Paul Holmes: Out of the blue? Hardly

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This is Blue September, designed to highlight New Zealand's prostate cancer problem, blue because women have pink for breast cancer. I know you don't particularly want to hear about it, but prostate cancer is a bugger of a thing and we have to get more men aware of it and the importance of catching it early.

Awareness might almost be everything. A couple of years back, my friend the Mad Butcher organised a lunch attended by several hundred men and women, during which Leighton Smith and I, both prostate cancer survivors, told our stories.

The Mad Butcher told me only the other day that the lunch probably saved 23 men who, as a consequence, had themselves checked out and found their PSA readings were rising dangerously.

This is why I went public with my prostate cancer experience again this week in New Idea. I don't want to be a poster boy for what is still regarded by many as an old man's disease - although it is not - but we have to talk about it and if my talking about it helps other men, I'm happy to oblige.

The PSA test is a simple blood test. That is all you have to do. There is a lot of tedious debate about the reliability of the PSA test. I don't bother with that myself.

A rise in your PSA does not mean necessarily that you have cancer, but it is a good warning that something might be up and can lead to the next stage of examination. If you are over 45, it is probably advisable to get a PSA test every six months.

Nearly 3000 men in New Zealand this year will be told they have prostate cancer. Six hundred will die of it and many others will die with it. Of all the cancers, prostate cancer is the third-biggest killer of men.

The mortality figures are pretty close to those for breast cancer. In terms of how these two cancers affect our attitudes to ourselves as men and women, they probably offer a valid comparison. Life changes after breast cancer, just as life changes after prostate cancer. While women have gone out and made their sisters aware of breast cancer, men have failed to make their brothers as conscious of the dangers and prevalence of prostate cancer.

Government focus has, without a doubt, been on breast cancer for more than a decade. My impression is that prostate cancer has been overlooked by both the last National Government and by the current Labour Government.

Since 1999, mortality rates for breast cancer have declined, whereas prostate cancer mortality rates have risen. I am not aware of any in-your-face campaigns in the last 10 years encouraging men to get checked out, even though prostate cancer occurrence rates are rising. That is probably all we need, publicity campaigns. Reminders. Men need to be nagged into medical checks.

I must say that there is a reluctance by the news media generally to engage in a discussion about prostate cancer, possibly because media organisations are heavily staffed by young women who, naturally enough, do not want to be thinking about diseases of middle-aged and old men's bits.

But I have to say also that the glib one-line reference to my story in New Idea which appeared on the Stuff website this week was prurient and facile.

Prostate cancer occurs in the walnut-sized gland which sits under the bladder and is moulded to it. The cancer feeds on testosterone, which is produced by the testes. At the start the cancer is likely to be slow-growing, but when it has finished in the prostate it can spread to nearby lymph glands which then take it straight to the bone.

When it gets to the bone you are finished. As my oncologist told me years ago as he sat on my bed at home, "If it had gone to the bone, I would be making you comfortable". I will never forget those words.

So first, you get the PSA test. Demand one. National's Dr Jackie Blue, who is very exercised about prostate cancer, says there are still no guidelines for doctors on who should be tested. Some doctors, she says, tell men they do not need tests, some insist a man waits until he is over 50, some recommend testing more often than others. She says, until recently, the Ministry of Health website actually recommended men not get tested.

This is as absurd as the Ministry of Youth Affairs back in the 90s refusing to discuss youth suicide on television because they believed such discussion encouraged more of it.

Just go in and demand a test, I say. Over 45? Get tested!

I note there is research by the Cancer Council of Australia which found that men who masturbate frequently, five times a week, may be less likely to develop prostate cancer.

It is not the masturbation that is important. It is the frequency of ejaculation. The more you ejaculate between the ages of 20 and 50, the better. If you ejaculate five times a week in your 20s, you have a one-third lesser chance of developing aggressive prostate cancer later in life. The more sex the better. This is in complete reversal to what was previously thought, that frequent sex increased the risk. Not so. Life is good.

Lower the animal fats in your diet. This is another piece of advice that comes through in the reading.

Adopt the Mediterranean diet. At this point I must again recommend my very fine Paul Holmes Extra Virgin Olive Oil. Extra virgin olive oil is great for the heart and keeps you young, so why should it not help ward off cancer of the prostate? It is probably not a bad thing to rub a bit of the oil on where it matters either.

Governor Sarah Palin rocked the hall this week at the Republican Convention. She walked straight out of the snow and into the headlights of the world and did not flinch. She went out there a nobody and came back a star. I think she will be around for a very long time. She was normal. I loved her. She was one of us.

Reports tell us John McCain turned to her very late in the piece, probably in realisation that after the stunningly successful, if slightly messianic, Democrat Convention, he would have to pull a swifty on the Obama people. McCain is a shrewd old bird, a man of immense personal strength and principal. There remain questions about her experience in a national arena and how she will last the distance but history has a way of finding people and we should never underestimate history's ability to surprise. As to her character, what do we know of her?

Certain facts might be indicative. Her mother was a school secretary, her father a science teacher and track coach and she went moose hunting with him. She has always been a Christian. She is athletic and was captain of the school basketball team that won the state championship when Palin potted a free throw in the last seconds of the game despite a fractured ankle. So she can deliver under pressure.

She was known as Sarah Barracuda because of the intensity with which she played. So she is determined. When she came second in Miss Alaska at the age of 29 she won Miss Congeniality. So she can be charming. She has been a sports broadcaster. So she can communicate.

In 1996, she beat a Republican Mayor in Wasilla. As mayor, she reduced her salary and lowered city taxes. So she is principled. While she was mayor Alaskan Republican bosses started to notice her. In 2006 she beat another Republican for Governor. So she is ambitious, she backs herself, she is ruthless and not afraid to eat her own. As Governor she sold the gubernatorial jet on eBay. So she keeps election promises.

I do not write Sarah Palin off. American elections are not decided by what the rest of the world thinks. Palin is going to cause some real caution in the Obama camp.

It will hard for Joe Biden to deal with her in the Vice-Presidential debates, for a start. He might suddenly look too old and too Washington. He might turn people off by knowing too much and may fall into the trap of condescension. Sarah Palin might just be the animation, the attractiveness and the freshness McCain needs against Obama.

- Herald on Sunday

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