"Don't travel by train" is one of Michael Bird's key lessons from prostate cancer treatment in Melbourne. He says trams are a safer bet because, for the copious amounts of water a man must drink before radiation, there are more frequent stops and often near pubs or supermarkets with toilets to wee.
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But such challenges to dignity are still not often talked about among men.
This is let alone the bigger concerns of incontinence and sexual dysfunction, which Mr Bird said some men experienced worse than others.
Mr Bird said he was dumb-founded there was not a federal government campaign to get men talking more - and encouraging them to have their prostates checked.
The King Charles phenomenon created a spike in men seeking prostate checks, including in Australia, after he made public his treatment for an enlarged prostate. This procedure discovered an undisclosed type of cancer.
Prostate cancer is the third-leading cause of death among Ballarat men, behind heart disease and almost on a par with lung disease, Australian Institute of Health and Welfare data shows.
Mr Bird said it was disappointing prostate cancer did not have the same awareness or attention as breast cancer.
When Mr Bird was diagnosed with prostate cancer about 20 years ago, he knew little about the disease or treatment, who to ask for advice or how to tell friends and family.
Mr Bird's efforts since in raising awareness and support for other men and their loved ones has been recognised with Prostate Cancer Foundation of Australia's prestigious Max Gardner award.
He said he was just doing his volunteer job.
In time this has changed. As a Ballarat Prostate Cancer Support Group member, Mr Bird has often given talks to bowls clubs, golf clubs, community service organisations and schools.
Opportunities to do this since the COVID-19 pandemic started have become fewer and Mr Bird is often guest speaker for free because he has been determined to raise awareness and promote early detection.
Prostate cancer typically grows slower than other cancers and, if diagnosed early, has one of the highest five-year survival rates.
Mr Bird said early detection needed men to be vigilant about their health.
He considered himself fortunate to have had a general practitioner in Cobram, where he was living at the time, who recognised the importance of the digital rectal examination and further blood tests.
They monitored his prostate specific antigen levels (better known as PSAs) and when these rose, Mr Bird had a biopsy. He said men were given the choice of an anaesthetic for the procedure and it surprised him how many men opted against the drug.
This procedure has since become less invasive with men in western Victoria able to access a transperineal grid prostate biopsy machine in Ballarat Base Hospital since 2016. The equipment had been the first of its kind in an Australian public hospital.
Mr Bird said much had changed since his diagnosis.
"In my case, the cancer was rapid," he said.
"I had six weeks of radiation which was an awful experience, not because it did damage but it was a small thing every day for six weeks. I was living in Cobram and working as a school teacher and took the term off school."
Mr Bird was 58 years old. The average age for an Australian male to be diagnosed with prostate cancer is 70.
When Mr Bird had been diagnosed, his doctor presented him with options to mull over. He walked out of the medical office and straight back in again to start the process.
He knew he wanted to try radiation but he also knew for other men the decision might not be so straightforward.
After his radiation stint at Peter MacCallum Cancer Centre in Melbourne, Mr Bird was sent home for two weeks.
Mr Bird returned to the centre for internal radiation delivered by uncomfortable rods but all he could remember was his right foot going numb.
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Effectively clear of cancer since, Mr Bird said there were lots of new methods now, such as active surveillance, that were far less intrusive with good outcomes for men.
Mr Bird said support groups were also vital.
Ballarat Prostate Cancer Support Group has about 110 people, aged 50 to 80-plus, on their mailing list. Often partners would attend monthly meetings in what Mr Bird said was a great chance to "compare notes" with each other.
In Mr Bird's experience, too many people would ask his wife about his progress rather than ask him directly. A support group in Cobram was his introduction to peer support.
A prevailing concern in the group was why it often took so long before treatment.
Mr Bird said prostate cancer research was good but access to treatment needed far greater national support.
This is what helps drive Mr Bird to continue making a difference.
