Opening up about health concerns with a physician can be difficult for anyone, but men seem to struggle most with bringing up health topics, or even planning regular visits, with their doctors.
Studies have shown that men visit physicians less often and use fewer health services than women, even when they have health problems. This inactivity, paired with certain lifestyle choices such as smoking tobacco or drinking alcohol, put many men at an increased risk of developing lifestyle-related health issues and having underlying health conditions remain undetected.
Washington University physicians, including experts from the specialties of urologic, cardiothoracic and colorectal surgery, highlight the importance of speaking openly about your health with your doctors to learn the proper screening guidelines for several conditions that can affect men’s health.
General Health Screenings
Even if you feel fine, it is important to see your general practitioner or family physician for regular check-ups to help avoid future problems. Annual check-ups normally include the following to help you manage your health:
- Updating your health history.
- Vital sign checks, such as blood pressure reading, heart and respiratory checks.
- A visual exam, checking parts of your body such as your head, chest, eyes, abdomen, musculoskeletal system, or nervous system functions that could indicate existing health issues.
- A physical exam, using tools to look in your ears, nose, eyes and throat. The exam also includes touching or “palpating” parts of your body to feel for abnormalities and testing your motor functions and reflexes.
- Laboratory tests such as a urinalysis, complete blood count, and a complete metabolic panel. These tests can indicate any issues with your kidneys, liver, blood chemistry, and immune system to detect any irregularities in your body that may be a bigger problem. If you have an increased risk of heart attack, stroke, or heart disease, they may also request a lipid panel (cholesterol test).
- Most men are advised to begin regular cholesterol checks at age 35 (however, if you have a history of or genetic predisposition to diabetes or heart disease, you may begin cholesterol checks as early as age 20).
Upon a discussion about your health concerns, your family physician or general practitioner may refer you to a specialist to tackle your concerns head on with the expertise and care required for your situation.
The American Cancer Society recommends that men have a chance to make informed decisions with their health care providers about whether to be screened for prostate cancer. The screening test that should be considered is a prostate-specific antigen (PSA) test. These discussions should occur at:
- Age 40 for men at a higher risk of developing prostate cancer (more than one first-degree relative, such as a brother or father, who developed prostate cancer younger than 65)
- Age 45 for men at a high risk of developing prostate cancer (including African Americans and men who had prostate cancer at an early age)
- Age 50 for men who are at average risk of prostate cancer
If it is deemed that you are indeed at risk for developing prostate cancer or developing symptoms, your doctor may perform a digital rectal exam (DRE) to feel for any bumps or hard areas on the prostate that may be cancerous. Additional testing may also be recommended, but a biopsy is the only way to determine if a man has prostate cancer and to determine its staging.
“Washington University has always been a leading center in the development of prostate-specific antigen testing and leading-edge procedures to diagnose and treat prostate cancer,” says chief of urology Sam Bhayani, MD, MS. “Now, our team at Siteman Cancer Center uses the most advanced surgical techniques and innovative clinical therapies tailored to each patient’s unique needs.”
According to the National Cancer Institute, testicular cancer is the most common cancer diagnosed in men aged 15 to 34. Since there is no standard or routine screening test for testicular cancer, men are encouraged to perform self-examinations on a monthly basis. If you have a family history of testicular cancer, have previously had an undescended testicle, or previous germ cell tumor in one testicle, please discuss these conditions and your potential risk factors for testicular cancer with your physician.
If you become aware of any differences to your testicles, such as lumps, changes in size, and tenderness, tell your physician to determine if additional testing or physical examination are necessary.
Sexual dysfunction issues, such as erectile dysfunction, are often underdiscussed with medical professionals. Though some physicians might inquire about any sexual issues that may be troubling their patients during their regular wellness exams, it is currently a patient’s responsibility to report any changes in their sexual health with their doctors.
“Erectile dysfunction is very common and affects more than 30 million men in our country,” says Washington University urologist Arnold Bullock, MD. “Although this condition can feel embarrassing or even difficult to discuss with your doctor, it is incredibly important to discuss your symptoms with your doctor, who may refer you to a specialized men’s health expert like one of our team’s urologic surgeons.”
Erectile dysfunction is most commonly a secondary side effect of existing cardiovascular conditions, such as hypertension, elevated cholesterol, peripheral vascular disease, or myocardial infarction (heart attack). Men with diabetes are also at high risk of developing severe ED. Additionally, men who struggle with depression often experience erectile dysfunction. Your physician may also conduct blood screenings to test for low testosterone.
“Mild to moderate erectile disfunction can be improved by addressing any underlying cardiovascular issues and improving overall medical health through exercise, weight loss, and diet,” says Bullock. “If their condition requires surgical intervention, our team of urologic surgeons are experts in helping patients decide what surgical ED treatments are right for them and guiding them through their healing process.
“Patients should never feel embarrassed to discuss this type of condition with their physician or a specialist,” says Bullock. “We’re here to help our patients navigate their issues and lead them on a path toward recovery.”
You should discuss your potential risk for infertility with your physician if you find that you and your partner have been trying to conceive without success. Additionally, you should discuss if you have a history of having a low sperm count or other issues with sperm, a history of testicular, prostate or sexual problems, previous cancer treatments, small testicles or swelling in the scrotum, or a family history of male infertility.
Upon having this discussion, your physician may refer you directly to a men’s fertility specialist. Men’s fertility expert and urologic surgeon Dane Johnson, MD, helps his patients identify all factors that may be affecting their ability to conceive.
“When you arrive for your appointment, we begin your evaluation and physical examinations right away,” says Johnson. “Our team will start by collecting blood and semen samples for testing and get right to work in determining the medical causes for your infertility struggles.”
Alternatively, for men hoping to explore more permanent contraceptive measures, urologic surgeons can provide vasectomies. The minimally invasive surgical procedure can be completed in a urology office using local anesthesia and takes only about 10 to 15 minutes. This common and effective method of contraception can also be reversed.
The colorectal cancer screening guidelines, as outlined by the Centers for Disease Control and U.S. Preventative Services Task Force recommends that all adults, both males and females, who are at “average risk” of colorectal cancer should begin regular screenings at age 45. However, patients may need to be tested earlier than age 45 or more frequently than others if they suffer with an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, a personal family history of colorectal cancer or polyps, or a genetic syndrome such as familial adenomatous polyposis or hereditary non-polyposis colorectal cancer.
“There are several screening tests that can be used to determine the presence of polyps or colorectal cancer,” says Washington University colorectal surgeon Steven R Hunt, MD. “Some of these tests, such as stool-based tests can be done once a year and in the comfort of your own home, while other tests are more involved and must be performed by a doctor.”
The most accurate and comprehensive screening method for colorectal cancer is a colonoscopy, which has the ability to detect cancer as well as treat it in its early stages. If your colonoscopy results come back clear of any polyps or concerning areas, this procedure can be repeated once every ten years unless changes in health history occurs or increased risk factors develop.
Lung Cancer Screenings
According to the Centers for Disease Control and Prevention, smoking cigarettes harms nearly every organ of the body, and causes about 90% of all lung cancer deaths.
“People who currently smoke or have smoked in the last 15 years are at a higher risk of developing lung cancer,” says Washington University cardiothoracic surgeon Benjamin Kozower, MD. “Thanks to recently expanded lung cancer screening guidelines, anyone between the ages of 50 and 80 years old with a smoking history of at least 20 “pack years” or a pack-a-day for a year or equivalent amount can now be screened for lung cancer.”
Since lung cancer is often diagnosed in its late stages, when it is most deadly, early detection and treatment is critical to helping at-risk patients have their best shot at surviving after receiving a lung cancer diagnosis.
“Lung cancer screenings save lives, and these expanded guidelines, along with the lung cancer screening program at Siteman Cancer Center, aims to help patients understand their risks and catch lung cancer diagnoses early on when they are most treatable.”
Quitting smoking is one of the most important actions a person can take in order to improve their health, and if you are a smoker and wish to quit, your physician can provide a wide range of resources to help your quitting journey more successful.
Washington University Men’s Health Experts
Washington University surgeons are part of a multidisciplinary group of specialists who bring together expertise and personalized treatments to help their patients achieve their best outcomes. Patients can be seen at Barnes-Jewish Hospital, St. Louis Children’s Hospital, five Siteman Cancer Center locations, and a number of community hospitals in St. Louis County and beyond.
- To schedule an appointment with a urologic surgeon, please call 314-362-8200 or request an appointment online.
- To schedule an appointment with a colorectal surgeon, please call 314-454-7177 or request an appointment online.
- To schedule an appointment with a cardiothoracic surgeon, please call 314-362-7260.