Why do men die younger? Is it the beer?

WORDS: Retired Emergency Medicine Physician Dr Bryan Walpole AM

Why does it seem the media are always banging on about men's health, there's even a glossy magazine in the newsagent dedicated to just that?

Since the seventies, women have been actively promoting gender-based health services, as they often saw themselves as not being taken seriously and poorly serviced, and they were correct, eighty per cent of doctors were men, and there was a lot of unconscious bias in the system.

Women with ill-defined illnesses were labelled as hysterical, with no corresponding term for men. Post-2000, we (men) came to realise that we were not fully aware of the man specific stuff that was killing and maiming us, yet most of it was preventable. As a gender, we go to the doctors less, and often play down our symptoms; as a matter of fact, I recall a man who came to the hospital in the middle of a heart attack, he said to me: "I got this nasty chest pain, so I went up to the pub for a few beers, to see if it would settle it."

Let's think about a few issues, and where we can do better.

Suicide

We beat the women easily on this one, it's the most prevalent male killer between 15 and 35 and increasing in the older man too.

My uncle suicided, he was a popular local GP, involved in medical politics, and the leader of a large and disparate group arguing with the government. One day, he came home early, alone, and hung himself from the balcony. No one suspected anything was wrong; but when we went through his desk, there were all these notes of despair, including one where he thought he was broke.

R U OK means we look out for each other, its first aid for mental health, uncovering distress, and getting help. In the "olden days", you got this support from the wise old uncle, grandpa, the church, or sports club. Sadly, those days are long gone as refuges of help, and it's now more formalised, but if we instead look on depression and anxiety as the 'flu, a temporary problem that will lift with treatment. Every even mildly confronting TV show has Lifeline or Beyondblue appended.

A small number of elderly rural men often isolated after the death of the wife, with distant family, doesn't drive, and is sometimes unwell, can become depressed, feel life not worth living, and suicide. For some, this may be a reasonable assumption, but they can be helped with community support. RAW (Rural Alive and Well) comes to mind here.

Cancer

Cancer is the worst of all diseases killing from within, with insidious onset, and a possible painful, unpleasant death, yet so much has changed over the past 30 years. Prevention is paramount; we all know about diet, alcohol, sun exposure, obesity, that all predispose to cancer. Early detection is also paramount, as the current round of TV ads encourage, "see your doc about anything unusual, loss of weight, persistent cough, blood in the stool, skin changes, as these may be early cancer signs."

For heaven sake do the poo test when it arrives, alarmingly only 30% are returned. I find this unbelievable that people are refusing a free, easy to do and life-saving test.

Sensible people don't smoke anymore, but hazardous drinking is rife, the new recommendations are no more than two drinks a day, and if you can't manage that please keep it under five, and have at least two alcohol-free days a week to give your liver a chance, and reduce your risk of stomach and pancreatic cancer too.

Another nasty cancer can affect the balls, mostly in younger men. Still, they are within arm's reach, so any irregularity there needs urgent attention, as again, early removal can be curative!

Prostate cancer has become controversial, as the prostate-specific antigen (PSA) test for cancer is quite unreliable. Yet, when positive, patients want surgery for what may turn out to be an indolent low-grade cancer needing no treatment. Biopsy, where a small sample is taken, can be hazardous. A medical colleague had a biopsy followed by septicaemia, a two day stay in intensive care and a week off work, for what turned out to be a near harmless slow-growing tumour. Don't have the test without thinking through what you will do with the result. If a man lives long enough, he has a 70% chance of getting it, and dying of something else! For older men, radiotherapy can be helpful. Chemo can be devastating.

Even late discovered cancers are now treatable; there are new wonder drugs, monoclonal antibodies that work with the immune system, so have way fewer side effects than chemotherapy, which is still the mainstay of treatment, along with X Rays. If all that fails, at the end of life, we now have wonderful palliative care, though still primarily confined to the big cities, soon we may have medically assisted dying, to spare interminable pain and indignity. A friend's 82-year-old mother in law had several strokes (in Holland) and could now no longer swallow, and was offered a stomach tube, and so bedridden, with food her only joy, opted for death, a celebration was arranged at home, and at 3:00 pm the GP attended, checked her desires and the paperwork and administered a fatal dose, five minutes later she was unconscious, and after another 10 minutes, dead, just as she and family wanted it.

Obesity

Being fat is a significant risk factor for several intestinal cancers. Retirement can lead to elevenses, then the long lunch, with a nice bottle of wine shared, mid-afternoon snacks, followed by dinner out in the evening, finishing with a port or brandy, excellent stuff, yet the kilos slowly pile on, bringing with it arthritis from worn joints, diabetes, as the pancreas fails to digest the load of sugars. Blood pressure rises, as the ageing heart has to pump harder, multiple drugs to try and keep pace, followed by the heart attack or stroke, so watch your diet, weigh yourself at least weekly, check for your ideal Body Mass Index (BMI), you can look this up yourself by heading to the website - www.healthyweight.health.gov.au

Exercise is also important, as regular workouts and a meat-free diet have been shown to be better than medication for mood disorders.

There you have it, a bit to chew on fellas, get on to it and we may get up to women's lifespan, feeling better, living longer, happier, and no burden to the kids!

CONTACT: 

Communications AMA Tasmania – Nadine Cove – 0409159285