House Call: Men – stay on top of your health

Staying or trying to get healthy is much the same for all of us. However, there are a few differences between genders, so there are specific things that men need to be aware of to stay healthy. The top differences involve the prostate gland, testicles and penis. They are exclusive to those of us born male and can cause problems, especially as we age.

The most common problems are benign prostatic hyperplasia (also called enlarged prostate) and prostate cancer. Some of the symptoms for these two conditions overlap, most commonly trouble urinating and decreased force in the stream of urine. Even if you don’t find your symptoms bothersome, you should still bring them up to your doctor.

Other symptoms of an enlarged prostate are:

Frequent or urgent need to urinate

Increased frequency of urination at night

Difficulty starting urination

A urine stream that stops and starts

Dribbling at the end of urination

Inability to completely empty the bladder

There are good treatments available for an enlarged prostate, so you shouldn’t think that your symptoms are just something you must put up with as you get older.

Screening for prostate cancer is a complicated discussion. Large studies show a small reduction of prostate cancer deaths from screening. I tell my patients that if we screen thousands of men for prostate cancer, we will find some early cases and save a few lives.

We also will find a lot of false positive tests, do a bunch of prostate biopsies on men who ultimately did not need them and will unfortunately kill a few patients with complications of prostate removal surgery and biopsies.

Some of those treated men will have lifelong inability to hold their urine, and many will not be able to get an erection. In groups that are not screened, we will have a few men who die from prostate cancer, but we don’t harm or kill anyone.

Statistically, the two groups, screened or not screened, look about the same over long periods of time. Men with fathers or brothers with early prostate cancer and black men are at higher risk, and those factors should be part of the decision to screen. I give my patients the choice.

I have a patient right now, a black man, who was screened a few years ago and had a level in the upper part of normal. After having the above talk, he decided to be screened again. His test was higher, and he was referred to a urologist, biopsied and found to have cancer. He is having a prostatectomy soon. He is probably one of those with a life saved.

Testicular cancer is the most common cancer in males ages 15 to 35, but it can happen at any age. It is highly treatable. If you notice a lump on your testicle, get it checked out.

Penile cancer is extremely rare and occurs almost exclusively in men who have not been circumcised. Keeping the penis clean by regularly retracting the foreskin, washing and drying are preventive. Like cervical cancer in women, it is caused by the human papilloma (venereal wart) virus. There’s another good reason to get your kids vaccinated.

Something more unusual for men to get is breast cancer, but it does happen. Just like in women, it is more common with advancing age. If you notice a lump in your breast area, get it checked.

As always, my best advice is to get enough sleep, maintain a healthy weight through a diet rich in vegetables and fruit, and get regular exercise. If you use tobacco, quit. They are the things that affect your overall health that are the most under your control.