Archive for March, 2014

by Owen Sharp – Chief Executive, Prostate Cancer UK

For many working in public health, March is all about prostate cancer.

Since we launched the first ever prostate cancer awareness month back in 2009, we’ve certainly made an impact, but one thing we’ve realised is that one month a year just isn’t enough to highlight the huge impact of prostate cancer in the UK.

Prostate cancer is the most common cancer in men in the UK and predicted to be the most common cancer overall by 2030 . The disease kills over 10,000 men each year , putting it firmly in the top 10 causes of male death in the UK .

But it’s also a disease with no one-size-fits-all health message. There’s no test good enough for a national screening programme, no hard and fast symptoms – and often no symptoms at all. And it’s a cancer which targets a group who can be notoriously neglectful of their own health – men.

On top of that, research into prostate cancer is badly underfunded leaving tests and treatments trailing behind other common cancers. And the quality and availability of treatment and care can vary depending on where men live.

So this year, we’ve taken a different approach to getting prostate cancer on everyone’s agenda. Instead of 31 days of activity, we’re going to be campaigning 365 days of the year.

Men United v Prostate Cancer, which launched in January with Bill Bailey fronting our advertising, is our ongoing campaign to build a movement for men to unite against prostate cancer, raise awareness and funds, support each other, campaign for change – and make a real difference to men’s health in the UK.

If you work in public health, you’re probably already aware of some of the complexities around diagnosing and treating prostate cancer.

Prostate cancer can grow slowly or very quickly. Most prostate cancer is slow-growing to start with and may never cause any problems or symptoms in a man’s lifetime. However, some men will have cancer that is more aggressive or ‘high risk’, which needs treatment to help prevent or delay it spreading outside the prostate gland.

It’s these men that we need to reach. But, at the moment, there’s no reliable way of differentiating between slow-growing or more aggressive disease. Prostate cancer is diagnosed by a combination of PSA testing, physical examination of the prostate and prostate biopsy. Yet none of these techniques can conclusively tell whether a tumour is aggressive in its early stages, when it’s still confined to the prostate.

This means that newly diagnosed men can be faced with a tough decision – to have radical treatment and risk long-term, potentially debilitating side effects, like incontinence and erectile dysfunction, when the tumour might never affect life-expectancy or cause symptoms. Or, to have their cancer monitored and run the risk that the tumour might spread without warning.

Two of the main aims of our research strategy aim to tackle this.

On the one hand, we’re funding research into detecting men who are at high risk of developing aggressive prostate cancer, potentially enabling men to be closely monitored, giving a better chance of diagnosing aggressive cancer at an early stage when treatment is more likely to be successful.

And at the same time, our researchers are looking at how to differentiate between slow-growing and aggressive disease, so that men can choose the treatment paths that are right for them. By funding this kind of prostate cancer research we’re playing the long-game, working to create a better future for men with prostate cancer. But what about the men who are at risk now? Men United v Prostate Cancer aims to get men talking and engaging with their own health.

Although current testing for prostate cancer isn’t perfect, we want men over 50 to go to their GP if they have any health concerns at all – whether about their risk of prostate cancer or if they are worried about any symptoms.

But we know that men are much less likely to go to their GP than women and that issues around masculinity and embarrassment can be a barrier to men addressing any health concerns or worrying symptoms until it’s too late.

Joining Men United is a conversation-starter. Anyone joining takes a short prostate cancer awareness test which they can then share with their friends and family via email or social media. Over 150,000 people have taken the test so far, smashing our original target of 15,000.

We can’t force health information down men’s throats but we can get them to start thinking and talking about it.

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  • by Baroness Kinnock of Holyhead

This article was originally published in the December 2013 issue of Public Health Today, FPH’s members’ magazine. It is reproduced here to mark World Water Day tomorrow, 22 March 2014.

When, in 2007, readers of the British Medical Journal were polled to discover what they believed to be the greatest medical advance since 1840, many people were surprised that they chose ‘sanitation’.

They shouldn’t have been. History emphatically demonstrates that clean water, functioning sewers and public hygiene are basic to health and wellbeing. That truth is plain – but may be so simple that it invites complacency.

In 1854, when Dr John Snow recognised the connection between a communal hand pump on Broad Street in Soho and a raging cholera epidemic, he isolated the pump, saved countless lives, helped to found the new science of epidemiology and swept aside the previous conventions that attributed cholera and several other diseases to ‘foul air’. The implications of this breakthrough seized the whole of society. The rich and powerful were almost as grievously affected by filth-generated disease as slum dwellers.

In addition, the economic benefits of protecting the workforce against a mass killer like cholera were evident even to those usually reluctant to support improvements in living conditions. Public investment in sewers, water filtration and chlorination became prodigious and rapid. Victorian civic modernisers, engineers and entrepreneurs laid a sewerage system through most of urbanised Britain, much of which is still in use today.

Progress on a proportionately huge scale and at rapid pace is needed now in large parts of the world. For at least 2.6 billion people in the ‘developing’ world lack of sanitation is the prime cause of ill-health and premature death, especially among under-fives.Great improvements have been secured since the 1980s when cholera killed an estimated three million people a year globally – but the annual mortality level is still around 100,000.

Incompetence or malice can have devastating effects. In Zimbabwe, Mugabe’s government took funds away from water treatment plants and refused replacement international aid until the cholera crisis became acute. In South Africa, privatisation of water programmes resulted in disease for the poor who couldn’t afford clean water, but not for the relatively prosperous who could.

The economic and social penalties of bad or non-existent sanitation are monstrous and the advantages of good sanitation huge. The World Bank has calculated that for every £1 spent on sanitation, £3 is returned in increased productivity. The association between cleanliness and Godliness is not proven. The link between hygiene and efficiency is.

However, the compelling evidence for the multiple benefits of good sanitation is still not enough to attract the high priority it deserves. Lack of money, pressure to pursue other objectives, packed and expanding cities, industrialisation and desperate water shortages all impede improvement. But these challenges must not be allowed to stall progress.

Let those who decide policies and funding make just one visit to a place where a two-year old girl is dying in agony and exhaustion from diarrhoea that could have been prevented if her district had access to clean water and a safe means of disposing of sewage. I have seen too much of such avoidable tragedy. It’s why I plead for more reporting, recognition and determination to cure this scourge by stopping its cause.

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