Letters to the Editor
In Reply
We wholeheartedly agree with the correspondence from Prof. Bardehle. She has emphasized once more the importance of thinking systemically and of taking action if the aim is to reduce health inequalities in a sustained manner. This also reflects the approach we took in our studies to improve access for men with cancer and male relatives to psychosocial counseling. It clearly isn’t enough only to display flyers with information for men. A young cancer patient in one of our studies articulated this as follows: “This means I have a leaflet in my hand, which is easy these days because various flyers etc are being handed out everywhere. What this is at first is just dull information.” (1)
Flyers can convey information succinctly and are undoubtedly often helpful. Furthermore, they are comparatively cheap to produce; another reason why their use is so popular. But they are less good at communicating emotional and motivating messages than person-to-person contact—for example through an appeal by a doctor (2, 3). They are—as the patient said—“dull.” Furthermore, they target the individual and neglect structural barriers.
Measures to improve men’s health have to start at different levels instead. It takes patience, a comprehensive perspective, thorough preparation, as well as longer-term follow-up and unerring evaluation—in other words, a strategy.
This is exactly the point Bardehle is making. Quite rightly she laments Germany’s lack of commitment in this regard and demands more political determination. We think that in this setting, in addition to prevention, psychosocial provision for men requires particular attention.
DOI: 10.3238/arztebl.m2024.0085
On behalf of the authors
Prof. Dr. rer. med. Susanne Singer, Dipl.-Psych., M.Sc.
Abteilung Epidemiologie und Versorgungsforschung, Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitätsklinikum Mainz und Universitäres Centrum für Tumorerkrankungen, Mainz
(UCT), Johannes Gutenberg-Universität Mainz
singers@uni-mainz.de
Conflict of interest statement
SS receives consultancy fees annually from Lilly in the context of the Lilly Quality of Life Award.
| 1. | Bayer O, Billaudelle F, Alt J, et al.: Was Männer davon abhält, Krebsberatungsstellen aufzusuchen. Eine multizentrische qualitative Studie. Onkologe 2020; 26: 1047–55 CrossRef |
| 2. | Frey Nascimento A, Tondorf T, Rothschild SI, et al.: Oncologist recommendation matters! Predictors of psycho-oncological service uptake in oncology outpatients. Psychooncology 2019; 28: 351–7 CrossRef |
| 3. | Billaudelle F, Bayer O, Hechtner M, et al.: „That was a tip from my physician“—gender-specific pathways of patients and relatives to outpatient psychosocial cancer counselling centres—a qualitative study. Psychooncology 2022; 31: 1022–30 CrossRef |
| 4. | Singer S, Wünsch A, Ihrig A, et al.: Men’s access to outpatient psychosocial cancer counseling—a cluster-randomized trial. Dtsch Arztebl Int 2024; 121: 121–7 VOLLTEXT |
