Men's health is not all balls

A survey reported this week showing that more young British men checked their balls for cancer than men from any other country in Europe had health campaigners patting themselves on the back. Malehealth editor Jim Pollard isn't so sure.  

Wow. Top of the league.  An impressive 36% of British men said they carried out testicular self-examinations (TSE) compared to European average of 18%.

We're used to our teenage lads being at the bottom— drunk more often, getting their girlfriends up the duff more often, taking drugs and fighting more often etc. But at last, British men are behaving healthily.

Maybe — the only problem is I don't believe a word of it. The survey involved students. Now, if there's one thing that students are good at it, it's giving the answers they think the people asking the questions want to hear. Are 1 in 3 British students really checking their balls regularly? I doubt it. But they've got the message that they should be so they say that they are.

Getting that message over is a tribute to the Men's Health Forum (MHF), who run malehealth, and, more particularly, to initiatives such as the Know Your Balls schools-based campaign and video from the Orchid Cancer Appeal founded by Colin Osborne who had testicular cancer himself.

It's a success for health awareness-raising but is it really changing behaviour?

That's difficult to know short of putting a CCTV in every bathroom and bedroom in the country but I know what I think.

There is another potential problem with successful health awareness raising. Professor Michael Baum wonders if, given that testicular cancer is relatively rare, TSE is more trouble than it's worth because it makes men worried and usually for nothing. Hackney GP Mike Fitzpatrick goes even further and reckons that ALL health awareness is bad for your health.

Now, I can't go that far. Would you want to be one of Dr Mike's patients?

You: OK so I've got piles, what's that?

Dr Mike: It's better that you don't know.

You: And what do these drugs do?

Dr Mike: I'm sorry I can't tell you.

I know you worked hard for your medical degree, Mike but you could share a little. Still at least it must be pretty easy to get an appointment at his practice.

I recently debated the benefits or otherwise of men's health campaigning with the two Mikes and sociologist Dana Rosenfeld. There's more about the debate and the chance to read the views of Fitzpatrick and Rosenfeld on MHF website. I think that in making a good point — that worrying about our health all the time or becoming obsessed with it causes anxiety which will make us ill — Mike Fitzpatrick goes so far as to be ridiculous. A little scary in a doctor, really. Perhaps, he simply can't quite conceive of his patients as adults although to be fair, he's not the first doctor to make that assumption.

The sad death from a different form of cancer of BBC Radio 4's Nick Clarke last month at the age of just 58 shows that raising awareness without changing behaviour is not a lot of use.

Shortly before he died and already having lost a leg as well as both parents to the disease, he wrote a piece in Good Housekeeping magazine headlined 'Why Didn't I Go To The Doctor?' He concluded: 'For me, the big unanswered — and unanswerable — question is how much difference an earlier diagnosis would have made. Would I still have a left leg? Not even my excellent doctors are able to tell me. But I think it's fair to say that it might have been worth trying to find out.' That conclusion is all the more poignant today. (There's a PDF of Nick Clarke's article here.)

Dr Ian Banks, the president of the MHF, puts his finger on the real dilemma for health campaigners when he says of the TSE findings: 'there is a danger with highly effective campaigns on any medical condition that it might skew men's perception of risk. Most men for instance, place a higher fatality risk from testicular cancer than from suicide despite overwhelming evidence to the contrary.'

So why has testicular cancer awareness been such a highly-effective campaign?

It's certainly not a major killer of men (like heart disease), nor the major cancer killer of men (that's lung cancer), nor even the major killer of the male-only cancers (that's prostate cancer).

Its success is down to the media. Fiddling with your balls has been the breast cancer of men's health. That is to say, a media health fad that has attracted attention out of proportion to the real risk because the media like it. In the case of breast cancer it's the opportunity to talk about tits and show pictures of them; in the case of testicular cancer, it's a laugh, innit, with lads like Jonathan Ross and Chris Evans queueing up to put their hands down their pants. No coincidence that boobs and balls are both sexy.

Now, don't get me wrong. I'm not knocking this. Men's health campaigners aren't daft. Talking about balls was a great tactic to get the sort of media coverage needed to put men's health on the agenda as a separate subject from women's health. It has worked. It is on the agenda — the political one too.

Now we need to get the media, politicians and men in general talking about the health problems that hit the majority of men. And that's a little tougher.

Suicide, as Ian Banks says, is a major killer of young men Three young men kill themselves every day in Britain. But it's very hard to get that on the news agenda. The Manchester-based organisation CALM managed it recently but only by creating a media furore by producing a suicide-awareness raising ad that exploited the 7 July suicide bombings.

But why are men so unhappy? And what should we both as health campaigners and men do about it? A balanced discussion is next to impossible.

For me, perhaps the key issue highlighted in last year's Men's Health Week was that we are richer than ever before yet unhappier than ever before.

Fifty years ago half of us said we were 'very happy'. Now it's only 1 in 3 yet average incomes have doubled. Solve that conundrum and you will make a lot of men — and women — a lot healthier. Pressurising our politicians to do just that should now be a major priority for the MHF. Men's health is not all balls.

What do you think? The MHF will be shortly asking malehealth readers to help it identify its priorities for the future. Let us know what you think.