Dear Healthy Men: I just found out that September is both Suicide Awareness and Prostate Cancer Awareness Month. What do we need to know about those two issues?

A: Prostate cancer and suicide are among the top 10 causes of death for males. Let’s take a closer look at both:

Prostate Cancer

Only biological males have a prostate, and one in eight men will get prostate cancer, the second deadliest cancer (after lung cancer) in men, according to Zero Prostate Cancer (zerocancer.org). Every year, about 230,000 American men are diagnosed with the disease and more than 33,000 will die, according to the National Cancer Institute. That said, the risks vary greatly depending on a number of factors. Being aware of those risks, early diagnosis, and appropriate treatment can greatly increase one’s chances of survival.

Age: Prostate cancer is quite rare in men under 40. But the risks increase rapidly starting at about age 50, and most prostate cancers are found in men over 65.

Race: Black men are more likely than white men to develop prostate cancer and twice as likely to die of it according to the Prostate Cancer Foundation (pcf.org).

Family history: Having a father or a brother with prostate cancer more than doubles a man’s chances of getting the disease.

Environmental factors: Exposure to pesticides and certain chemicals.

Lifestyle: Men who are obese, eat a high-fat diet, and/or don’t exercise regularly are more likely to develop and die from prostate cancer. They’re also more likely to develop aggressive forms of the disease.

Caught early, prostate cancer can be treated, usually successfully. But in the early stages, there are frequently no symptoms. So it’s critical to have a strong relationship with a health care provider and to get screened regularly — especially if you’re in a high-risk group. The two most common screens for prostate cancer are:

Digital rectal exam (DRE). Nope, it doesn’t sound pleasant, but because the prostate can’t be seen from the outside, feeling it through the rectum is the best way for a provider to determine whether there are any irregularities in the shape or texture of the organ.

Prostate Specific Antigen (PSA) blood test. Although in recent years, the PSA has become somewhat controversial, many organizations, including Healthy Men, Inc. (healthymen.org) strongly recommend it. The key is to get a baseline number at age 40 or 45 and then watch for changes over time.

Suicide

In the US, there are over 48,000 suicides every year — 80% of which are committed by males.

We hear a lot about gun violence in this country, but most people don’t realize that 54% of firearm-related deaths in the U.S. are suicides, according to USA Facts (usafacts.org). And there are twice as many deaths by suicide as murders, according to the National Institute of Mental Health (nimh.nih.gov). Overall, males are nearly four times more likely than females to commit suicide, according to the CDC.

That disparity is generally consistent across races, but the suicide rate is highest among middle-aged white men, and white males accounted for 68% of suicides in 2022.

The suicide rate also varies by age group. Among 10- to 14-year-olds, male suicide victims outnumber females 1.8 to 1. Among 24- to 54-year-olds, males outnumber females 3.9 to 1. And among those over 75, the male-to-female inequity rises to more than 10 to 1.

Most male suicides occur in boys and men who have not been diagnosed as depressed or don’t have a history of mental health issues. This is largely because males access health care far less frequently (about half as often) as females; there are no clear guidelines on when and how to screen men and boys; and health care providers don’t properly or regularly screen them for emotional wellness, according to Dr. Jean Bonhomme, founder of the National Black Men's Health Network.

For females, however, mental-health screenings are considered so important that they are specifically covered—at no cost—in well-woman visits (which are mandated under Obamacare and most insurance plans) and postpartum care. No such well-man visits or mental-health screenings exist or are routinely covered for males, according to Dr. Salvatore Giorgianni, co-founder of Healthy Men, Inc. and chair emeritus of the American Public Health Association's Men's Health Caucus.

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