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Men need educating about prostate cancer, SCMP poll shows

One of the most frightening things about prostate cancer is the lack of awareness of the disease, says Jeanette Wang

Prostate cancer awareness campaigns often focus on early detection through identification of symptoms and screening, but results from a recent survey of local men conducted by have shown perhaps a basic biology lesson is first in order.

Nearly 30 per cent of the 100 men polled earlier this month thought that prostate cancer affects both men and women. This shows a frighteningly low level of awareness for a disease that is growing at the fastest rate among all cancers affecting Hong Kong men.

Prostate cancer is a disease that forms in the tissues of the prostate, a walnut-sized gland in the male reproductive system. According to the latest Health Department statistics, it's the third most common cancer among Hong Kong men, affecting 45.2 per 100,000 people in 2009. In 1999, the rate was 18.3 per 100,000 people. Experts believe the rising incidence may be due to a Westernised diet, an ageing population and improved diagnostic techniques.

So women are obviously spared - but this is not the only fact that many respondents to 's true-or-false quiz got wrong.

More than 80 per cent underestimated the extent of the disease, answering "true" to the statement: "About one in 30 men will be diagnosed with prostate cancer during his lifetime."

In reality, according to the American Cancer Society, prostate cancer will affect one in six men in their lifetime - but only one in 34 will die of it, as most prostate cancers are slow-growing.

About one in three people did not know that the most important risk factor for prostate cancer is ageing - prostate cancer is rarely found in men below the age of 50. The Health Department notes that other risk factors include family history of prostate cancer, and physical inactivity, though the causes of prostate cancer are not yet fully understood.

Another one in three people did not know that prostate cancer symptoms begin with urination troubles, such as difficulty in urination, pain during urination and frequent urination. Other symptoms include stiffness in the lower back, hips or upper thighs. That said, these symptoms are usually caused by advanced prostate cancer. The disease in its early stages may not cause symptoms at all.

The survey was done to ascertain the level of knowledge of prostate cancer among Hong Kong men ahead of Movember - or "the month formerly known as November", when men sprout moustaches to raise funds and awareness for prostate cancer.

Fifty-five of the 100 respondents were enlisted through e-mails to friends, friends of friends, and colleagues, and the rest through a street survey over a weekday lunchtime in Central.

The respondents, all men, were aged from 18 to 63, with an average age of 35.8 years. About two in five were Asians - mostly Chinese. Occupations ranged from students to sportsmen, administrative staff to professionals in the fields of finance, education, aviation, engineering, property, media and marketing. Only five of the 100 respondents answered all seven quiz questions correctly. More than 20 per cent got three or fewer correct - meaning they "failed" the quiz. Clearly, more education is needed on prostate cancer.

With Movember launching officially in Hong Kong this year, hopefully there will be more conversations about the disease. After all, that's a goal of the annual campaign that first began in Melbourne, Australia, in 2003 as a joke among some friends to bring the moustache back in fashion.

"The moustache has been really powerful in getting guys to talk about their health," says Greg Rafferty, 36, manager for Movember Asia. "Guys the world over don't engage with their health as well as they should, and I think Movember has given them a platform to start those kind of conversations."

In the first year of Movember, 30 "Mo Bros" participated, raising no money. The following year, the moustaches were grown in aid of the Prostate Cancer Foundation of Australia - 450 participants raised A$54,000. Last year, more than 854,000 people worldwide raised a total of A$124 million (HK$997 million) for charities in 14 official campaign countries, and also for Movember's global prostate cancer research programme.

According to the Movember Foundation, the not-for-profit Australian-based organisation behind the campaign, Movember has had "a significant impact on [the] health-related behaviour of its participants." Research shows that 71 per cent of participants talked about men's health, 84 per cent convinced others to take action, and one in five participants went to see a doctor specifically because of Movember.

's survey showed that only about 30 per cent of the respondents have annual health check-ups. An annual physical exam can not only help identify health problems you may not be aware of, but also address known medical issues and help build up a good relationship with a doctor. That way, when problems arise, the right care can be given.

Hong Kong is one of seven new countries to join Movember this year and, along with Singapore, marks the campaign's first official foray into Asia. It's a timely move: while the incidence of prostate cancer remains much lower in Asian nations - specifically China, Japan, South Korea and Singapore - than in North America, there is a clear trend of increasing incidence in these four countries, according to a study by the US Department of Defence's Centre for Prostate Disease Research.

The study, published earlier this year in the , noted that when prostate cancer is detected in many Asian nations, it is typically due to the onset of symptoms and at an advanced stage. And this relatively high rate of advanced prostate cancer detection has been blamed on the lack of a mass screening effort.

With the UN predicting a population of six billion in Asia by 2050, and with life expectancy rising, the number of prostate cancer cases is likely to continue rising in Asia. Rafferty says Movember might make its presence official in the mainland in two years' time, and possibly India, too.

An official campaign means that funds raised will go towards prostate cancer initiatives in that country, benefiting the local community. In previous years, Movember was unofficially in Hong Kong with an estimated 500 participants, mostly expats. Funds raised went to these expats' home countries.

This year, 35 per cent of all money raised by local participants will go to the Hong Kong Cancer Fund to support its patient care services. The remainder will fund research by a local scientist, who will be part of Movember Foundation's global collaborative research programme. But Rafferty says the No1 aim of Movember is still to raise awareness for men's health - the money is secondary.

"People are more inclined to donate and fund-raise the more people engage in the campaign and the more we can demonstrate the outcomes we're achieving through the funds. It's not something we push or particularly worry about. We know that it will happen," he says.

Interested men can register at hk.movember.com Start with a clean-shaven face on November 1, and groom your moustache for the entire month. Women are encouraged to do their part, too. "Mo Sistas are a huge part of our campaign," says Rafferty. "Over 50 per cent of our donations globally have come from them."

He says women can get their partner or male friends to take part, and encourage them along the way by complimenting their moustache, "even if she has to lie a little bit".

"Often a moustache doesn't look great … so it's really a badge of honour that says 'I'm going to make a difference and take part'," says Rafferty. "Besides, a lame moustache tends to generate more conversation."

Additional reporting by Joanna Gwynne-Jones and Crystal Ha Cheuk-yu

This article appeared in the South China Morning Post print edition as: What men don't know
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