Health for Men
Men may have different health concerns than women, but they have just as many risks that require vigilant screenings and upkeep. One thing is the same across the board: Everyone needs to be proactive to ward off major problems. For everything from a healthy heart to keeping off extra pounds, doctors recommend maintaining a nutritious diet, avoiding excessive alcohol, not smoking and knowing your family’s health history.
Cardiologist Dr. Omar Almousalli of Frontenac Cardiovascular Center says there are a number of ways doctors can test men for heart and blood vessel problems. “We see a lot of patients who already have symptoms like chest pain, shortness of breath or leg swelling, but it’s also possible to screen proactively for potential disease,” he says. “We can do a family history check and lab tests for conditions that contribute to heart disease, and we also can perform scans to check for deposits in arteries around the heart.” Almousalli says it also may be beneficial to do a stress test, especially if the patient has more than one risk factor for coronary artery disease.
>> main risk factors: High cholesterol, family history, smoking, diabetes, hypertension, obesity and sedentary lifestyle
>> genetic testing: “In families with a significant tendency for heart disease, we can test for a genetic mutation that may cause it,” Almousalli says. “The test is not common and not covered by most insurance, but it can be done if needed. It also can be beneficial if you don’t know your family history.”
Prostate cancer affects the prostate gland located at the bottom of the bladder in men. The tumor usually is slow-growing, but it can spread, so it’s important to be educated. A growth sometimes can be felt during a rectal exam by a doctor, but a prostate-specific antigen (PSA) blood test also may be needed, especially in men 55 and older, says SLUCare urologist Dr. Lindsay Lombardo. PSA is a protein produced by prostate cells, and it may be elevated in men with prostate cancer.
>> a baseline is key. Lombardo says it’s important to have a baseline PSA test so doctors can see if your antigen levels start trending upward and at what rate. “Normal values are usually between 0 and 4,” she says. “If your level is .6 at age 55 but it reaches 4 by age 59, that’s still in the normal range, but it’s also a big jump. That may be concerning.”
>> guidelines have changed. “In the past, we advised men to screen for prostate cancer every year,” Lombardo says. “Now, if the patient’s PSA numbers are on a stable trend, we may do it every other year, or every three years if the baseline value was 1.5 or below.”
>> it’s not an exact science. If your PSA level is elevated, it doesn’t necessarily mean you have prostate cancer, according to Lombardo. “You may just have a large prostate that’s making a lot of the antigen,” she explains. “It’s also possible for the test to show false elevations, so we look for two elevated levels in a row.” If the level is still high on the second test, doctors may recommend a biopsy or prostate MRI to look for tumors.
>> some men are at higher risk. Lombardo says research has shown that African-Americans and men with a family history of prostate cancer may have higher risk for the disease. “Patients in these groups should have a conversation with their doctor about it before age 55,” she says. “Men whose fathers had prostate cancer should get screened 5 to 10 years earlier than the father’s age of diagnosis.”
The eyes are more than windows to the soul; they also can give doctors insight into a person’s physical health, says Dr. Todd La Point of Eye Care Associates of St. Louis. “There are conditions that might not be symptomatic in the body, but we can see them in the eye,” he notes. “Hypertension, diabetes and high cholesterol can have effects on eye tissues like the retina, and blood vessels in the eye may signal stroke risk.” Eye diseases like glaucoma may not cause symptoms until they’re advanced, La Point says, so it’s important to schedule regular eye care visits. Other conditions men should be screened for by an eye doctor include:
>> macular degeneration. This condition causes the central part of the retina to deteriorate, resulting
in vision loss.
>> vision problems. See a doctor if you are experiencing blurriness, double vision, trouble focusing near or far, spots or ‘ghostlike’ images.
>> dry eye. This common problem results when tear glands don’t keep the eye’s surface well lubricated. Many factors can contribute to it.
>> cancer concerns. La Point says it’s important to have a doctor check for cancers of the skin around the eyes.
“Colorectal cancer screening helps reduce the incidence of illness and death from the disease,” says Washington University gastroenterologist Dr. Michael Bennett. “We use colonoscopy to find precancerous polyps (small growths) in the large intestine and remove them before they become advanced cancers.” According to the American Cancer Society, colorectal cancer is the third leading cause of cancer death in both men and women.
The most common type of this cancer is adenocarcinoma, Bennett says.
>> how long does a colonoscopy take? “It lasts about half an hour and requires sedation,” Bennett says. “We normally recommend that patients take the day off work.”
>> what does it involve? The doctor inserts a long, flexible tube with a tiny video camera into the rectum. The tube (colonoscope) is advanced through the colon so the doctor can see the tissue inside it. Growths can be removed and biopsies taken during the procedure.
>> what do the growths look like? “Some are attached by a thin ‘stalk’ and resemble a mushroom,” Bennett says. “Others are spread along the tissue and can be more challenging to remove.”
>> how do you prepare for the test? “Before the procedure, the patient takes two courses of a laxative several hours apart,” Bennett says. “The idea is to clear the colon so nothing obstructs the doctor’s view of the tissue.”
>> when should you have it done? “Earlier recommendations were for the general public to be screened starting at age 50, but new American Cancer Society guidelines recommend starting at 45,” Bennett says. African-Americans, Native Americans and people with a family history of colorectal cancer may be at higher risk, so they should talk with a doctor about it in their 40s.
>> why is it important for men? Some Western lifestyle behaviors associated with higher cancer risk are more common in men, Bennett says. Smoking, alcohol use, excess weight, physical inactivity, inadequate dietary fiber, and diets high in red and processed meats can play a part.
Doctor visits aren’t just for when you are ill or injured. Develop regular relationships with your health providers, and start with these important screenings:
ages 18 to 39
>> blood pressure: Check every three to five years, unless your pressure is 140/90 or above or you have a condition like diabetes or heart disease. Then follow your doctor’s recommendations.
>> cholesterol: Check every five years. If you have risk factors like diabetes or heart disease, start in your 20s.
>> diabetes: If your blood pressure is high or you are overweight, your doctor may want to do yearly blood sugar tests.
>> teeth: Visit your dentist every six to 12 months for an exam and cleaning.
>> eyes: Get an eye exam every two years (once a year if you have diabetes).
>> testicular cancer: Authorities no longer recommend that men perform self exams for this type of cancer. Ask your doctor about a screening.
ages 40 to 64
>> cholesterol: Check every five years. If it tends to be high, have it tested more often.
>> diabetes: Get screened every three years once you reach age 45. If you are overweight or your blood pressure is high, your doctor may recommend yearly screening.
>> eyes: Get an eye exam every two to four years from ages 40 to 54, and every one to three years at 55 and above. Your doctor may recommend more frequent exams if you have diabetes, vision problems or glaucoma risk.
>> colon cancer: Between ages 40 and 50, get screened if you have family history or inflammatory bowel disease. After age 50, your doctor likely will recommend screening for colorectal cancer.
>> other cancers: At age 50 to 55 and above, talk to your doctor about family history and prostate cancer screening. If you have been a smoker, ask about lung cancer screening.
>> blood pressure and teeth: Recommendations are the same