Too many men refuse to go to the doctor unless they can’t stop the bleeding. According to local experts, it’s a deadly trend.
Unlike women, who because of reproductive health are trained from the teen years to schedule annual visits and perform self-exams, men lack the opportunity to form a similar habit. They also may have a more difficult time admitting weakness, be disinclined to discuss emotional health, engage more often in risky behaviors, get less sleep, forgo skin care, and carry more “dangerous” fat around the midsection. According to Robert Alt, who specializes in internal medicine at Dean St. Mary’s, and Dr. Mark Olinger, a family practitioner at Group Health Cooperative, this is what to watch for at each age group.
• “This is the time when boys are imprinted with the notion that ‘big boys don’t cry,’” says Alt. “We need to help males understand their feelings and permit emotions other than anger.”
• Bravado behavior also emerges, so awareness of personal safety is critical. Wear helmets and seatbelts, teach about drugs and alcohol, and slather on the sunscreen (melanoma at any age is one of the most devastating, lethal kinds of cancers).
• The current obesity epidemic is presenting in kids as metabolic syndrome. “Obesity is one of the major contributing factors to 70 percent of the preventable health problems,” says Olinger, adding that kids need at least one hour of daily physical activity.
• The highest incidence of testicular cancer occurs in men ages 15 to 35. Caught early it’s curable, but monthly self-exams and doctor visits annually are a must.
• Teen boys are four times more likely to drop out of school than females, nine times more likely to have conduct problems and fifteen times more likely to be victims of violent crime.
• Beginning at age 15 there is a huge leap in male suicide. According to the CDC, the rate per 100,000 is 21 for males, 4 for females. This trend continues throughout life.
• Men exercise less regularly, resulting in either higher blood pressure and cholesterol or “weekend warrior syndrome” injuries. Get regular lab work, as well as proper eye and tooth care (flossing reduces inflammation, which directly impacts heart health).
• A man may not notice the effects of steady drinking, smoking or drug use until his 30s and 40s, when problems such as high blood pressure, impotence and certain cancers may arise. Addiction may also exaggerate existing issues, such as engaging in risky behaviors, aggression and depression.
• Annual prostate screening should start at age 40 for African Americans or those with family history, 50 for everyone else.
• Some slowing in libido and function is normal, but abrupt changes may indicate a more serious problem with circulation and heart health.
• Chronic illness and injury are common—bum knees, osteoarthritis, diabetes, heart disease, joint pain and more must be addressed at the clinic.
• Prostate cancer is most prevalent over 50, and African American men are at highest risk. Digital rectal exams should be annual, and possibly a PSA (see sidebar).
• By 50 men should have regular colon cancer screening by colonoscopy (every 10 years), flexible sigmoidoscopy (every five years) or stool cards (annually).
Ages 60–75 and beyond
• Bone density tests: osteoporosis occurs at a rate equal to females, but about ten years later.
• If you’ve ever smoked (as little as five packs in a lifetime) get an ultrasound to screen for abdominal aortic aneurism.
• Bone, joint and muscle health, continued issues with chronic illness and injury and depression over aging, combined with stresses of caring for both young adult children and aging parents, make regular clinic visits a continuing priority.
When to Test
Prostate cancer is one of the most common cancers in men over 50. For many years a rectal exam was the only form of early protection, but in the late ’90s the FDA approved the prostate specific antigen (PSA), a discovery that sharply divides today’s medical community.
PSA is a blood test that when high may signify serious problems in the prostate. However, high levels may also indicate simple prostate inflammation.
“There are those who believe PSA has been responsible for a massive decrease in prostate cancer death among men,” says Robert Alt, an internal medicine doc with Dean St. Mary’s, “and there are those who say it has resulted in an enormous increase in unnecessary and invasive testing with ill consequences.”
Alt says the most important thing is to examine the prostate annually after age 50 and to have a conversation about PSA with your doctor.
“At the very least, it’s a reason for men to be in the doctor’s office at least yearly.”
Maggie Ginsberg-Schutz is a contributing writer for Madison Magazine.