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What Symptoms?

Simeon de la Torre looks at the trouble with men and medicine

What Symptoms?

As an RAF airman of 15 years, Sy Glendenning, 34, had lived at close quarters with danger, surviving tours in both Iraq and Afghanistan and returning home safely. But it was a mole on his neck — little more than a seemingly harmless blemish — that would pose the greatest threat to his health and his life.

In October 2010, the mole had changed. It had grown from a mere freckle into something much more deadly, and the cancer that was creeping out through Glendenning’s skin might have gone untreated had he not been persuaded to get medical attention. “When I got back from Afghanistan, my girlfriend thought the mole was getting bigger and started telling me to go to the doctor,” he explains. Yet despite her efforts at persuading him to see a GP, he kept putting it off. “I just kept telling her to stop nagging, and that I’d go when I had a chance.”

It was three months before Glendenning finally got round to making the appointment. And following a swift referral and routine procedure to remove the mole, the shocking results of his biopsy were delivered. “They sat me down and explained what they’d found. I couldn’t believe it when they said that it was a malignant melanoma.”

The mortal threat of the spreading disease saw him go under the knife again soon after. “They explained the next steps, and I had further surgery to remove the skin and tissue surrounding the melanoma, which has left me with a 4in scar down my neck,” he says. “But, thankfully, it stopped the spread.”

DOCTOR PHOBIA

Glendenning’s tale is not an uncommon one among men, and it appears that our lackadaisical attitude to our own health is putting us at risk. It is well known that men die, on average, younger than women, yet a 2011 EU report says that under the age of 65, we are twice as likely to die as our female counterparts, and three times more likely between the ages of 20 and 24 according to the Department Of Health.

Of course, there are biological reasons for this. Testosterone makes us more prone to risk-taking, particularly in our younger years, and we are genetically far more susceptible to heart disease — the biggest killer of men in the UK. And when it comes to cancer, we continue to lose out to the fairer sex. A report published in 2009 by the National Cancer Intelligence Network (NCIN) and Cancer Research UK revealed that men are 40 per cent more likely to die of cancer than women, and 16 per cent more likely to develop the disease in the first place. And yet, in the face of such chilling odds, we remain rigidly unwilling to visit our GP when stricken with serious symptoms.

“Culturally, men are more reluctant to go to the doctor,” explains Dr Rupert Gabriel of Snowberry Lane Clinic, Wiltshire. “It’s as if men stick to the gender stereotypes about asking for directions when they’re lost — I guess men see it as a sign of weakness.” However, it’s not just a case of gender typecasting that keeps us from getting checked out: our reluctance may be down to a lack of experience. “Men are just not used to going to the doctor. Women have a history of coming in regularly from their late teens, through pregnancy, and because of other common screening procedures. Visiting the doctor is a part of life for them,” Dr Gabriel explains.

We’re a reluctant bunch when it comes to a trip to the GP — a trait which, given the importance of early diagnosis in common diseases such as cancer, is alarming. “The fact is that when cancer is diagnosed at an early stage, more people survive,” explains Jessica Harris, senior health information officer for Cancer Research. “If you delay for months, there is a chance that your outcome might not be as positive, so the overriding message is to request advice as soon as possible. Get to know your body, and seek help if something seems at all different.”

All good advice indeed, but there’s still that ‘seeking help’ sticking point…

MISGUIDED MACHISMO

Pierre Cachia, a counselling psychologist and psychotherapist, believes the problem stems from our idea of what it is to be a man, and a sense of self that goes back to childhood: “It’s almost as if being tough and mischievous is what ‘makes’ a boy. And of course, this stands in the way of being vulnerable and taking care of yourself in later life.

Cachia believes that the problem is ‘life-span related’: “In our 20s, 30s and 40s, we are making huge efforts to progress and achieve in our lives. Admitting to yourself that there is the possibility of a health problem impacts upon your dreams and plans. It also impacts upon your children’s welfare, and your lifestyle. This is not an irrational fear — it is entirely rational.

“If you accept that you are unwell, you move away from an identity of being an achiever and a performer; a tough and competitive man who is a doer. And if your body lets you down, let’s face it, sometimes you might not recover. So if you have constructed an identity around achievement and performance, what are you left with?”

Cachia’s prognosis is discomforting, but not nearly as horrendous as the alternative. Putting your health on the backburner may keep everyday life ticking along nicely, but if it ends in disaster, no one will thank you for it.

For some men, it isn’t until they’ve had a brush with their mortality that they come round to the idea of keeping on top of their health. Glendenning, for one, is now more self-aware. “I’m far more conscious of the danger signs than I used to be,” he says. “I’m classed as ‘high risk’ now. I’m considered more susceptible to skin cancer, so I check myself all the time.”

Encouragingly, we’re not all reluctant to seek help. For 34-year-old Rob Waite, finding a lump on one of his testicles was all the motivation he needed: “I was in the shower one Saturday night when I discovered it — although I have absolutely no idea how long it had been there.” He acted immediately, and was in the doctor’s surgery on Monday morning. By Thursday, he found himself in the BMI Chaucer Hospital in Canterbury, where the surgeons were forced to remove one of his testicles.

It’s a sobering — all right, frankly terrifying — account, but Waite’s acceptance and quick action is almost certainly what makes him a cancer survivor, rather than another worrying male statistic. “Am I glad that I went to the doctor as soon as I did? Definitely,” he says. “I needed chemotherapy, but three years later I was given the all clear. There’s no need to be embarrassed; no need to think twice about it. Just go and get yourself checked out.”

To find out more about skin cancer, visit Cancer Research UK’s SunSmart website, sunsmart.org.uk; snowberrylane.co.uk; surreypsychotherapy.org.uk