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Get Your Guy to the Doctor

separator According to the Men’s Health Network, many men, particularly single men, are reluctant to visit doctors. Some reasons for this include
  • Fear
  • Embarrassment
  • Lack of trust
  • Lack of awareness of risk factors for specific diseases

It is not unusual for primary care physicians to hear their 40-or 50- something male patients who are having a general physical say, “My wife made me schedule this appointment.”

Women visit physicians more often than men, both for specific problems and for preventive care. Women are also more likely to take responsibility for the healthcare of family members, including children, spouses and aging parents. Interestingly, in the past 30 years, the ratio of male mortality over female mortality has increased in every age category.

What should men—and the women in their lives—be concerned about when it comes to taking care of themselves?

Benign Prostatic Hyperplasia (BPH) Also known as an enlarged prostate, this condition is common in men in their 50s and 60s. The prostate, a walnut-sized gland that produces semen, becomes enlarged, blocking the urethra and making urination difficult. It may cause urinary tract infection and burning or pain during urination. BPH is not a sign of cancer and usually does not interfere with sexual functioning.

The first-line treatment for BPH is often “watchful waiting.” This means an annual (or more frequent) examination to determine if the condition is getting worse. The physician may recommend limiting liquid intake before bed and avoiding over-the-counter decongestants. If the symptoms become bothersome and require treatment, the physician may prescribe an anti-blocker medication, the type that is often prescribed to treat heart blockages, such as Cardura® and Hytrin®. Another option is a medication that will act to shrink the prostate. In severe cases, surgery to remove the blocked area may be required.

Prostate Cancer According to the National Prostate Cancer Coalition, this is the most common cancer among men, striking 1 in every 6. The incidence is much higher (35-50%) among African Americans, who are also 50% more likely to die from it than Caucasians. Cancer that is confined within the prostate and has not spread is “localized.” Advanced cancers may spread to other parts of the body, such as the lymph nodes or bones.

Prostate cancer may be detected during a digital rectal exam or by having a blood test to check for prostate-specific antigen (PSA). Remember, prostate cancer cannot always be found with a digital rectal exam, and there are other medical conditions besides cancer of the prostate that can cause an elevated PSA. If cancer is present, an ultrasound examination can determine the size of the prostate, and a biopsy will help determine the extent to which the disease has progressed.

Depending on age, family history and other health factors, “watchful waiting” may be appropriate since prostate cancer may grow very slowly. Other treatment options include radical prostatectomy (removal of the prostate and surrounding seminal vesicles), radiation therapy and hormone therapy. Risks include difficulty controlling urine flow and loss of sexual drive.

Testicular cancer Testicular cancer is not as common as other types of cancer (an estimated 6,900 cases and 300 deaths per year), and it is one of the most curable. As with all cancers, early detection is key. In about 90% of cases, men will notice a lump on the testicle, or notice testicular growth. They may also have a feeling of fullness or aching in the lower abdomen or the scrotum. Sometimes, although less commonly, men may notice breast tenderness or breast growth, resulting from disease-related hormonal secretions.

Testicular examination is an important part of a man’s regular preventive checkup. Self-examinations are best performed during or after a bath or shower, when the skin of the scrotum is relaxed. Stand in front of a mirror and examine each testicle separately. Hold the testicle between the thumbs and fingers with both hands and roll it gently between the fingers. Look and feel for any lumps, or any change in the size, shape or consistency of the testes. Tell your doctor about any changes that you notice. Ultrasound, blood tests or surgery can be used to diagnose cancer in the testes. Surgery, radiation and chemotherapy are the most common forms of treatment.

Colorectal cancer
Cancers of the colon and rectum have common characteristics, and are often referred to together as colorectal cancer. It is the third most common cancer in the US, with over 90,000 new cases every year. These cancers develop slowly and may be associated with precancerous polyps, which are small growths in the lining of the colon or rectum. Colorectal cancers are most commonly detected by digital rectal exam, or by fecal occult blood test (FOBT), in which patients provide feces samples to be checked for hidden blood. The inside of the colon can be viewed with a sigmoidoscope, or the longer colonoscope, to allow physicians to see and remove polyps.

The American Cancer Society recommends annual FOBT and sigmoidoscopy every 5 years for everyone over age 50. People with the following risk factors should be tested at an earlier age:

  • Family history of colorectal cancer
  • Personal history of intestinal polyps or inflammatory bowel disease
  • Sedentary lifestyle
  • Obesity
  • Diet high in animal fat

Diet and physical activity are risk factors that you can control. A healthy diet includes plenty of fruits, vegetables and whole grain foods, and limited intake of high fat foods. Physical activity—at least 30 minutes of physical activity on most days—is beneficial. Some studies indicate daily aspirin use and multivitamins containing folate can also reduce risk.

Erectile Dysfunction (ED) The inability to achieve or sustain an erection is a treatable medical condition that affects about 18 million men, although only about 10% receive treatment. Unfortunately, treatment is often delayed or avoided because men are reluctant to talk about it with their partners and physicians. While occasional ED is normal, certain physical conditions can cause recurrent ED:

  • Arterial blockage
  • Diabetes
  • Kidney or liver disease
  • Neurological disorders
  • Heavy smoking or drinking
  • Side effects of certain medications

ED can result from (and cause) stress, depression or relationship problems. It’s especially helpful if your partner is supportive during the diagnosis and treatment process. Counseling is often a good idea for couples who are experiencing this problem.

A number of treatments are available for ED. The physician may recommend quitting smoking, or changing medications to eliminate unwanted side effects. The prescription medication Viagra®, which can increase blood flow to the penis, is often prescribed for ED. Hormone therapy is another option, as is psychological counseling. Finally, surgery is possible if a blockage is discovered to be causing the problem.

Heart Attack It is important to be aware of the signs and risks associated with heart attack. Symptoms may include:

  • Pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes
  • Pain spreading to the shoulders, jaw, neck or arms
  • General chest discomfort with lightheadedness, sweating, nausea or shortness of breath.
  • Cold, pale skin
  • Increased or irregular heart beat

Any of these symptoms may come and go, and any one is definitely a reason to call for emergency medical help. The longer treatment is delayed, the more irreversible—possibly fatal—damage is incurred by the heart.

One of the country’s largest studies, the Framingham Heart Study, found that 25% of heart attacks produce no recognizable symptoms. So it’s important to know what the risk factors are, and if you are at risk, to have regular checkups to screen for heart conditions. Risk factors include

  • Age over 50
  • Excess weight
  • High LDL (bad) cholesterol levels
  • Low HDL (good) cholesterol levels
  • High blood pressure (hypertension)
  • Smoking
  • Diabetes
  • Sedentary lifestyle.

A healthy diet that limits intake of cholesterol, fat and sodium, as well as regular physical exercise, are important for both prevention and recovery.

Getting your guy to the doctor
How can you persuade the man in your life to start getting routine medical care? Nobody will tell you it’s easy. But there are some things you can do. Some couples actually go get physicals on their anniversary. This may seem like an odd way to celebrate, but they figure it’s something they can do for each other. You and your spouse could start a similar ritual. It wouldn’t have to be on your anniversary, but it could be on the same day every year.

American Cancer Society; American Foundation for Urological Diseases; Journal of Family Practice, February 2000; Men’s Health Network;
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