The Medical Minute: Men's Health Week 2010

By: John J. Messmer

In 1994 Congress passed a resolution that led to an annual Men’s Health Week to promote awareness of the health issues specific to men. By now, most people realize that it’s better to deal with problems early or as Ben Franklin said, “An ounce of prevention is worth a pound of cure.” But men are half as likely to heed this advice. 

One explanation for this imbalance in medical visits is that women tend to have the responsibility for getting the children to the doctor and are thus more likely to think about their own health. True, men may tend to just “tough it out,” but I think the main reason women get to a doctor more often is because there is a specific screening exam for cervical cancer, the Pap smear, for women beginning early in their lives, so regular exams are standard fare. The earliest male cancer screen is the testicular self-exam, but because it is a self-exam, there is no trip to the doctor. It’s not until age 50 when a colonoscopy is recommended that men must go to the doctor for a cancer screen.

To be sure, cancer screening is important, but even more important is the leading cause of death in men – cardiovascular disease. Early detection and treatment of high blood pressure, high cholesterol and diabetes, and help with smoking cessation, proper diet and exercise could have a significant impact for men’s health and simultaneously save billions of dollars in health care expenditures.

If you are a man, you may be thinking, “Why should I worry about heart disease? I feel fine. I’ll just wait until I have symptoms.” For many men, the first symptom of heart disease is sudden death. Even if a man reports chest pain and has an intervention, the disease is not gone, only the acute problem. Cardiovascular disease is already established when symptoms show up and every organ is involved.

Erectile dysfunction (ED) drugs get plenty of coverage in commercials, but ED is, in many cases, an early symptom of cardiovascular disease. It just showed up in a different organ first. The same strategies for prevention of heart disease can prevent ED also.

Lung cancer is the most common cancer in men, but there is as yet, no completely satisfactory way to screen for it. Prostate cancer is next in line as a cause of death, then colon cancer. Colon cancer screening is usually accomplished by colonoscopy although sigmoidoscopy (which examines the lower half of the colon) and stool testing for blood can be used also. Age 50 is the typical time to start screening, as colon cancer is unusual before age 50 unless there is a family history of early colon cancer.

Prostate cancer screening presents a conundrum. The digital rectal exam to feel the prostate is not sensitive enough to pick up prostate cancer early. The prostate specific antigen (PSA) test is useful if it is very high or very low to suggest the presence or absence, respectively, of prostate cancer. The problem is that a modest elevation of the PSA could be due to something other than cancer, so routine screening is not a universal recommendation but must be decided on an individual basis.

For the 2010 Men’s Health Week, let’s keep the message simple.

  • The most important item is to avoid tobacco. If you have been unable to quit, see your doctor.
  • Next, exercise regularly. That means 30-45 minutes of some activity that raises your heart rate and makes you breathe faster, four times a week.
  • Eat a variety of vegetables including legumes, fruits and grains mostly and some fish and lean meat. Learn what foods are salty and minimize them. Keep fatty foods to a small part of your diet.
  • Men are more likely to suffer intentional and unintentional violence. Moderation in alcohol use, never operating a car or machinery when drinking and 100 percent regular use of seatbelts are a good beginning. For gun owners, locking the unloaded gun and ammunition is critical since more people are injured by their own guns than intruders are stopped by them.
  • Check in with your doctor regularly beginning in your 20’s. Your doctor can help you with your health maintenance and recommend the age appropriate health screening to reduce your risk of the major health issues you as a man are more likely to face.

If you are a man or there is a man in your life whose health is important to you, make this year’s Men’s Health Week the beginning of a change so men and women one day will be equally likely to seek regular health maintenance care.

John J. Messmer is an associate professor of family and community medicine and associate vice chair for inpatient medicine, Penn State Hershey Medical Group, Palmyra, Pa.

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Last Updated June 16, 2010