It is not exactly clear why men are deemed ‘poor consumers’ of health services, but a few possible reasons have been given by researchers:
Once appointments have been made, men tend to spend less time with health professionals. They are therefore less likely to take their time to ask enough questions and receive important and helpful advice from the health professional.
In addition to the reasons cited above for men in general, research has also found that 15% of black gay respondents and 7% of white gay respondents delayed seeking treatment because of fear of discrimination.
If we read these findings in the context of current statistics on preventable illnesses (e.g., cancer) it becomes clear that more needs to be done for and by men. The World Health Organisation says that cancer is the leading cause of death worldwide and that more than 30% of cancer deaths can be prevented if detected early.
According to the National Cancer Registry of South Africa, one in five men are affected by cancer. As such, various initiatives (see www.cansa.org.za) are taking place throughout the month of June – which is Men’s Health Month – to raise awareness about cancer among men in South Africa.
It is important that men in general become more aware of the status of their health and begin taking active control of it, irrespective of their beliefs and/or anxieties. What follows is a story to illustrate what may happen if you remain complacent about your own health.
Nick is 28 years old and works as a Financial Consultant in one of South Africa’s top financial firms. He has steadily worked his way up the corporate ladder and considers himself to be very successful in what he does. He is not in a steady relationship choosing rather to focus completely on his career without any distraction. However, he will occasionally hook up with guys that he meets at a club or online for a bit of what he calls “R&R”. He generally considers these encounters to be safe.
At the beginning of 2007, Nick noticed some itching and burning around his anus. He interpreted this as a possible sign of piles developing as he was also very constipated at the time. Although slightly uncomfortable, he chose to ignore it, preferring rather to focus on his enormous work load. Over the course of the next three weeks the itching and burning sensation became more intense.
Still thinking it was piles irritating him, he eventually decided to go to his local pharmacy rather than see his doctor as this appeared too minor and was rather embarrassing for him. He purchased some over the counter medication and began applying it to the sensitive area. The ointment eased his discomfort somewhat but it didn’t last for very long.
Nick suffered in silence over the next month before he finally plucked up the courage to discuss his ‘condition’ with his best friend Jason. Jason responded with a joke or two but then noting his friend’s discomfort and pain urged him to go to his doctor to have it checked out. Nick put it off for another two weeks, trying to work up the courage to make an appointment to see his doctor. The day of his appointment arrived and Nick was sick to his stomach with anxiety and embarrassment.
Nick burst into tears. “I can’t deal with this now” he thought to himself between the sobs
Once, in his doctor’s office he started with some small chat and then when the anxiety became too unbearable he blurted out, “It’s my backside doc, it hurts like hell!’ The doctor asked him a few questions and then requested that he undress so that he could examine him more closely. Nick responded mechanically and dropped his pants and bent over the edge of the bed. With beads of sweat dripping down his face he wondered whether the doctor was mocking him from behind. The doctor examined his anal area and then asked Nick to get dressed. Nick was relieved that the worst was over.
Once seated again at the doctor’s desk Nick is told that he has anal warts. Nick felt slightly embarrassed about the ‘nuisance’ and hoped silently that his doctor wouldn’t ask him any awkward questions about his sexual practices. The doctor then went on to inform him that anal warts are caused by the Human Papilloma Virus. If left untreated, they can cause cellular changes in the affected area. “What does that mean?” he heard himself utter. The doctor explained that if left untreated the virus could lead to anal cancer.
Nick couldn’t believe what he was hearing! The situation just kept getting worse. The doctor then went on to inform him that gay and bisexual men are 17 times more likely to develop anal cancer than heterosexual. It occurs more frequently among men who are HIV positive than men who are not. Nick sat there still trying to process the words ‘anal cancer’. The doctor went on to tell him that various treatments exist depending on the location, size and quantity of the warts.
These treatment options include burning, freezing or surgically removing the warts. In Nick’s case a number of warts were located around the anus and within the anal canal. As such, he recommended surgery with follow-up treatment at a later stage, as the warts tend to re-appear.
Nick felt completely distraught at this point and felt a strong desire to escape the confines of his doctor’s office. Once back in his car, Nick burst into tears. “I can’t deal with this now” he thought to himself between the sobs. Nick returned to his office that day and through himself back work. The thought of undergoing the treatment and telling his friends and family was unbearable.
An immediate solution was to delay treatment until he could figure this all out. A few weeks later Nick mustered up the courage to schedule the surgery. Nick then shared this with his best friend and underwent the surgery. After the surgery Nick experienced considerable pain and discomfort especially when he sat for long periods of time or when he had a bowel movement. Nick eventually recovered and decided to put the entire nasty experience behind him.
The following year the itching and burning returned. He remembered the pain following surgery and could not bear the thought to go through the whole process again. He decided to soldier on despite the discomfort. Eventually in March 2009