A 'tache of reality

With Rocktober behind us and the eleventh month of the eleventh year under way, it is possible that you will come across a previously clean-shaven gentleman over the next 30 days suddenly possessing a fine display of top-lip topiary. If so, do not be alarmed.

While this could simply be a mid-life crisis taking an alarming direction or - on the basis that fashion is cyclical, and the Freddie Mercury full-on hedge approach will come back sooner or later - he has just adopted the 'in' look, it is more likely that the newly-moustachioed bloke before you is embracing Movember.

This is the admirable charity initiative designed to raise awareness and money to combat various men's heath conditions, in particular prostate cancer. To support it men (a fairly exclusive requirement) must register - by today - at Movember.com, commencing the month with a hairless visage and then do nothing other than maintain their facial garden for the remainder of the month while coining in donations for the effort.

I, alas, will not be joining them, as my attempts at selective facial hair design have been deliberately limited to either the full holiday beard or the David Brent-style goatee on the grounds that a moustache really does look absolutely ludicrous on me and would probably do more harm than good to the charity. Instead, please sponsor my game-for-a-laugh nephew James who, now he's reached shaving age (senile fool - what am I saying, he's 24 and married), is plunging in with great gusto - http://mobro.co/jamespoulter/d.

Cancer, as frequent flyers of this low-cost airline of mine will recall it mentioning in April, comes in some 200 varieties. Some aggressive, a few inevitably fatal, but with all sufferers benefitting from the earliest detection to increase the odds of prolonging life or, at least, improving or maintaining the quality of it.

Prostate cancer is the most common of all cancers men succumb to. In the UK alone, 40,000 men are diagnosed with it every single year. One man dies of it in the UK every hour and 250,000 British men are currently living with it. It is thought that half of all men might have the first symptoms of prostate cancer by the age of 50, and that by the age of 80, that figure has risen to 80%. It is, though treatable, but as my 82-year-old father - who has it - will testify, the treatment has some unpleasant side effects.

Doctors are currently engaged in a discussion as to whether the main means of prostate cancer detection - measurement of the prostate-specific antigen (PSA) protein - is as beneficial as it intended to be. PSA testing is a catch-all to identify any problem with the prostate gland, from infection to cancer. Two-thirds of men with a raised PSA will not have cancer...but there is a one in six chance that a man with a normal PSA reading will have the disease. That said, PSA testing can also help detect milder cancers that wouldn't have been found otherwise. However, some medical experts have questioned whether submitting men with even mild symptoms of other cancers to a range of treatments that might lead to permanent side effects such as incontinence or impotence is worth it, especially in younger patients to whom quality of life can be seriously impaired by such side effects.

The PSA test is not flawless, either: while it might pick up relatively harmless slow-growth tumors it might not be of any help to any man whose cancer is already advanced and aggressive. A raised PSA level might also be a symptom of something else, non-cancerous, but will lead to all manner of distress in men who receive a high PSA result for benign reasons, or even undergo a biopsy when often as few as 25% of men with an elevated PSA level actually have cancer in their prostate.

While the debate continues, any man over the age of 50, who either has a father or brother already with prostate cancer, or who is having to get up in the middle of the night more often than normal to take a leak, would do themselves an enormous favour and get themselves checked out properly.

We men are not at our proudest when discussing issues in or around the gentleman's area, but with the odds of getting prostate cancer so high, is the loss of pride really worth the risk? I don't think so.