Listen up. We gotta have a talk. Man to man.. June is men’s health month and it’s time for some serious reflection. Did you know that men, on average, die almost five years earlier than women? The statistics show that men deal with more illness than women, and yes, they die younger. One of the reasons for that is that men are more reluctant to go to the doctor. In fact, studies show that women go to the doctor twice as much as men.
I’ve been pondering why that is the case and I’ve come to a few conclusions. As a man, I get it. I probably don’t go to the doctor as much as I should. And it’s not because I think I’m invincible or that I don’t care about my health. For me, it’s about prioritizing the time to go when I feel like… well, the recommended screening tests are probably just gonna be negative anyway because I feel just fine. That rationalization, mixed with a little bit of laziness is probably keeping me from the doctor. Does this ring true for you? Well then join me and commit to making a change here and now.
As a cancer doctor, I see some pretty heart-wrenching health challenges. Fortunately, we are able to cure a lot of patients thanks to modern advances in technology. However, I see way too many patients who have to fight (and sometimes lose) battles that could have been made much easier or even avoided altogether if they had undergone the recommended screening. It’s a known fact (and it makes sense) that if you can detect a cancer early in its development before it has spread, it is much more curable. Put simply, early detection saves lives. But if you wait until you have symptoms, your fight may be much more difficult. Unfortunately, the COVID-19 pandemic has resulted in many elective procedures being put on hold, and this has led to a substantial decline in cancer screening. It’s time to get back on track.
Let’s explore together the top three cancers in men and what we can do to screen for them.
Many of us have heard that prostate cancer is the most common cancer in men. It’s true. 1 in 6 men will be diagnosed with prostate cancer at some point in their life. It’s even been said that if you live long enough, you will probably get prostate cancer. An estimated 268,490 men in the United States will be diagnosed with prostate cancer this year. Fortunately, we are able to cure a lot of these patients due in part to the early detection afforded by prostate cancer screening with the PSA blood test. A blood test… that’s it. Don’t let confusion about prostate cancer screening prevent you from having the discussion with your doctor. The American Cancer Society recommends beginning this discussion starting at:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).
- Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).
The second most common cancer in men and the leading cause of death from cancer is lung cancer. The reason it is so deadly is because most lung cancers are diagnosed at an advanced stage where the five-year survival is less than 25%. If you wait until you are symptomatic from a lung cancer (ie. short of breath, coughing up blood, etc.), treatment is much more difficult and oftentimes much less effective. Did you know there are treatments for early stage lung cancer that have a 95% cure rate? Even if you are not a candidate for surgery, technologically advanced forms of short-course radiation therapy can effectively ablate small lung cancers (90-95% cancer control) and usually with limited, if any, side effects! As always, the trick is to catch it early. According to the American Cancer Society, low-dose CT scans for lung cancer screening are recommended for people who:
- Are 50 to 80 years old and in fairly good health,
- Currently smoke or have quit in the past 15 years,
- Have at least a 20 pack-year smoking history. (The equivalent of 1 pack of cigarettes a day for 20 years)
Screening of smokers with CT scans seems to be working well and saving lives. In fact, over the last few years, there has been a shift toward more early stage lung cancers and less late stage lung cancers being diagnosed. Part of this is due to a recent expanding of the eligibility criteria that allows more people to obtain lung cancer screening.
The third most common cancer in men is colorectal cancer which is commonly discovered because of rectal bleeding. Don’t wait until you’re bleeding! I know, I know… everyone dreads the thought of having a colonoscopy (or at least the prep to get ready for it!). But here’s the thing – a colonoscopy is not only a good screening and diagnostic tool, but it is also able to treat you for precancerous polyps by removing them before they develop into a colon cancer.
The American Cancer Society recommends colorectal cancer screening from age 45 through 75 for men who are at average risk of colorectal cancer as long as you are expected to live another 10 years. After a good colonoscopy, you may not need another one for 10 years! There are other testing options including stool-based tests and other imaging tests. Your doctor can discuss which test is right for you. For men at higher risk, such as those with previous polyps, ulcerative colitis, Crohn’s disease, or family history/hereditary condition, your doctor may recommend more frequent or earlier screening.
Of course, this is by no means an exhaustive list of health screening examinations. Your primary care provider is the best person to discuss your specific needs. Additional testing for men over 65 may include screening for:
- Abdominal aortic aneurysm
- Blood pressure
- Diabetes mellitus, type 2
- Lipid disorders
The first step is to make an appointment with your doctor. Let’s start with that. I’m calling mine right now. I invite you to join me and commit to taking that first step that will lead to longer and healthier lives.