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Thanks to advances in diagnosis and treatment of illness, the life expectancy for both men and women is almost double that of a century ago. Yet, on average, women still continue to live longer than men.
According to Statistics Canada, the average life expectancy at birth for Canadian men is 80, while for Canadian women it’s 84. This gender gap is not only reflected in life expectancies, but also general health and wellness. Men tend to be more burdened by illness during their lifetime.
The COVID-19 pandemic has heightened the real inequities that exist in gender health – for every ten women that the pandemic has killed, 13 men have died. In 2022 Canadian men live on average, 4.5-5 years shorter than Canadian women. Of the top thirteen causes of death in Canada – including all cancers, cardiovascular disease, accidental and non-accidental trauma, to name a few – men lead women in 12 of the 13 causes.
Some of this discrepancy can be accounted for by biological factors, which are hard to modify. However, there is a major factor influencing this gap that can be changed – men are less likely to seek medical care. How to change this behavior is an ongoing concern in health care, and is the driving force behind Women for Men’s Health.
Dr. Shelley Spaner is a Calgary radiologist and partner at Mayfair Diagnostics. She is also the founder of Women for Men’s Health – an initiative that encourages women to become active players in closing the gender gap when it comes to health and wellness.
“My father and I used to talk about how great it would be if there was one place people could go to for all of their medical and wellness needs. When I started working with the Prostate Cancer Centre, an incredible facility conveniently located across the hall from the Southern Alberta Institute of Urology, I remembered those discussions. I started talking to some friends about how we could build on that and create a sort of one-stop shop for men’s health,” says Dr. Spaner. “They encouraged me to do something about it.”
So she did. In 2016, the Women for Men’s Health initiative held its first fundraising event – raising money to help support research and awareness in areas impacting men’s health. Since then the group has raised over 500 thousand dollars through fundraising initiatives, and has secured more than one million donor dollars. With some of these funds a men’s health clinic was opened across the hall from the Prostate Cancer Centre in June 2018.
Dr. Spaner has been raising awareness about men’s health through speaking engagements and fundraising initiatives, and was a recipient of the 2019 Pathfinder’s Award from PROSTAID Calgary for demonstrating leadership and contributing to significant advancements in prostate cancer research and treatment. PROSTAID Calgary is a support network that provides peer-to-peer support for men and their families on their journey with prostate cancer.
“They are a wonderful organization that helps care for people who are affected by prostate cancer. I have spoken to their group several times about how imaging can help with the diagnosis, staging, and management of prostate cancer. Along with Dr. Brendan Diedrichs and Dr. Grace Yeung, we have also kept their members up-to-date about the evolution of MRI [magnetic resonance imaging] as it affects patients with prostate cancer,” says Dr. Spaner.
The prostate is a walnut-sized gland that sits underneath the bladder, near the rectum. It manufactures a specific protein, called prostate-specific antigen (PSA), which can be measured as an indicator of its health. If a PSA level is elevated, this could be a sign of prostate cancer.
Medical imaging can be ordered to assess the prostate, but traditionally a prostate biopsy is ordered to investigate high PSA levels and determine whether prostate cancer is present. During a standard transrectal prostate biopsy a needle is inserted into the prostate gland, and twelve random tissue samples are collected and sent to a lab for analysis.
Because prostate cancer is known to be multifocal in nature, random sampling has its challenges – prostate cancers can be omitted in the tissue samples. Both overestimation and underestimation of the grade and burden of prostate cancer is a concern. Prostate biopsy is also an invasive procedure – not without risk. Since 2012, improvements in magnetic resonance imaging (MRI) technology and increased research into the subject has lead to MRI being used more often to evaluate men suspected of having prostate cancer. The technique can help guide decisions about prostate biopsy.
Mayfair Diagnostics operates a 3T magnet at their Mayfair Place location. This stronger magnet has the potential to generate more detailed or faster imaging. The highly sensitive diagnostic information that 3T imaging can provide for the prostate can be very helpful in determining the management of prostate-related disease.
The Prostate Imaging – Reporting and Data System (PI-RADS) was initiated in Europe in 2012. It outlined technical parameters for prostate MRI and helped guide specific sequences that would be useful for prostate imaging. This lead to a number of research projects around the world that looked at the usefulness of prostate MRI for prostate cancer, including several based at the Prostate Cancer Centre. In 2018, the New England Journal of Medicine published the results of the Precision Trial that affirmed that, “…in men with a clinical suspicion of prostate cancer, we found that a diagnostic pathway including risk assessment with MRI before biopsy and MRI-targeted biopsy in the presence of a lesion suggestive of cancer was superior to the diagnostic pathway of standard transrectal ultrasonography–guided biopsy.”
“It’s exciting to be a part of the way prostate MRI is changing the way prostate cancer is diagnosed and managed and treated. But the most exciting part is that at the Prostate Cancer Centre all the people that are involved in that care are in one place, all working together,” says Dr. Spaner.
One of the goals of both the Women for Men’s Health program and for Mayfair is to encourage men to visit their doctor and get checked regularly. Identifying modifiable health risk factors related to diet, weight, blood pressure, and blood glucose may help with preventable health concerns and may aid in early detection of many cancers including prostate cancer.
The American College of Radiology (2015) “PI-RADS: Prostate Imaging – Reporting and Data System.” www.acr.org. Accessed October 21, 2019.
Harvard Medical School (2019) “Mars vs. Venus: The gender gap in health.” Harvard Health Publishing. Accessed October 21, 2019.
Kasivisvanathan, V., et al. (2018) “MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis.” The New England Journal of Medicine. 2018; 378:1767-1777. Accessed October 21, 2019.
Statistics Canada (2019) “Changes in life expectancy by selected causes of death, 2017.” www.statcan.gc.ca. Accessed October 21, 2019.