1. Hold On!!! Bladder Cancer and
Men
GREG RIEHL RN BSCN MA
25TH ANNUAL UROLOGICAL EXCELLENCE CONFERENCE
REGINA, SK
SEPTEMBER 20 - 22, 2012

2. How did it all start?
I SAW RED

3. Objectives
 Share my story – it is one  Describe why men do not
of denial and reflects seek health care
broader issues of men’s
health in general.  Recognize that we all have
 I hope to share my a role to play, especially
thoughts and reflection on women!
my ongoing journey so
nurses can support and  Plan for action
advocate for the health of
men in their lives.

4. De-nial? What was I thinking?

5. Nurse becomes the patient
 This was difficult for me
 My story, in a ‘nut’ shell
 You might need your earmuffs

6. Knowledge does not = Behaviour change
Men's health is My story is a typical
important. We know example of the
that knowledge does importance of
not always impact communication in
behaviour change, so health and
what can we, as nurses, relationships, and
partners, leaders, do to working through denial
support men’s health. and fear.
Communication with
health professionals &
your family/friends

7. And Now for Some Stats

8. What do Canadian stats tell us?
Type of cancer New cases Cases per 100,000
Total M W Tota M W
l
Prostate 26500 26500 — — 121 —
Lung 25600 13300 12300 54 62 49
Colorectal 13300 13000 10300 49 60 40
Breast 22900 200 22700 50 1 96
NHL 7800 4300 3500 17 20 14
Bladder 7,800 5,800 2,000 16 27 8
ww.cancer.ca/~/media/CCS/Canada%20wide/Files%20List/English%20files%20heading/PDF%20-%20Policy%20-%20Canadian%20Cancer%20Statistics%20-%20English/Canadian%20Cancer%20Statistics%202012%20-%20English.ashx
‡ Ontario does not currently report in situ bladder cases.

9. What do Canadian stats tell us?
Type of cancer New cases Cases per 100,000
Total M W Total M W
Prostate 26500 26500 — — 121 —
Lung 25600 13300 12300 54 62 49
Colorectal 13300 13000 10300 49 60 40
Breast 22900 200 22700 50 1 96
NHL 7800 4300 3500 17 20 14
Bladder 7,800 5,800 2,000 16 27 8
ww.cancer.ca/~/media/CCS/Canada%20wide/Files%20List/English%20files%20heading/PDF%20-%20Policy%20-%20Canadian%20Cancer%20Statistics%20-%20English/Canadian%20Cancer%20Statistics%202012%20-%20English.ashx
‡ Ontario does not currently report in situ bladder cases.

10. What do Canadian stats tell us?
Type Deaths Deaths per 100,000
Total M W Total M W
Lung 20,10 10,80 9,400 42 50 36
0 0
Colorectal† 9,200 5,000 4,200 19 23 15
Breast 5,200 55 5,100 11 <0.5 19
Pancreas 4,300 2,100 2,100 9 10 8
Prostate 4,000 4,000 — — 19 —
Non-Hodgkin Lymphoma 2,800 1,500 1,300 6 7 5
Leukemia 2,600 1,500 1,100 5 7 4
Stomach 2,100 1,350 790 4 6 3
Bladder 2,100 1,450 670 4 7 2

11. What do Canadian stats tell us?
Type Deaths Deaths per 100,000
Total M W Total M W
Lung 20,10 10,80 9,400 42 50 36
0 0
Colorectal† 9,200 5,000 4,200 19 23 15
Breast 5,200 55 5,100 11 <0.5 19
Pancreas 4,300 2,100 2,100 9 10 8
Prostate 4,000 4,000 — — 19 —
Non-Hodgkin Lymphoma 2,800 1,500 1,300 6 7 5
Leukemia 2,600 1,500 1,100 5 7 4
Stomach 2,100 1,350 790 4 6 3
Bladder 2,100 1,450 670 4 7 2

12. Three Types of Bladder Cancer
Transitional cell Who knew, to this day I
carcinoma have no idea, but if I had
Squamous cell carcinoma to guess, I would think it
Adenocarcinoma was transitional cell
carcinoma
Greg’s type of Cancer?

13. Where do men get health information?

14. Where do
men get
their health
information
from?

15. Bladder cancer search??? On the internets
 About 10,300,000 results (0.14 seconds)
 People have to wade through a lot of information
 Men, especially, can be a bit impatient, and maybe even lack attention
 We need to develop resources that make sense and are targeted at
different generations
http://www.nih.gov/news/pr/aug2007/nci-29.htm

16. Bladder Cancer Canada
Sunday, Sept 23, 2012 the Bladder Cancer Canada 5K Awareness Walk
takes place right across Canada!!!!!!!!!
www.bladdercancercanada.org/main.php?lan=1

17. patientslikeme
At PatientsLikeMe, people with every type of condition are
coming together to share their health experiences, find patients
like them and learn how to take control of their health. The
result is improved care for patients as well as an acceleration
of real-world medical research.
http://en.wikipedia.org/wiki/PatientsLikeMe

18. Totally Unrelated
Networking, who cares!!! I was asked to do a
presentation on networking for Federal Employees
who were affected by the latest round of cuts from
the Dear Leader.
I related my bladder cancer story, somewhere in my
presentation, linked to the patientslikeme site
A lady approached me afterwards, and wanted to
talk to me about her brother, who was diagnosed
with bladder cancer and was refusing to go for
surgery.

19. The Good - Bad Rule
 Most people overestimate  Words like asthma, radon,
the lethality of cancer, diabetes are much less
there are actually a lot scary but can be more
more dangerous things in lethal.
life that could kill you.  Emotions have a huge
 Some people simply hear influence on our actions
the word cancer, or as men.
tumor, or surgery, and  Most men repress our
they either stop listening emotions & do not
or they freak out a bit. communicate effectively
with our families &
friends or health
professionals.

20. Shhhhhh
Most health information for men is targeted at their penises

21. The difference between men & women’s health
Health for girls/women starts earlier than ever.
 HPV vaccinations
 PAP test - a letter comes in the mail
 BSE?
Health for boys/men starts when?
 Most likely in the emergency ward
 TSE? Not likely
 PSA?
 When you are 40 the glove comes out.
Traditionally, boys and men are taught that they should be self-reliant, control their
emotions, and maintain a strong image by denying pain or weakness.

22. Complete physical – Primary Care
Does this even happen for most men?
 My GP said I could talk about one issue, maybe two.
The worried well go more often than the rest of us.
Men rarely seek medical attention, and when they
do, it should be taken seriously.
Culture plays a lot in this.
Being male should not mean poorer health status.
Episodic health care does not work in the long run.
False evidence appearing real = FEAR

23. What is up with men?
 Men seem to invest more resources in getting bigger and
stronger early on in their lives. But women are geared for
endurance in life. Women are typically shorter and
smaller than men. Use fewer of your own resources and
you will live longer, it seems.
 We see it in animals: the earthworm lives four times as
long if it doesn’t eat or have sex.
http://www.telegraph.co.uk/health/8566594/Why-do-men-die-younger-than-women.html

24. Men’s health

25. So why do men die before their wives?
Because they want to . . .

26. What to do?
 We need to improve  Men disregard symptoms
overall communication and present later –
 We need to improve the possibly connected to that
dialogue between men risk-taking behaviour,
and their families and more likely denial, fear, or
caregivers within the culture.
health system  We all have to get men to
 Major illnesses need to be communicate more about
detected faster. their health – if not with a
 Women are still the nurse or doctor, then with
friends, buddies, or on the
gatekeepers!!!!!!
inter-web.

27. What things do I specifically do?
 I speak
 I volunteer  Stars of Hope Dance Gala
 I tell my story
 Movember
 I involve my family,
friends, and co-workers
 I could do more
 riehldance@hotmail.com
 I am optimistic

28. What’s next for me, or the man in your life?
Urinary Incontinence? BPH???? I think I
have this already????
EDOMG  Note to self . . . . . .
The Lower Urinary Circumcision
Tract Symptoms  old& young
(LUTS)  HIV Recommendations
Urology consults

29. Questions? Comments?
Thoughts?
THANKS FOR YOUR PARTICIPATION

30. Greg Riehl RN BScN MA
Contact
information Email: gregriehl@sasktel.net