Women tend to be health-aware. Between annual mammograms and gynecological care, most women have a primary-care physician and recognize the importance of regular health screenings. Now it’s men’s turn.
June is national Men’s Health Awareness Month, but men are less likely than women to seek regular preventive care, often seeing the doctor only when a concern arises.
“Men tend not to have a reason to go to a primary-care doctor at regular intervals,” says Dr. Amit Bhatt, a St. Luke’s Hospital radiation oncologist. Bhatt treats cancers in men, the most common being prostate, lung and colorectal cancer, yet stresses that early detection for these and other diseases begins with regular primary care. “The one thing I think that men lack is the routine follow-up that they need to maintain general health.” He notes that a trusting long-term relationship with a family physician or internal medicine specialist is key.
“Men need to utilize common sense in proper nutrition, weight control and exercising regularly after discussing with their doctor what is their best approach,” adds Dr. Collins Corder, an internal medicine and geriatric specialist at Missouri Baptist Medical Center. “The most common medical problems of hypertension, diabetes, obesity, arthritis and sleep apnea can be helped with weight and exercise intervention.”
When it comes to cancer, there has been some debate in recent months about recommendations from the U.S. Preventive Services Task Force regarding prostate cancer screening. The task force found “convincing evidence that treatment for prostate cancer detected by screening causes moderate-tosubstantial harms, such as erectile dysfunction, urinary incontinence, bowel dysfunction and death. These harms are especially important because some men with prostate cancer who are treated would never have developed symptoms related to cancer during their lifetime.”
Bhatt says the recommendations must be considered in light of a patient’s individual health risks, ethnicity, medical history and age. “When you get to the 60s and 70s, you have to give some thought to whether the person would live long enough to benefit from treatment,” he notes. “PSA (prostate specific antigen) screening is valuable as a screening tool. The question in my mind is what do you do afterward? After you get an elevated PSA, you have to think of a patient’s other medical conditions and decide if intervention is relevant.”
In past years, some patients, particularly those who are older or have other significant health problems, practiced ‘watchful waiting,’ in which they and their physician would keep an eye on prostate cancer progression without taking action. Bhatt prefers the more recent term ‘active surveillance’ to describe the strategy of continued testing and decision-making based on how quickly the cancer progresses in balance with other individual health factors. “There are generalized guidelines, but we understand that every patient is unique.”
Despite the focus on prostate cancer, Bhatt notes that there are more cases of skin cancer diagnosed in men each year than all other cancers combined. Many are easily treatable lesions caused by years of sun exposure, especially on the face, ears and scalp. However, melanoma is a dangerous cancer that can spread rapidly to internal organs.
Regarding the second most common type of solid tumor cancer in men, Corder says, “Lung cancer diagnosis by routine chest Xrays has not been effective in screening. A low-dose CT scan in a high-risk person who smokes is being used, and you should ask your doctor about the risks and benefits. Stopping smoking is the most important step to prevent lung cancer.”