health, specifically prostate cancer, testicular cancer, mental health and suicide prevention.

Movember has embraced by over five million supporters across the world, funding more than 1,200 innovative men’s health projects in over 20 countries. Named after a portmanteau of the words moustache and November, Movember began in Australia with a group of men who came up with the idea of growing moustaches in November to address the little-discussed fact on men’s health.

This was shared by Pantai Jerudong Specialist Centre (PJSC) Executive Director Dr Haji Mazrul Adimin bin Haji Awang Besar during the centre’s awareness campaign last November.

He pledged for PJSC, by marking Movember this year, to be on the forefront in shedding light on the importance of men’s health.

“The power of a moustache as a fun way to engage in a very serious conversation is core to what we want to achieve at PJSC,” he said.

‘More than just a Moustache…Let’s share’ panellists PJSC’s Goodwill Ambassador and Messenger of Cancer Awareness Wu Chun, prostate cancer survivor Lim Siew Yong, medical oncology specialist Dato Seri Laila Jasa Dr Babu Sukumaran and radiation oncology specialist Dr Haji Jamsari Khalid. PHOTO: RIZAL FAISAL

The event saw a morning interactive session titled ‘More than just a Moustache…Let’s share’ with panellists including PJSC’s Goodwill Ambassador and Messenger of Cancer Awareness Wu Chun, prostate cancer survivor Lim Siew Yong, medical oncology specialist Dato Seri Laila Jasa Dr Babu Sukumaran and radiation oncology specialist Dr Haji Jamsari Khalid.

Wu Chun reiterated that life is more vulnerable than ever with the current pandemic and said being healthy can be a secret weapon against any disease.

He elaborated that people have the power to beat cancer by living a healthy lifestyle with good sleeping habits, eating well and regular exercise, and the power to take control of cancer with early detection.

Lim Siew Yong shared his heart-wrenching experience and journey, from being diagnosed with cancer to remission, in hopes that his story will inspire others to take action against cancer.

The afternoon session titled ‘Cakap-Cakap: Let’s talk about men’s health’ highlighted key messages to include signs and symptoms, red flags, general men’s health and concerns between the public and health professionals.

Meanwhile, in conjunction with the event, PJSC also highlighted the need to dispel myths surrounding male breast cancer.

Although it is a rare form of cancer among men, it can happen; family history is not the only indicator of risk of getting breast cancer.

Other risks include older age – mostly diagnosed in men in their 60s; exposure to oestrogen (men can have high oestrogen levels as a result of taking hormonal medicines, being overweight, being heavy users of alcohol and having liver disease); Klinefelter’s syndrome, which causes men to produce less male hormones than female hormones; and testicular disease or surgery involving the removal of a testicle can.

Breast cancer in men is very rare and studies have not yet shown that the disease is different from that of women’s.

However, breast cancer is usually easy to diagnose in men as there is an obvious breast mass, often behind the nipple. Sometimes, it will show symptoms such as nipple changes, ulceration, discharge and inversion.

When a breast mass is found, it is evaluated just like in a woman. Men with breast cancer are encouraged to undergo genetic testing.

In terms of prostate cancer, men are encouraged to know the risk factors like age, family history, obesity and race, and at the same time, lower risks by quitting smoking (or not start at all), maintain a healthy weight, eat a balanced diet and be physically active.

Prostate cancer begins when the cells start to grow and multiply out of control. The accumulating abnormal cells form a tumour that can grow to invade nearby tissues. It usually grows slower than other types of cancer.

About six in 10 cases are diagnosed in men 65 or older. It is rare in men under 40. The average diagnosis age is 65.

Globally, one in nine men will be diagnosed with prostate cancer during his lifetime. In Brunei Darussalam, prostate cancer is the third most common cancer in men.

The symptoms of prostate cancer are: painful or burning sensation during urination; frequent urination, especially at night; blood in urine or semen; difficulty in starting urination or holding back urine; frequent pain or stiffness in the lower back, hips or upper thighs; and pelvic discomfort. Erectile dysfunction, painful ejaculation and weak urine flow can also be present.

Meanwhile, in testicular cancer, it usually begins in the germ cells – the cells in the testicles that produce immature sperm.

What causes germ cells to become abnormal and develop into cancer remains unknown. However, according to the Brunei Darussalam Cancer Registry, testicular cancer made up 1.4 per cent of all cancers in men in Brunei Darussalam between 2009 and 2018.

Signs and symptoms of testicular cancer include lump in the testicle, feeling of heaviness in the scrotum, pain in the testicles or groin, collection of fluid in the scrotum, back pain and feeling unwell and tired.

Testicular cancer risk factors are an undescended testicle, abnormal testicle development, family history and age, especially those in between 15 and 35.

Detections can be made by physical examination, testicular self-examination, ultrasound scan, abdominal and pelvic CT scan.

Treatment options range from surgery to removing the affected testicle, radiation therapy, chemotherapy and bone marrow transplant.

PJSC also revealed key points of testicular cancer, including its rarity, contributing to only one to two per cent of all cancers in men. However, it is the most common malignancy in young adult men aged 15 to 40.

Most men do not have issues with their sex life once they have recovered from testicular cancer. However, some treatments may affect fertility.

The most common cancer in men in Brunei Darussalam is colorectal cancer, the centre highlighted, adding that it is the second most common cancer in women in Brunei Darussalam.

Men will be diagnosed with colorectal cancer in their lifetime in Brunei Darussalam within the odds of one out of 20, while in women, it is one out of 22. The natural history of colorectal cancer is that it arises from a precursor lesion called the adenomotous polyp or adenoma. It is an abnormal growth from the colorectal lining.

Early stage colorectal cancer has mild to no symptoms, whereas presence of symptoms is indicative that the disease has been with the sufferer for several years.

The common symptoms are: change in bowel habit, change in shape of stool, blood in the stool (bright red or dark), bleeding from the rectum, diarrhoea, constipation or feeling of incomplete emptying of bowel, non-specific abdominal pain, bloating, symptoms of anaemia, weight loss, loss of appetite, nausea or vomitting and lethargy.

There are also modifiable risk factors which can be avoided, include consuming a diet high in red and meats, and having a low fibre diet, smoking, alcohol consumption, obesity and sedentary lifestyle.

Non-modifiable risk factors are age, genetic predisposition, previous history of polyps and inflammatory bowel disease.

Colorectal cancer can be prevented by maintaining a healthy lifestyle, consuming a healthy diet, maintaining a normal body weight and quitting smoking.

Citizens and permanent residents of Brunei Darussalam are eligible to join a National Colorectal Cancer Screening Programme by undergoing a stool test if they are between the ages of 50 and 75, have no current or previous history of colorectal cancer, have not had a colonoscopy in the last 10 years, and have not had a stool test to check for blood in the past two years. If the stool test is positive, referral for colonoscopy at the Gastroenterology Clinic will be made.

PJSC’s observations also show how quitting smoking can be greatly beneficial. They also highlighted the dangers of vaping. According to them, e-cigarettes contain nicotine which is highly addictive and dangerous for pregnant women, the foetus, infants, children and youth; its aerosols contain substances that harm the body and contain cancer-causing chemicals. They added that e-cigarettes can cause injuries such as fires, explosions and poisoning from the liquid.