Get a rectal exam or watch the hockey game? Not a tough choice, is it? But for many men, not getting tested for prostate cancer could cost them their lives.

Prostate cancer is the most common cancer in Canadian men—about one in six males are diagnosed with it, said Dr. Neil Fleshner, chair of urology at the University of Toronto and chief of urology at the University Health Network, at Benefits Canada’s 2015 Employers Cancer Care Summit on Wednesday. And about one in four men who get it, die from it.

Read: Will cancer screening save your life?

Although research shows prostate cancer often has early onset, it may not present in men until they’re in their 60s or older. Screening methods include the digital rectal exam and the prostate specific antigen (PSA) test. The PSA test is quite effective—since it was established, mortality rates have dropped by about 50%, said Fleshner.

But not all forms of prostate cancer are aggressive, so there is a concern about overtreatment, he explained. Add the fact that about half of men treated will experience erectile dysfunction, and it’s no wonder men aren’t lining up to get tested.

There’s a dangerous silence around prostate cancer, noted Rocco Rossi, CEO of Prostate Cancer Canada. “When it comes to their health, men are idiots,” he said. “And when it’s health below the waist, if we ain’t braggin’, we ain’t talking about it.”

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This silence is reinforced by the fact that the Canadian Task Force on Preventive Health Care has released guidelines recommending against the PSA test as a screening tool, citing insufficient evidence that the risks outweigh the benefits. “I think this is really an abomination,” said Fleshner.

Rossi agreed, noting if the same philosophy was applied to mammograms, there would be a huge public uproar. “It’s a couples’ disease; it’s a family disease. It’s a workplace disease,” he said.

Read: Support employees affected by cancer

Both Fleshner and Rossi stressed the need for greater funding and support for prostate cancer research. Rossi encouraged men to break the silence and get tested in their 40s as a baseline.

“What’s worse than overtreatment is death,” he added.

Want other related articles? Click here for more stories about cancer.

Copyright © 2020 Transcontinental Media G.P. Originally published on

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