Men’s Health Month: Getting Back to the Basics

You know the type. The macho guy who’s rough, tough, go-it-alone, leader-of-the-pack, help-not-wanted. Macho man may put off seeing a doctor for a checkup – because he thinks he’s invincible, doesn’t get sick, it’s a waste of time, only for the weak.

Physicians at the University of Maryland Medical Center say some men only give in when they have symptoms, when major treatments are required, or when preventive steps are more demanding. Even so, it’s never too late to start on the road to health.

June, Men’s Health Month, is a great time to focus on preventable health problems and encourage early detection and treatment of disease among men of all ages.

So, you’re out of shape?

Heart disease kills 1 in every 4 men in the US. One clue to heart health is endurance. Can you walk up two flights of stairs or four city blocks without stopping (barring traffic lights, etc.), or has there been a change in your activity level over the past 6-12 months? A man may shrug off the changes and blame them on being “out of shape,” but these changes could signal changes in heart health, says Michael Miller, MD, professor of cardiovascular medicine, epidemiology and public health at the University of Maryland School of Medicine and director, Center for Preventive Cardiology at the University of Maryland Medical Center.

Dr. Miller: “If the answer to both questions is ‘no’ (presuming they have no other limitations such as joint disability, emphysema, etc.), then their heart is considered to be in reasonably good shape and no further workup is usually necessary.  If the answer to either question is ‘yes,’ then further questioning and/or workup is indicated.”

The paunch and the pound

Dr. Miller: “I ask men what their weight and waist size was when they considered themselves to be in good physical health (often in their early-to-mid-20s). If either their current weight or waist size exceeds 10 pounds or 2 inches, the risk of Type 2 diabetes and heart disease begins to increase.  After checking for the major cardiovascular risk factors (cigarette smoking, high blood pressure, high cholesterol, diabetes), we make recommendations aimed at improving their cardiovascular health.”

Recommendations: Eat a big breakfast or lunch with a light dinner, have a snack between meals, take a walk after dinner, and relax 30-60 minutes before bedtime to increase the odds of getting at least seven hours of uninterrupted sleep.

All or nothing

Diabetes in men jumped 177 percent in the US from 1980-2014, fueled in part by weight gain and obesity. Shedding the pounds is often a struggle, but If your ideal, normal body weight is 180 pounds, and you’re 300, it may be unrealistic to set a goal of getting back to 180, says diabetes expert Kashif M. Munir, MD, assistant professor of medicine at the University of Maryland School of Medicine and medical director of the University of Maryland Center for Diabetes and Endocrinology.

Dr. Munir: “Of course, getting back to 180 is worth striving for, but to make differences that affect your risk for diabetes and heart disease, we’ve shown in studies that if you lose just five or 10 percent of your body weight, you can reduce those risks in a big way and improve your overall health, often within weeks.”

Exercise snacks. Diet is the main mechanism for losing weight, but the other side of the equation is exercise and doing more.

Dr. Munir: “What I tell people is to take exercise snacks. Instead of snacking on peanuts or cookies or whatever, do a 5-10 minute moderate-to-high-intensity workout. And if you can do that several times per day, all the better. Most people can spare 5-10 minutes here and there, so I tell people in the morning before you go to work, do a quick 5-minute jog, or something like that. At work, if you have a lunch break, go out for a walk, or get in some activity, and in the evening try to do the same thing.”

Lung Cancer: Put out the fire before it starts

Lung cancer is the leading cause of cancer death in Maryland men, yet men tend to wait longer to seek medical treatment for the condition than women, says Gavin L. Henry, MD, assistant professor of surgery at the University of Maryland School of Medicine and thoracic surgeon at the University of Maryland Medical Center.

Dr. Henry: “Many men who are referred to us have symptoms, but the referral is often a good sign because it likely means the cancer is in an early stage when there’s time to take action. As surgeons, we always say ‘the chance to cut is the chance to cure.’”

Annual lung cancer screening. Low-dose screening CT scans have become the standard for detecting early lung cancer.

Dr. Henry: “We recommend that men get a primary care physician, get regular checkups and screening, especially for men ages 55-70 with a significant history of smoking, (greater than 30 packs of cigarettes a year), and those with a family history of lung cancer.

Quit smoking. 80-90 percent of patients with lung cancer have a history of smoking.

Henry: “If a man is a smoker, the best thing he can do for himself is to quit. Many of my patients know smoking is bad for them. But it’s tough, it’s a habit. We recognize it’s a struggle, and we try to help with a variety of smoking cessation tools and techniques.

A man’s a man, and all that

Prostate cancer, the second leading cause of cancer death in Maryland men after lung cancer, is one of three major issues in urology for men, including sexual dysfunction and prostate enlargement, also known as BPH. “These three areas can disrupt men’s lives significantly; the incidence really starts to go up when men are in their 50s-60s-70s,” says Michael J. Naslund, MD, professor of surgery and chief of the Division of Urology at the University of Maryland School of Medicine and director of the Maryland Prostate Center.

Prostate cancer:  Cancerous cells develop in the prostate, one of the male sex glands. There’s not good data on preventing prostate cancer, and since there are no specific signs or symptoms, screening is the best way to detect it early. If it’s found, there are many treatment options, depending on health, age, expected life span, personal preferences, state and grade of cancer and the anticipated effects of treatment.

Dr. Naslund:  “When a man gets to age 50, he should be getting prostate cancer screening that includes a rectal exam and PSA blood test once a year, along with a blood and urine check. If there’s anything abnormal, then he’ll need further testing.”

Sexual dysfunction: It usually takes the form of erectile dysfunction, the inability to sustain or maintain an erection.

Dr. Naslund: “There are many things a man can do to prevent sexual dysfunction: maintaining good physical shape, not gaining a lot of weight will lower the risk of getting sexual dysfunction later in life. Not smoking is key: that helps prevents all kinds of vascular disease including erectile dysfunction. Eating smart, exercise, don’t smoke are the things men can do. Those three benefit men in a lot of other ways as well. As for treatment, pills are the first option and probably solve the problem three times out of four.”

Prostate enlargement (BPH): Partially block the bladder, resulting in a weak stream of urine and frequent urination

Dr. Naslund:  “Virtually all men get prostate enlargement, when compared to young men in their 20s. I would estimate that half of men don’t have any effects from it. They urinate normally and it never becomes an issue. Men often ignore symptoms and may not realize that treatment, if required, is less invasive with fewer side effects than it used to be.”