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Movember and the Importance of Patient Advocacy




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In October 2009 the resident on my service was Dr Dean Elterman. I have had many residents and fellows over the years and have always felt that as much as they hopefully learn something from me I probably learn more from my time with them. The concept of ‘drilling down’ to make lasting connections with leaders of the next generation is not something that is always intuitively grasped in the hierarchy of surgical life. As it was, in late October of that year Dean mentioned Movember to me and asked whether I would like to participate. At that point, not knowing what he was talking about I proceeded to tell him to consult his spell-check. Having once before sported facial hair in my early 20s to very little acclaim I had not entertained the thought since. My immediate reaction was dismissive. Nevertheless after some further discussion it became obvious to me that the whole concept of Movember is not simply to raise money for men’s health and prostate cancer research but to generally shine a brighter light on the nature of the disease, the work we do as urologists and to start a dialogue. This grassroots movement, started in 2003 in Australia by Adam Garrone has quickly grown into a worldwide phenomenon. That fall I anchored Dean’s team of residents and we broke into the top 20 of small teams worldwide.

Last year I set up a local team at Toronto East General Hospital with tremendous success. On an individual level I raised $46,000 in support of men’s health, the seventh highest individual total worldwide. While that certainly was nice, as the month wore on what became increasingly clear to me was the larger role that my involvement in Movember had created in engaging patients, other healthcare providers and society at large. The quirky nature of the campaign lends itself to a fun, easy discussion about an important topic. Having a dialogue around prostate cancer including how to screen as well as when and when not to treat is very important. The significant emotional and physical consequences of treatment deserve attention. A particularly great example by the terrific @docmikeevans illustrates the space that Movember now inhabits. The role that urologists in particular have as advocates of men’s’ health is very clear. 

It is with this last thought in mind that I call upon my colleagues in Canada and around the world to take up the charge. In recent years, much of the progress that we have made in treating prostate cancer is at risk of being undermined. The confusing and rather opaque nature of screening guidelines have increasingly promoted prostate cancer as an indolent disease not worth having a discussion about. I certainly have previously written about this and recently a group of experts met in Melbourne and attempted to better make sense of screening and stratify risk. Prostate Cancer Canada, an important advocacy group in Canada has also done a great job this fall with their #knowyournumber campaign. I was proud to be a part of it. Their CEO Rocco Rossi has embarked upon a terrific campaign of support by walking the Camino to Santiago de Compostella this month. All leaders must actively embrace the role of advocacy for our patients. Movember to me is a great vehicle for this. Will you look silly and unprofessional in the clinic during Movember? Absolutely not. In reality, every patient in the clinic is immediately reassured that their urologist walks along beside them, although perhaps not as far as Rocco. 

It is in this context that I would call on all of my urological colleagues to stop shaving in Movember, start a team, create a network and share this experience with our brave patients and their partners for a month. The amount raised is really secondary. Having that visible presence is crucial. With epidemiologists, policy makers and many others expressing expert opinions about a disease that we treat every day don’t you think we should also embrace that role? Movember is the forum where the most important group, our patients, will be having that conversation for a month. Join them. Simply caring for them after diagnosis or waiting for a research grant to materialize is not good enough. My female colleagues can join as ‘mo-sistas’. You can certainly follow my ‘progress’ and support my venture as well. I look forward to seeing my colleagues from around the world and the self-described #urotwitterati that contributes regularly on #urojc in particular to join in the fun. I expect to be pushed on the leaderboard.

Dr Rajiv Singal is a Urologist at Toronto East General Hospital and an Assistant Professor in the Department of Surgery at the University of Toronto

Follow him on Twitter at @DrRKSingal

  1. Jonathan Livergant
    Across the world people will be approaching the mustachioed men to ask about the cause and about men's health. Who better than an expert to answer them. I'd urge all oncology, urology, and related allied health trainees and practitioners to take Dr. Singal's message to heart and sport a Mo or help out as a Mo-sista.
    Just the awareness is fantastic, but the fundraising is no slouch either. See the reports of hundreds of projects funded by Movember across various realms here - the numbers are astounding and hopefully will continue to grow! https://ca.movember.com/report-cards
  2. Pete Bombaci
    Rajiv, thank you so much for sharing your Movember story. To have your support and the support of the Urology community will be a big win for Movember and a win for all men facing the journey of prostate cancer or any men's health issue. The conversations that will be created during discussions patients have during the hairy month will lead to more knowledge, more clarity, more confidence and likely more action as the moustache becomes the conduit for the conversation by breaking down the barriers and clinicalness of the interaction. In actuality, it changes the doctor/patient relationship into one of Mo Bro and Mo Bro chatting about their health within the trusted environment of health professional. What a powerful opportunity to make a huge impact on those important relationships and to help all men open up to the discussion of their health.

    For those in the community, please take the time to either join Rajiv's team, start your own team or join as an individual at www.movember.com. If you want to be a part of the collective community to demonstrate your support for Changing the Face of Men's Health, please link your profile to the Canadian Urology Network here.

    Together we are making a difference one moustache at a time and this Movember, as a community, we can lead the change that is needed.

    Nice Handlebars Dr. Singal!

    Pete Bombaci
    Country Director, Movember Canada
    416-591-7771
  3. Amrith Rao
    Well written blog by 'Mo Bro' Rajiv. I hope this year you will be able to break into the Top 5 in the individual total worldwide!

    I would urge all Urologists to not only support prostate cancer during Movember, but to support on wider context on all aspects of Men's Health. There are more men who die to Smoking related illness (including bladder cancer) and obesity related medical problems (including higher risk of urogenital cancers). Therefore, the emphasis should be on the overall health of men rather than to focus narrowly on prostate cancer.

    At our centre, last year all the consultants supported the cause by growing their own 'tache' (https://www.heatherwoodandwexham.nhs.uk/news/consultants-grow-taches-to-change-the-face-of-mens-health) and we are planning to do the same again this year!

    Go Movember Go!
  4. Aaron Blumenfeld
    Will we look silly and unprofessional in the clinic during Movember? Sure we will - but that's the point, I suppose. Since prostate cancer can often be asymptomatic, it's only fitting that the best way to draw attention to this important issue in men's health would be so visible, smack-dab in the middle of our faces.
  5. Dr. Brian Stork
    Rajiv,

    Very nice post!

    You've persuaded me to grow a Mo for Movember.

    If you will have me, I'd like to join you and your team at Toronto East General Hospital.

    https://ca.movember.com/mobile/#team/963365/members It would be great if a number of other #urojc participants could join the team as well.

    #urojc has nicely demonstrated no matter what country we represent, we all have a common interest in advocating for our patients.

    Beyond that, It would be awesome if a urologist or team of urologists made it into the top five. I think it would send a pretty clear message about the passion and compassion that we have for our patients.

    Brian
  6. Dean Elterman
    Rajiv,
    A really great post and message that you've articulated. We've spoken many times about the expanding role of the Urologist as the Men's Health doctor. That includes being an advocate for our patients and their partners. The urologic community is at the forefront of men’s health. We have the privilege of caring for boys and men over the course of their entire lifespan. As respected leaders in the field, Urologists should take a prominent role in education, advocacy, and research. Movember is now the world’s largest donor for prostate cancer research and continues to support many other areas of urology.
    This year we have established a Canada-wide network of urology teams to collaborate during the Mo-growing season. We now have our own team (Division of Urology, University Mo Toronto; https://ca.movember.com/mospace/36857) who will join forces with your Toronto East General Team to bring the hairy message to the masses.
    I really applaud you for sticking with the Mo and spreading the word since that first Movember together so many years ago!
    Cheers,
    Mo Bro Dean Elterman, MD
  7. Robin Roy
    Thank you Dr. Singal for remembering the other side of the equation in this battle...seeing those taking the lead on the treatment side recognizing the need to provide a physiological boost for everyone affected is quite simply powerful medicine.
  8. Ed Collis
    We all need to work together to find a solution to this "Pain in the ass."

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