The King has done everyone an enormous favour – he’s admitted he’s human. Men have issues with being human. This manifests itself in quite harmless ways as we swallow our way through the sad bits of a film to avoid weeping in our local Everyman and say things like “It’s nothing” about horrible cuts and minor burns.
However, this phobia about our own physical vulnerability can kill us when we fail to investigate potentially serious medical conditions.
The King has been open about receiving treatment for an enlarged prostate. The strangeness of our response to this says a lot about our attitude to our “below stairs” bodily functions as a society, and, beyond that, our attitudes to men.
If the King had broken his arm during some particularly vigorous organic gardening, we would not be agog at his openness. We are not at home with the side of our health that involves acknowledging functions that happen behind closed doors.
Urination, defecation, and sexual functioning are part of a massive society-wide conspiracy to pretend we do none of these things. This is not helpful. And men are a special case. We are 60 per cent less likely than women to go to their GP, according to a survey by Blue Horizon Blood Tests.
It seems that the King’s honesty has had an immediate and dramatic effect. There has been a significant increase in searches for “enlarged prostate” on the NHS website after the King shared his diagnosis.
The NHS website’s prostate enlargement page received more than 11 times as many visits on Wednesday compared with Tuesday, as 1,414 visits jumped to 16,410 – an average of one every five seconds. Prostate Cancer UK has also witnessed the Charles Effect. From 15.30 onwards yesterday, Prostate Cancer UK’s risk checker received 2,754 visits, compared with 1,703 on the same day the previous week.
So over 1,000 more checks, at an increase of over 61 per cent. This matters: more than 52,000 men are diagnosed with prostate cancer every year on average, according to the charity, and there were over 12,000 deaths in the years 2017-2019 Cancer Research UK says.
I’m about to turn 60. I’ve had one prostate test so far and also, while we’re here, two full colonoscopies. So I’m happy to admit I have both bowels and a urological system, but part of me would much rather be the kind of man who needs no help of any kind.
The kind of man who is calm in every crisis, who grins during car chases and makes pun-based quips during gun battles. That was and remains the gold standard from James Bond to Jack Reacher. A self-image that’s hard to maintain with a medical team in your private areas.
Letting go of a masculinity that places us somewhere between a machine and a cartoon hero is surprisingly hard. Admitting to being nervous about something that may be nothing is difficult, the looming and (completely unwarranted fear) of being marched out of your GP’s office for time-wasting somehow stops us walking into the surgery.
Also, there’s a set of vague yet very physical fears about painful and invasive investigations. For most, the starting point is a simple blood test.
Clive McCombie had no symptoms and had already taken a number of negative PSA tests (the blood test that can be an indicator of cancer) but a joint celebrity openness effort from Stephen Fry and the late TV presenter Bill Turnbull did finally lead him to go again.
He is keen to emphasise that testing is an ongoing process as the disease can develop at any time. This visit effectively saved him from cancer. But why the reluctance?
“Like many men, I don’t like going to the doctors and I have an inveterate fear of needles. Until my prostate operation, I had never been in hospital.” He was fortunately free of commonly held manly constraints. “I’m not a very macho sort of person and happy to cry in front of people. I don’t find talking about it at all embarrassing.”
McCombie was in his late 70s when his cancer was discovered, but some are much younger. Curator and DJ Martin Green was in his 50s when his prostate cancer was discovered. He says, “If you are under 55 and concerned about anything insist on a PSA test from your GP as it can still affect younger people.”
Green echoes McCombie on the issue of male reluctance to discuss this aspect of our health. “Don’t be embarrassed or worried about discussing it with mates as we need more people to be aware of it, support each other and get checked out.”
There is a very British symmetry in the King being one of the two most prominent men associated with the prostate in recent months; the other, of course, being the impeccably working-class actor Ray Winstone.
Winstone is known for his portrayals of tough,frequently violent men and he has also been the face of Prostate Cancer UK’s awareness campaign. I can’t think of anyone better placed to stand shoulder-to-shoulder with King Charles in a society where class is still, sadly, something of a divider.
Between a man associated with cockney gangsters and a man who lives in a literal palace, we have most British males covered.
The medical profession is also delighted with the King’s boost to the awareness campaign, which has been slowly gathering pace over the past decade thanks to initiatives like Movember. Dr Charles Levinson, medical director and chairman of private GP service DoctorCall, applauds the King and feels this is exactly what is needed in our national conversation.
“This is invaluable awareness work from His Majesty. A benign prostate enlargement is usually nothing to be concerned about, but having it examined by a medical professional is vital – especially at an earlier stage. In comparison to years gone by, tests are relatively non-invasive so those with concerns should not be afraid to seek medical help.
“Generally, this is a topic that can make men feel very uncomfortable, which leads to delayed diagnoses and therefore worse outcomes. The King’s openness will undoubtedly generate conversation, awareness and more favourable pathways for thousands of men. We need more of this honesty in public life.”
There is a balance sheet of concerns for every man as he considers going for a test. On the negative side, there’s a lot of people and equipment going where few have gone before and the possibility of discovering something that will entail some serious medical decisions.
On the other side, an early and preventable death. Not much of a contest when you look at it like that. Speaking to people who have come through a serious diagnosis breaks through all the many layers of medical and manly concerns and reminds you what these checks are truly about.
McCombie, the very pragmatic and boldly honest cancer survivor, was keen to talk about one unwanted consequence of having his prostate removed. “You probably won’t want to include this,” he said, before going on to explain that he’s had to make a few changes to his sex life since the operation. But adds that he and his wife agreed, “How much more important is it that I continue to live?”
It seems that, thanks to the King, many more men will be making a choice that will enable them to continue to live and face what was once a rarely mentioned, little understood and quietly feared part of the male anatomy.