#Why are men reluctant to seek medical help?

By Tom Geoghegan

BBC News Magazine

When doctors first examined former footballer John Hartson last week, he was already in the advanced stages of testicular cancer, which had spread to his brain and lungs. Why do men commonly get medical help later than women?

Hartson remains in a critical condition

It's not clear whether the former Celtic and West Ham hero had ignored warning signs - sometimes testicular cancer has no symptoms.

Cycling legend Lance Armstrong, who has sent Hartson his best wishes, admitted he delayed going to a doctor for months before he was given a similar diagnosis in 1996.

A survey last month for the Everyman Male Cancer Campaign suggested that nearly twice as many men as women had not visited their GP in the past year.

Evidence suggests fewer men go to dentists or ask the pharmacist for advice and information, or attend contraception clinics, although men are more likely to end up in hospital because they delay for so long.

Even male cancer helplines are used more by women, speaking on behalf of partners, fathers or sons. And the fact that more women get skin cancer than men but more men die from it, indicates how late men are going to doctors.

Men are slowly getting better at it, says Mike Shallcross, associate editor of Men's Health magazine, but the contrast is made between men's attitude to testicular lumps and women checking their breasts for potential tumours.

Martin Carter waited nine months to check his swollen testicle

'I thought it was something sexual, something I'd caught, and that made it even harder to talk about it.

'Also, I didn't know where to start. I was young and had hardly been to my doctor and when I had it was with a parent. That lack of experience meant I didn't know where to start when it came to seeing my GP.

'When I finally got help I felt ashamed that I had left it so long. It would have saved myself and my family so much worry and pain.

'My family were really upset and felt so guilty that I had felt as if I couldn't talk to them.'

There's that fear when you find a lump on your testicle of thinking 'If I go to the doctor he'll just lop it off', which is the standard treatment, but you can get by perfectly with the one. But in the vast majority of cases, it's not cancer at all and you've done the right thing and got a weight off your mind.

This kind of comparison can be misleading, however, because women need to be more vigilant, he says, Breast cancer is much more common, with about 45,000 new cases a year compared with 2,000 new cases of testicular cancer, which makes up only 1-2% of male cancers and has a very high survival rate.

Men could learn from women about attitudes to health. I would characterise it as the way they treat their cars. Women drive very carefully and make sure they take it into the garage at the right time but men just put their foot down until it's knackered.

Embarrassment and inexperience were the reason Martin Carter, 37, waited nine months to get his testicle checked after it became swollen and hard.

He finally got it seen when it swelled to four times its normal size and he had severe back pain and was losing weight. By then the cancer had spread to his lungs and abdomen and was pushing against his spine.

I was only 20 and quite shy, he says. Even though I was close to my family and friends, I just felt too embarrassed to tell anyone. I felt awkward.

MOST COMMON MALE CANCERS