How Movember puts their money where the mo is

Around 17,000 Australian men receive a diagnosis which could be deadly. Here's what's being done about it.

It was delivered, as a cancer diagnosis often is, as an unexpected, devastating blow.

A blood test Greg Bright took as standard procedure before his knee replacement surgery revealed elevated Prostate Specific Antigen (PSA) levels, a key indicator of prostate cancer. A biopsy confirmed the diagnosis.  "Being told you have any sort of cancer is scary. Your first thoughts are that you are possibly going to die soon," Mr Bright says.

Prostate cancer is the most commonly diagnosed cancer in Australian men. When detected early, survival rates are better than 98 per cent. But find it late, and those survival rates drop below 26 per cent.

Mr Bright was faced with the dilemma some 17,000 Australian men work through every year. If the cancer is slow growing, radical treatment or surgery isn't required for all situations. In a lot of cases, men opt to just keep an eye on the progress with their specialist over time. The prostate gland is nestled cozily between the bladder and the penis which can make treating prostate cancer a tricky business. In cases where surgery is necessary, life might be very different afterwards. It can take a long time for the erectile function to return, and for some men, the ability to have sex goes away entirely.

After weighing up the different treatment options, Mr Bright opted for robotic surgery to remove the prostate.

"I didn't even know what the prostate did before. I do now. It's the little walnut-sized organ in between the rectum and the penis which regulates urination and erections. If it's not there, you have to learn how to function without it, which is manageable but annoying."

He lives a little differently these days, cancer free. Mr Bright has become an advocate for men to get tested once they hit the age of 45, as well as talking about their health more.

"I'm a firm believer in the old saying that "sunlight is the best disinfectant", meaning men should talk about it openly," he says.

Communication is at the heart of Movember's revolutionary TrueNTH program, an initiative built around the goal of halving the number of men dying from the disease by 2030. As well as funding research to try and find a cure, TrueNTH is dedicated to improving the lives of men who've been diagnosed with prostate cancer.

The program brings together clinicians and researchers to help support and empower men to make informed decisions on their treatment plan, through to how to manage incontinence and sexual dysfunction; and how to eat well and exercise effectively.

"In essence, TrueNTH is part telehealth service." Dave Hughes, TrueNTH care coordinator, says. "The idea is we can access people through their phone wherever they live in Australia, to help them through their prostate cancer journey, no matter what point that is."

Crucially, the service reaches blokes living in rural areas who might not have access to specialists and medical facilities like their city neighbours. Statistically speaking, those living in rural areas are 24 per cent more likely to be diagnosed when the disease has already spread and are therefore more than 30 per cent more likely to die from their cancer. And if cancer is detected, the grim reality is they are less likely to undertake radical prostatectomies to remove prostate cancer.

Why? Tragically, it all comes down to geography, time and expense.

"There's no alternative way for a guy to go from Broken Hill to Sydney other than to pay about $600 each way on a plane. Then they've got to find accommodation and catch taxis while they're there. And they have to make the trip back there two or three times. It doesn't take long before thousands and thousands of dollars are raked up," Mr Hughes says.

Often, TrueNTH connects with men in the wake of a recent diagnosis. The team of clinicians plug the gaps where the health system cannot provide support.

"They have no idea what's going on. They've been told they have cancer, so it's an incredibly frightening, confusing time in their lives," Mr Hughes says.

"We can come in and explain everything the guys and their partners need to know about their prostate, their cancer, their therapies, their options, the costs, the good, the bad, the ugly... their sexual stuff, their incontinence; we can talk about all these issues with these men and their partners."

More than just support, the TrueNTH team can expedite a treatment plan for those living in rural regions by working remotely with doctors. Post surgery, the program provides critical support in helping manage sexual dysfunction, a significant source of unhappiness and stress for men who've survived prostate cancer. Particularly within their first year of recovery, men are most vulnerable to mental health challenges, and in some cases, suicide.

The health inequality between country and city blokes is not new news. It's been talked about for years.

"It's free, and they get all the service they want in the privacy of their own homes," Mr Hughes says.  "And these guys are really happy Vegemites. Whenever you ring them up, it's always the same, 'Ah Dave, mate, thanks for ringing! I knew you'd call.' We keep in constant contact with guys and their partners for a number of years to make sure that everything goes right. If cancer does come back, we help them through it to the best of our abilities."

Cancer is one of the world's thorniest health issues, and prostate cancer is a controversial topic. The different opinions on the diagnosis, treatment and management of the disease are more divergent than ever before. Sometimes active surveillance is all that is needed. Other times, surgery is critical to surviving. There are no easy answers. While treatment options can be confusing, the difference between early detection and late detection can be life and death.

The problem is many men just "deal with it", rather than seeking help when needed.

The Movember Foundation funds more than 1200 men's health projects, and TrueNTH receives the largest single investment worldwide in prostate cancer care and services. As an estimated 300,000 people around the world participate in Movember, Mr Hughes says their facial hair helps fund critical support for men grappling with a diagnosis and provides them with access to the right services at the right times.