Tell Giselle: One in Eight Men

Out of the blue and unprovoked, someone made a comment about my weight, and proceeded to engage me in a lengthy conversation. They clearly took note I am slender, and, perhaps because they know I am nowhere near being 20 years old, may have been surprised and confused, or both, about how this was still possible.

I have said, half-jokingly, that if I had a nickel for every time I was asked “How do you stay so thin”? I could have retired years ago. At 66, for all intents and purposes, I am now retired, especially from all types of work that demand I show up and follow orders, other than my own.

But I am not like a great number of retirees or any of the currently employed, who are dealing with a weight concern. That is because years ago I took seriously the statistics, quite similar to that of this column’s headlines: One in eight men.

According to the American Cancer Society, one in eight men will be diagnosed with prostate cancer in their lifetime.

As I am a woman, and not a man, I took the stats about breast cancer and women just as seriously. It started when I was a teen, in the ’70s. I heard sobering facts that forever onward altered the course of my relationship to food, drink and exercise.

Statistics like “about one in a handful of women will be diagnosed with breast cancer” were enough to get my attention. I vowed then, to my teenage self, I would try to minimize my risks of getting any kind of cancer.

With time many stats have changed, but from my perspective, not for the better: About one in three of all new female cancers is of the breast, skin cancers are more common than breast cancer, and lung cancer takes more women’s lives than breast cancer.

So, what does my slenderness have to do with men and prostate cancer, which is the second most frequently diagnosed cancer in men in the world? Before I answer that, let me digress for a moment.

I have been troubled by the recent media coverage about prostate cancer treatments. The big takeaway concerns a study that strongly suggests men can opt for a “gentler” approach for dealing with a prostate cancer diagnosis.

The upshot to the messaging, particularly from the headlines or blurbs, is that most men who face a prostate cancer diagnosis can delay or even avoid entirely any of the “harsh” treatments for the disease. By harsh one is referring to the potential side effects of treatment that includes incontinence and problems of erectile dysfunction.

The takeaway to these recent reports is that this “gentler” approach won’t harm their chances of surviving prostate cancer.

The reason I am troubled is some people, maybe someone in your circle, might miss the details that could be life changing to them.

The caveat here is that this “gentler” approach, which includes doing nothing right away and choosing to be closely monitored – also known as surveillance or watchful waiting – is specific to a certain subset of men, and is not appropriate for ALL men.

Here’s the deal: Those men who have been diagnosed with prostate cancer through testing, as being high risk or high grade, are still recommended to consider going the route of prompt treatment, depending on their age and particular circumstance.

But in order for a man to know his rational choices, he has to be screened for prostate cancer. And in order to determine whether or not a man’s prostate cancer type is high risk or high grade, requires several levels of testing. Here we are talking about having one or more PSA tests, and undergoing a biopsy, ultrasound, and MRI.

So back to the issue of slenderness.

Much of what we have come to learn about cancers of all kinds, in men and women, has a relationship to one’s weight, particularly with being overweight and with obesity.

As reported by the CDC, more than 684,000 obesity-associated cancers occur in the U.S. each year, including more than 210,000 among men and 470,000 among women. Breast cancer after menopause is the most common obesity-associated cancer among women. Colorectal cancer is the most common obesity-associated cancer among men.

The CDC reported in 2017 that 47.6 percent of American adults are either obese or severely obese. It isn’t a stretch, especially if you have stood in any major city’s TSA airport security line or subway station, to assume those numbers have increased since 2017. So-called “normal” weight people, in many areas, are few and far between.

I eagerly await the CDC to update their information. Perhaps when they do get around to it, those stats will help motivate some people to get on with figuring out what they might do to minimize their cancer risks. Through lifestyle choices, including what one consumes and how one exercises, there are things that can make a difference and factor greatly in this risk equation.

Until then, I can offer a bit of support to those who want to lose weight but are still finding it frustratingly difficult, and who are not considering going the route of an injectable drug. I am not, however, addressing anyone who, due to other health factors or genetics, are in a particularly difficult subset of obesity that may require employing medical interventions, such as surgeries or severe restrictions that are well beyond the general public’s understanding of accepted weight control and exercise plans that are highly advertised.

Mostly, I think, my input may be helpful to those who are seeking practical, effective ways to minimize their cancer risk.

While simultaneously getting to feeling better and more energetic, perhaps my suggestion may even result in overweight readers finally being able to drop, and permanently keep off, at least some of their excess weight.

I know from listening to many who have confided in me over the decades, that their extra pounds burden them with embarrassment, fear, low self-esteem, guilt, shame or isolation. So being overweight is not only a risk factor to one’s health, it is a serious impediment to one’s ability to live in peace and be peacemakers.

Start this moment by putting aside all concerns of one’s appearance. By that I mean, anyone who has been working on, or wanting to work on, losing weight so that they will ultimately look better, might do better with losing weight by reframing the goal.

I am not suggesting all cancers are 100 percent preventable. What I am suggesting is that the research done in many countries and over many decades is encouraging. It shows we have certain choices that may influence the trajectory of our health, and the likelihood of developing certain cancers, like that of the prostate, breast and colon.

Instead of one’s appearance, I am suggesting every morning think about losing the extra weight through the lens of minimizing your disease risk, particularly cancer. Then choose wisely.