Man enough to heal: Redefining masculinity after prostate cancer

Men often confuse virility with notions of manhood, which affects their attitude towards their most common cancer.

- Martha Tara Lee

Prostate cancer has become the most common cancer among men in Singapore, accounting for about 17.4 per cent of all male cancers between 2018 and 2022. More than 7,500 men were diagnosed during that period - roughly one in six will face it in their lifetime. Risk rises sharply after the age of 50.

And yet, many men still shy away from screening. Here lies a troubling irony: Prostate cancer is highly treatable when detected early, but fear keeps men from the very tests that could save their lives for reasons related to their perceived masculinity, which we will touch upon.

The screening is straightforward. It typically begins with a digital rectal examination (DRE) - a quick, simple check in which a doctor gently inserts a gloved finger into the rectum to feel the prostate for irregularities. It takes seconds and can detect changes long before symptoms appear. Still, many men avoid it because it feels exposing or embarrassing.

If the DRE suggests anything unusual, a prostate-specific antigen (PSA) blood test may follow. PSA levels can rise for several reasons, including infection, inflammation, or benign enlargement, but persistently high readings warrant further evaluation. Taken together, the DRE and PSA test form an effective early-warning system.

Unfortunately, fear often outweighs reason. Many men delay testing because they worry that a diagnosis - and the treatment that follows - will rob them of sexual function or their sense of manhood. Research shows that between 40 per cent and 70 per cent of men experience some degree of erectile dysfunction after prostate surgery, depending on age, health, and surgical technique.