Shehan Karunaratne, 26, noticed a lump in his testicle and went to the doctor, only to report pain in his leg. His GP recommended physiotherapy.
A year later, he returned to the hospital coughing up blood and was diagnosed with stage four testicular cancer that had spread to his lungs, his back, around his hips and to the nerves in his legs.
His brother Roshan remembers that when Shehan revealed his diagnosis, the conversation took the form of an apology: “I’m so sorry. I have cancer.”
Roshan says he avoided being honest about his brother’s condition to protect his family and friends from the fear that he had cancer, but in fact being honest saved them the grief they suffered when his brother passed away in November 2016.
Testicular cancer has a very high survival rate if detected early. 97 out of 100 Australian men After his diagnosis, he is expected to live for more than five years. “That’s still the hardest thing, because if we had told the doctors then and had the tumour removed, he would have been perfectly fine,” Roshan said.
Sheahan is one of two in five Australian men – more than 37,000 who die prematurely each year – most of the time from preventable diseases, new research has found. report It was announced this week by the charity Movember.
The State of Men’s Health report makes clear that the stereotype that men tend to delay seeking help is not the whole picture and merely reflects larger structural issues that prevent men from connecting with the health care system and contribute to premature deaths before the age of 75.
Dr Zach Seidler, co-lead author of the report and global research director at Movember, said some of the most common preventable causes of death among men, including coronary heart disease, lung cancer and stroke, “all require ongoing engagement with the health care system”.
The report said women’s interactions with the health system are often established early because of reproductive and sexual health needs, such as obtaining a prescription for contraceptives during adolescence, and continue as women experience higher rates of non-fatal diseases throughout their lives.
In contrast, men are less likely to build trusting relationships with health professionals and as a result miss out on the health literacy (knowing when, where and how to get help) and preventive health advice that can come from those relationships, the report said.
Seidler emphasizes the importance of the “door handle response,” because patients often come in to discuss one issue with a health professional and then leave, talking about another important issue or symptom.
The top five leading causes of shortened life expectancy in men are coronary artery disease, lung cancer, self-harm/suicide, chronic obstructive pulmonary disease and stroke – which are largely preventable through lifestyle and behavioural changes, screening, early diagnosis and treatment. New research commissioned for the report estimates that Australia will spend around $10.7 billion treating avoidable cases of these five diseases in 2023 alone.
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The report includes a nationally representative survey of 1,658 men, of whom almost two in three (63%) feel gender stereotypes influence their behaviour and experiences in healthcare, particularly the need for men to appear strong, independent and “persevere”.
The emotional, vulnerable communication necessary for conversations about mental and physical health “is not the way men do things, we’re not socialized that way,” Seidler said.
In addition to challenging male patients’ own stereotypes about masculinity, he said, part of building a gender-responsive health system requires health care workers to be more aware of the gender bias they and their patients are subject to.
“We follow in the footsteps of, and owe a great debt to, women’s and LGBTQIA+ health advocates who have demonstrated the importance of a sex- and gender-responsive approach,” the report acknowledges.
“We share a vision of Movember and health equality, which means considering everyone regardless of sex or gender, and not losing sight of the evidence that men and boys also suffer from inequalities in many areas that require targeted strategies,” said Dr Sue Haupt, senior research fellow at the George Institute for Global Health, the Australian Human Rights Institute at the University of New South Wales and the Deakin University-led Centre for Sexual and Gender Equality in Health and Care.
“The Movember report sheds much-needed light on the fragility of masculinity that has remained hidden for far too long,” Haupt said.
The report also highlights health disparities among groups of men, with Aboriginal and Torres Strait Islander people, people from culturally and linguistically diverse backgrounds, socio-economically disadvantaged people and those living in rural and remote areas being disproportionately affected by poor health.
The report analysed differences in premature mortality rates between electorates and found that men in the Lingiari electorate, which covers 95% of the Northern Territory, have the highest premature mortality rate in Australia. Men in Lingiari are 3.5 times more likely to die prematurely than men living in Bradfield, in Sydney’s inner-city area, which has the longest life expectancy of any electorate.
Premature mortality was generally 3.5 times higher in rural constituencies than in urban ones, and rates in the 10 constituencies with the highest proportion of Indigenous men were almost twice as high as those with the lowest proportion of Indigenous men.
Roshan Karunaratne believes it’s important to change the narrative so that men understand that the best way to support their loved ones is not to suffer in silence, but to actually be transparent about their health issues.
“There is strength in weakness,” he says.
