IN THE battle of the sexes women are traditionally considered the losers when it comes to housework, salaries and childcare (and plenty more besides). But healthwise it's the boys who are the walking wounded.
This comes after a recent study by Cancer Research UK, which found that men were 16 per cent more likely to contract the disease than women and 40 per cent more likely to die from it. Worse, when taking the cancers that affect both sexes into conside
ration, men were 60 per cent more likely to get them and 70 per cent more likely to die from them.
Gullet cancer had the worst prognosis, with men a massive 168 per cent more likely to die from it than women. Then it was stomach cancer (132 per cent), liver cancer (99 per cent), bowel cancer (56 per cent) and skin cancer (46 per cent). Which rather puts all that fuss about man flu in perspective.
There is no known biological reason for these startling results, but at least part of the explanation must be down to the fact that men are traditionally so reluctant to consult their GP. "Looking at my list for this afternoon, 80 per cent of the names on it are female," says Dr Ken Lawton, chairman of the Royal College of GPs in Scotland and a practice GP in Aberdeen. "So it's women who are accessing the care.
"Men tend not to consult the doctor unless it's something serious or if it's something that is preventing them doing their work or undertaking their pastimes. They will tend to ignore worrying things like blood in their bowel motions or weight-loss and very often come to the doctor too late."
He adds, "I had a very good friend who had a lump in his testicle but ignored it for a good few months, and by the time he got himself down to the surgery it was too late. Things can escalate in a matter of a few months, going from something that is treatable to something that is not treatable very rapidly."
The reason for this steadfast refusal to seek medical advice is two-fold, says Lawton. "One side of the story is that women, by the very nature of their services for things like contraception, for childcare and for antenatal care, are used to using the doctor. And when children come to the doctor it tends to be mothers who bring them, so they are more comfortable in the surgery environment. But also they have a level of screening built into those programmes – cervical screening and breast cancer screening for women over 50.
"Men, on the other hand, very often have a fear of what it might be. 'I have a lump. Is it cancer? If I don't go, I won't find out, and so it won't be cancer.' There's the thought that until you have had the diagnosis it's not something nasty. It's a funny sort of nihilism."
"There are a few subtle signs for men to watch out for, and if we get them soon enough in the surgery we can get the investigations put in place," he says. "The health service targets mean people will be seen within a couple of weeks of attending a doctor, so treatment can be received at a very early stage, which increases the chance of survival."
Former Scotland footballer and Celtic legend Tommy Burns died last year after a three-year battle with cancer. At the time of his diagnosis with melanoma, he said, "I think men are careless about their bodies. If they notice anything a little out of the ordinary they tend to brush it to one side. But after my experience I would urge anyone who notices the smallest skin change to get it checked."
"We do have one of the worst cancer survival rates in Europe," says Lawton. "A lot of that is not due to the lack of technology, it's the fact that people are presenting too late."
And it's worse in socially deprived areas, where men are even less likely to access healthcare. But he admits there is more surgeries can do to make their services accessible. "If they're working, men may find they can't get to the doctor, so a lot of surgeries now have extended opening hours to meet that need.
"There's also a place for more health education; making men aware of the early symptoms of things like testicular cancer and prostate cancer, and saying to them that if they're at all worried they should be seeing their doctor, sooner rather than later," says Lawton.
One of the problems with cancer is that it can start manifesting itself in such an insidious way that often the symptoms aren't obvious until it has progressed too far. "What I say to patients is, 'I'd rather see you now and say that this isn't something to worry about than see you six months down the line, when it's very obvious what it is, and then have to be looking at what was probably previously a survivable cancer no longer being survivable.'"
Men are also less likely to look for help with psychological problems. "There is this macho culture where men think, 'I'm a bit down, but it's not depression.' That can lead to alcohol abuse, which only makes the depression worse, and it can be a downward spiral from there."
The answer, he says, is to encourage people to use their doctors as a source of information and reassurance, rather than being somewhere you go when you are already sick. "That's what we're there for," says Lawton.
"A lot of medicine is about preventing ill health as well as helping people who are ill."
For health advice or to find a local GP, log on to www.nhs.uk
Symptoms to look for
l passing blood in your urine or bowel movements
l a cough not going away if you're a smoker
l weight-loss
l persistent indigestion that doesn't go away with traditional antacids
l persistent difficulty in swallowing
l unexplained pain
The full article contains 1039 words and appears in Scotland On Sunday newspaper.
