Posted on 5/02/2018 by
For the avoidance of doubt, and with a nod to Betteridge’s law, it is not true that the reason prostate cancer research receives half as much funding as breast cancer, despite a higher mortality rate, is because of bias against men.
The real scandal is that men are less likely to be diagnosed early than women, are more likely to die, and are likely to die younger
Untangling the funding of science, and research into cancers in particular, is a fiendish task. If it is working well, it should be driven by the quality of proposals from the science community. Yes, breast cancer research has been more generously funded than prostate cancer in recent years, but uterine cancer is notoriously poorly funded. Lung cancer kills more men and women than either, and receives less funding than both. Leukaemia kills only 2.2% of cancer patients and yet is the third best-researched. This is not a male/female pattern.
As Cancer Research UK has noted about the new figures, the reason more men are developing (and dying from) prostate cancer now is because those men are no longer dying from other diseases – including other cancers – before prostate cancer gets the chance to set in. This is not to minimise the significance of the illness.
I lost my father to cancers in his early 80s, when it felt like he still had so much life to live. Do not try to tell me that cancers affecting older men are any less of a tragedy than any other. As prostate cancer moves up the ranks for fatal diseases and awareness and charitable donations grow, it is likely to become of increasing interest to researchers.
The efforts of charities like Men United should be encouraged and applauded, while Prostate Cancer UK, which published the new figures are surely right to call for better, earlier screening and testing for men.
At the same time, issues around men’s health are not restricted to prostate cancer. In fact male-specific cancers kill far fewer men than non-gender-specific cancers such as lung, bowel and colorectal cancers. The real scandal is that men are less likely to be diagnosed early than women, are more likely to die, and are likely to die younger. Among cancers affecting both men and women, a man is 67% more likely to die following diagnosis.
This can partly be explained by the fact that men are less likely to visit a doctor with illnesses or symptoms of all types at all ages. Some of this is undoubtedly related to our man-up/boys-don’t-cry model of masculinity which we instil into our children. To admit to a physical ailment is to admit to a weakness, something which remains anathema to many men. But it is not that simple either. The differentials in use of health services diminish significantly when men retire. This is not because suddenly men become less macho after the age of 65. It is because health services are rarely designed around the needs and lifestyle of men of working age.
Again, these are knotty problems without simple magic wand solutions, however the least we can expect is some political will. Every year the chief medical officer publishes an in-depth report into a specific area of health policy. In 2015 she devoted this resource to women’s health. There has never been an equivalent overview of men’s health. Last year the Centre for Men’s Health at Leeds Beckett University – the only academic unit of its type in Britain and a major research department on male-specific cancers – was closed due to funding cuts. The Men’s Health Manifesto is packed with proposals that could save countless lives and yet it goes unnoticed by policymakers.
Cancer affects women, men and families. The case for gender-sensitive, gender-inclusive policy is overwhelming, but the steps we take must be taken together, not men against women or cancer against cancer.