Cancer and cardiac care are always top of mind, but there are plenty of other concerns that men should know about. Of course, staying ahead of disease is always the best medicine.
Men today might think their biggest health issues relate to prostate problems. They wouldn’t be far off.
After skin cancer, prostate cancer is the most prevalent cancer found in men today, says Dr. Sunny Sharma, an internist with AMITA Health Medical Group in Hoffman Estates.
However, the biggest concerns in men’s health are still related to heart disease and cancer overall.
“After the past couple of decades, things have gotten worse,” says Sharma. “Obesity has worsened worldwide. Within the current decade, we’ve noticed cardiovascular diseases have increased – almost 50 percent of adults will have it, more males than females. And cancers, more than one-third of individuals will end up with a type of cancer.”
Obesity is definitely a contributing factor to those overall health conditions, says Amy Paulus, a weight management nurse practitioner at Advocate Good Shepherd Hospital in Barrington.
“People don’t recognize obesity as a chronic disease, which it is,” she says. “The percentage of men 20 and over with obesity is 40.5.”
That’s why it’s so important for men to maintain a healthy lifestyle and be consistent in visits to their health care provider. Men who are married or are in relationships will often receive a “push” from their significant other to go visit a doctor, Sharma says. In fact, that’s the most common reason he finds a man in his office: “Their wife or girlfriend said to come in,” Sharma says.
That’s not a bad thing.
“With so many health diseases across the board, if we catch them early, people can live normal lives,” Sharma says. “We have early intervention techniques. When we catch a problem too late, it’s hard to backtrack. Screening and prevention are key.”
When and Whom to See
Traditionally, diabetes screening and cholesterol screening – and, when age appropriate, prostate and colon screening – are the top medical tests that can help doctors detect any potential health disorders in men, Sharma says.
Thirty-five is the golden age for diabetes and cholesterol screenings, unless there are risk factors such as mild elevations of blood pressure, overweight/obesity issues, and others – in which case the screenings should take place earlier.
Colon cancer screenings used to start at age 50, but recently, top medical officials have reduced the recommended age of a colonoscopy to 45.
Many doctors – and even insurance companies – realized they were missing a lot of cases that sprang up in men between 45 and 50, Sharma says, and if those cases had been caught earlier, the severity of the disease could have been less.
Prostate cancer screening, meanwhile, is a discussion one should have with his primary provider, Sharma says. Traditionally, men start this screening between 50 and 55, but a personal doctor who knows a patient’s family history and possible symptoms may recommend screening earlier.
In fact, for all cancers, the age to start screening could change dramatically if a man has an extensive family history of a particular cancer, he says. It’s just another reason to make sure and follow up with yearly examinations.
“It’s never too early to start getting regular checkups,” says Sharma. “It’s important to establish with a primary care physician. Most men do not do this. It’s more common culturally for men to wait for an actual problem and bypass their actual screening.”
Maintain a Healthy Weight
In the fall of 2019, Advocate Good Shepherd Hospital opened a Weight Management and Bariatrics Program, the only one of its kind in the surrounding area.
It was an important step toward recognizing the importance of treating those who are overweight and obese, says Paulus, the bariatric coordinator for the program.
“Even through the beginning of COVID and throughout, we continued to grow,” says Paulus. “We still had patients coming in. If obesity isn’t the highest, it is one of the highest risk factors of severe COVID complications.”
Paulus works with men and women to create individualized plans to lose weight, though she’s not as worried about getting her patients to a specific BMI.
Instead, her initial goal is to help people lose 5 to 10 % of their presenting body weight.
“Even though some people may not get to a ‘healthy weight’ based on BMI, they could see many health benefits from that 5% to 10% weight loss,” she says. “Depending whether they have any co-morbidities associated with their excess weight, they could get off medications, or at least decrease medications, see improved sleeping, more metabolic stabilization with blood sugar and hormone levels – all of these outliers that can cause weight gain. When that’s all out of balance, it adds up for a perfect storm. So, improving all of that helps my patients have weight loss and improved health overall.”
She’s found that men, especially former athletes, enjoy the assignments that are involved with a specialized weight-loss plan and are eager to meet goals.
“For the most part, they are very task-oriented,” she says. “I require all of my patients to track their intake and then come back to me in a week or two with that tracking data. We use a mobile app that gives me average daily caloric intake and percentages of macronutrients, for example, so now I can see your calories aren’t that heavy, but your carb-to-calorie ratio is too high.”
Tracking food and drink is all about accountability, and getting the diet component down first is key, she says. Seventy percent of a weight loss plan comes down to dietary intake; the remaining 30 percent is comprised of exercise.
However, the two absolutely go hand-in-hand.
“You’re not going to lose weight if you’re not eating properly,” she says. “Conversely, there will be some weight loss just with adjustments in dietary intake, but if they’re not adding the component of exercise to it, they won’t get the full benefit from it. Additionally, it will not be sustainable. My long-term goal for my patients is to guide them through education and follow up regularly to ensure they are building lifelong, improved habits.”
Being fit absolutely affects other parts of a male’s overall health, says Dr. Henry Collier Wright IV, a urologist with Northwestern Medicine.
“As a urologist, I can tell you that maintaining a healthy weight can boost your testosterone levels and improve erectile function,” says Wright. “Eating a healthy diet can prevent kidney stones, and you’ll see better outcomes in cancers.”
Finding a weight-loss plan that works for each individual is key, says Paulus, and it can include things like HMR (Health Management Resources); medical weight management; bariatric surgery, if appropriate; anti-obesity medications; and more.
“There are multiple ways that we can go,” Paulus says.
Advancements in Prostate Surgery
Just as overall weight management is key to a man’s health, so is being on the lookout for possible prostate problems.
While the American Cancer Society says prostate cancer affects one out of eight men, there are other prostate issues that can affect an even larger percentage of the male population as they get older.
Benign prostatic hyperplasia, or BPH, is actually very common, says Wright, who is on staff at Northwestern Medicine’s Huntley Hospital, McHenry Hospital and Woodstock Hospital.
It’s estimated that 70% of men ages 60 to 69 are affected by symptoms that may be related to BPH; that rate jumps to 80% in men older than 70.
Weakened urinary steam, straining to urinate, going to the bathroom at night, urinating more frequently or urgently, and not being able to fully empty one’s bladder are common symptoms of BPH, although they also could be signs of other problems.
“Any time a gentleman has any issues with urinating, these could be signs he has prostate issues,” Wright says.
At the very least, any of those symptoms should prompt a visit to a primary care physician, if not a urologist, he says. With an evaluation, doctors can determine whether there is a prostate issue and what course of action to take.
If the issue is traced back to BPH, there are many treatment options, says Wright.
Doctors always start with behavioral moderations, like refraining from things that can irritate the bladder: caffeine, artificial sweeteners, alcohol, and other foods and drinks.
If that doesn’t work, doctors move on to medications that can alleviate symptoms, Wright says.
Surgery is the last course of action, and there are many surgical options available.
Holmium laser enucleation of the prostate, or the HoLEP procedure, is one of the best approaches to correcting BPH, says Wright, and it has good proven outcomes.
This procedure has been utilized for at least 20 years, but recent advancements have made it available to an even wider male population, he says.
“HoLEP can treat any sized prostate and has gained ground in newer laser technology, which allows for improved surgical recovery,” says Wright. “It has long-term, strong data supporting it as effective surgery, with low risk for blood loss. Plus, men can go home the same day or next day. And there’s no catheter draining the bladder for a long time. Most men get it removed within 24 hours of surgery.”
Unfortunately, this is also a tough surgery to learn, and not a lot a lot of urologists take it upon themselves to learn, Wright says.
In fact, in 2014, only 4% of BPH surgeries in the country utilized the HoLEP procedure, he says.
The good news is that Wright, who joined Northwestern Medicine in September, spent two additional years of fellowship training on top of his residency to learn HoLEP. He performed Northwestern Medicine’s Northwest region’s first HoLEP procedure in February, and he remains one of the only doctors in the northwest suburbs to offer it.
“We’re excited to offer this surgery,” he says. “It may not be appropriate for every patient, but at the very least, I’m willing to talk to the patient about this surgery or other urologic issues.”
It may not be fun, but scheduling regular visits and taking a proactive approach to your health can have many long-term payouts, not the least of which is a longer, more satisfying lifestyle. And, thanks to recent advancements, early intervention is making that payoff even sweeter. The message from local physicians is clear: when in doubt, don’t put it off.
Take Control of Your Health
If you need a little kickstart to make healthier lifestyle choices, begin with these simple tips from area doctors.
1. Quit smoking
“If a patient is a smoker, stop smoking,” says Dr. Henry Collier Wright IV, a urologist with Northwestern Medicine. “There are amazing benefits for their heart and lungs, but quitting also helps urologic health, too. A lot of cancers I see are kidney cancer, bladder cancer – they’re all related to smoking.”
2. Do the Basics of Healthy Eating
“More often than not, people are not eating enough fruits and vegetables,” says Dr. Sunny Sharma, an internist with AMITA Health Medical Group who recently became board certified in Lifestyle Medicine. “The reality is, up to 90% of the country is fiber deficient, not protein deficient. When you’re a kid, everyone tells you to eat your veggies. And then you become an adult, and nobody’s telling you that. If you go back to your basics of 5 servings per day, the better off you’ll be. It fills you up, keeps your cholesterol and sugar low, and keeps you at a regular weight.
3. Define “Real” Fruits and Vegetables
“People will tell me they have a couple of fruits and vegetables here and there,” says Sharma. “So I’ll ask, ‘What are they?’ They’ll say French fries – they count it as a potato – and the little freeze-dried strawberries in a box of Special K cereal. I wish I was kidding. But to be clear, you need whole fruits and vegetables.”
4. Check Your Alcohol Intake
“Alcohol has a very negative effect on weight – it’s empty calories,” says Amy Paulus, a weight management nurse practitioner and bariatric coordinator for Advocate Good Shepherd Hospital’s Weight Management and Bariatrics Program.
5. Exercise Outside Your Norm
Most major health organizations, including the CDC, American Heart Association, World Health Organization and others, recommend adults get at least 150 minutes of moderate-intensity exercise a week.
“150 minutes is the golden number,” says Sharma. “Mild intensity is when you can talk and sing; moderate is when you can talk but can’t sing without heavy breaths in between; high intensity is when you’re not able to do either. That’s literally how I explain it to patients. It’s about getting your heart rate up to a point where you’re putting your heart through a little bit of stress.”
6. Advocate for Your Partner
“Men typically are not their own advocate,” says Paulus. “So, we need ladies to take notice of their partner’s worsening sleep habits or snoring; if they notice they’re getting heavier, especially around the middle – this abdominal fat, the ‘beer belly,’ is where men tend to have their weight collect; seeing they’re having poorer eating habits; decreased stamina; blood pressure creeping up – things like that are definitely factors that would warrant a, ‘Maybe we need to look into this further’ conversation.”