Movember

Today's post is going to be a bit of a deviation from normal. It has pretty much nothing to do with games or gaming systems in any way. There are a few numbers that have been crunched by professionals but by and large this is more of a life post than a gaming post. But the topic is pretty important so it's probably worth reading on.

Today is the 1st of November which is the start of the event known as Movember where men around the world grow moustaches for men's health in general though by and large it's known for revolving around prostate cancer in particular. I was tangentially involved in 2008 through a group at work. I grew a moustache and was in the group pictures but didn't really advertise what was going on or really look into anything at all. In other years I either already had a moustache I didn't want to get rid of or had just gotten rid of one and didn't want it back so I'd stayed away.

This year I figured I'd sign up again. I haven't been approached at work so I've just signed up on my own. I'm actually opposed to a social system which requires charities so I'm not going to encourage anyone to donate money to anyone. Instead I figured I'd go after the awareness point of view and try to actually learn some things and share the results. My idea before I actually did any research was to use this as a catalyst to actually find a doctor and get tested but as we shall see that's not actually going to happen. I should really point out that I'm not a doctor and have no medical training at all. I've done some reading on various websites found via a google search for prostate cancer and from links off of the ca.movember.com site. So don't take anything I say as a diagnosis or a recommendation for a course of action. You should seek a professional if you have a need for consultation. I'm just trying to summarize the information available on the web and try to trick some people into reading it. Lots more after the jump!




People like to start off with shocking but ultimately misleading statistics, so here goes... 80% of men who live to be 80 or older will get prostate cancer. In Canada there are more people who get prostate cancer than who get breast cancer. Prostate cancer is the most common cancer in men.

Wow! That sounds like a big deal, right? Well... It turns out not as much as you'd think. More men _get_ prostate cancer than any other type of cancer but more men _die_ from lung cancer. It turns out that a lot of men who get prostate cancer have no symptoms and it never spreads to anything else. Autopsies after they die reveal that they had prostate cancer and were living with it but it likely didn't impact their lives or deaths in any way. Some researchers now think there are different types of prostate cancer with one that is aggressive, spreads to other areas, and is a real problem and one which pretty much just loiters.

The United States Preventative Services Task Force actually recommends that men 75 years or older NOT get screened for prostate cancer. The odds are just too good that they have prostate cancer and it's not going to do anything to them. Even if they have a bad form of prostate cancer that is going to hurt them they're so old they're likely to die from something else first anyway. The side effects from surgery or chemotherapy are more likely to hurt than they are to actually save the man's life. For men younger than 75 they make no recommendation. They don't feel they have enough evidence to suggest screening will either help or hurt.

The American Urological Association does recommend screening for some men 40 or older. It's a really long document which I didn't read the whole way through but it did make pretty clear that only well-informed men should get screened. This isn't something they recommend doing willy-nilly since there are real risks with overtreating a disease that very well could be benign forever.

One of the recommended treatment options is called active surveillance which means that even if they find out that you have prostate cancer they don't do anything. They test you with regularity to make sure it doesn't get worse but by and large you pretty much just live your life the way you would have if you didn't know about the cancer except you have a 'real' reason to go back to visit the doctor.



As I said earlier I was thinking I should go get tested as more of a curiosity than for any real reason. That is no longer the case. At my age I probably don't have prostate cancer. Even if I did, I probably wouldn't do anything about it. I actually think knowing I have it would probably hurt from an emotional point of view. There is one other factor going into that decision though... I have no symptoms. This is not going to be the case for some people and they absolutely should visit a doctor. It may not even be prostate cancer but it could be something bad and you definitely want to find out what it is.


What are those symptoms? Nothing that shouldn't already make you want to go to the doctor... Blood in the urine, difficulties with urinating or getting an erection, frequent back or leg pain... Pretty much if something is going wrong in your groin area you should see a doctor.


How about prevention? Even though the odds of prostate cancer killing you are pretty low (around 3%) if there are steps you can take to lower that number then it may be worth doing, right? Well, what are the primary risk factors?

• Age (The older you are, the more likely you are to be diagnosed.)
• Race (It's unclear why but African Americans are 60% more likely to get diagnosed and have 2.5 times the odds of dying. Asian men living in Asia have a drastically lower risk with apparently an African man being 100 times as likely to die from prostate cancer as an Asian man.)
• Genetics (If your father or brothers get it at a young age your odds of also getting it at a young age go way up.)
• Location (It seems like living in China is good for your odds of getting diagnosed and living way north is bad. The theory behind the second part at least is that reduced vitamin D levels from less sun in the winter hurt you.)

Now there's not a lot you can do to change most of those. The only thing you can actually change is where you live and I don't even know that you can show causation instead of just correlation. However there are a bunch of other risk factors which they associate with getting the aggressive forms of prostate cancer and not the more benign versions:

• Smoking
• Lack of vegetables (especially broccoli family vegetables?)
• Obesity
• Being tall
• Lack of exercise
• High calcium
• Race (As above, African Americans are more at risk.)
• Genetics (Again, as above.)

Now we're talking! I don't know what being tall has to do with anything but the rest of the new stuff seems like just being healthy. Exercise, don't smoke, eat decently...

And then there are some things that sites stick down at the end as sort of 'this probably helps' things:

• Enough but not too much of many vitamins and minerals. (Vitamin D, calcium, vitamin E, selenium...) A couple sites advised being very careful to not take extra multivitamins than you actually need.
• Masturbation is good for preventing prostate cancer.
• Sex with many partners not so much. (I imagine this is a result of increased risk of contracting an STD which probably hurts.)
• Aspirin and statins (cholesterol lowerers) seem to help.
• Alcohol is neither good nor bad in and of itself but low alcohol makes folates good.
• Other prostate issues don't seem to matter either.
• Omega-3 fatty acids from fish may help.
• Red meat may hurt.
• Japanese men living in Japan have the lowest rate of prostate cancer in the world, but if a Japanese man moves to the US he seems to lose any benefit within a generation. To me this implies there's something about the diet or lifestyle that helps. Well, or the detection methods are just really bad in Japan. I don't have enough information to say.

As far as I'm concerned I feel like I know a lot more about prostate cancer from reading about it the last few days. I intend to live until I'm 83 so I'm pretty favoured to get prostate cancer at some point, but I no longer really care. It seems like chances are pretty good that it's simply not going to do anything. (The smart money is probably on bacon grease related heart attack.) As far as risk factors go my diet may be a tad suspect but it's not terrible and other than not being born in Japan I seem to be doing pretty well. I'll definitely go see a doctor if I start peeing blood but I probably would have done that anyway. Maybe I'll actually get around to exercising more too...