By Pam Kamphuis and Fauquier Health
Let’s face it. Everyone knows what mammograms are and that women need to get them regularly. But what about men? Do you know what a PSA test is? It’s a blood test that measures Prostate-Specific Antigen, and it’s a screening tool for prostate cancer. “I’d never heard of a PSA test,” says Mary Ann Perrin of Warrenton (not her real name). “We didn’t know it was something that was important to keep up with as men get older. My husband hardly ever went to the doctor, so he’d never had one. When he finally did go, in his sixties, his PSA was elevated. His primary care physician sent him right to a urologist.”
Women are, in general, very health conscious and actually keep up with regular checkups and tests. Men, on the other hand, “are not always the most ideal patient,” says Sarah Cubbage, marketing director at Fauquier Health. It is typical to see that men are not as proactive about their health and often forgo regular yearly physicals.
Why is that? “It is very typical of men to want to avoid the doctor. They feel uncomfortable or they don’t like to talk about personal issues – especially urology-related issues,” says Dr. Brian DeCastro, Urologist at Fauquier Health. “Some men see it as a sign of weakness, others feel they are too busy, and some just hope their issues will go away by ignoring them.”
“We need to encourage wives to be more proactive with their husband’s health,” says Sarah.
Just like with cardiac health, men need to have urologic checkups regularly. Normally, a visit to your primary care doctor is a good start. “Men may not feel comfortable discussing issues with a male doctor, much less a female one,” says Dr. DeCastro. This can really cause a crucial lapse in health care for men.
Mary Ann said, “My husband had been for a pre-surgical physical a few years before, but the nurse practitioner was a client of his and maybe didn’t want to embarrass him, and the exam was less than thorough. If she’d been more thorough, we might have caught cancer a few years earlier.”
Dr. DeCastro says, “If you don’t feel comfortable talking about urologic issues with your primary care provider, ask for a referral to a urologist. A lot of insurance plans don’t require a referral for a specialist these days, so you can just call us up and we’ll be happy to help you out.”
Some men’s health conditions have physical symptoms, but some don’t, so it’s important to talk about any symptoms that are not normal. “I see a lot of men that don’t come in for months when they have symptoms. They put it off, especially if it’s not painful. They’re either in denial or they hope their symptoms will just go away,” says Dr. DeCastro. It’s absolutely crucial to have regular checkups to catch conditions that are often asymptomatic, like prostate cancer. That’s why screening is so important.
Men’s health issues to screen for:
Prostate cancer is the second leading cause of cancer death in men, second only to lung cancer. It is the male equivalent of breast cancer. “There seems to be a myth out there that prostate cancer is not very dangerous or aggressive. Each year, about 30,000 men die from prostate cancer. It is extremely treatable as long as it’s caught early.” A cancer diagnosis doesn’t necessarily mean immediate surgery or radiation. “Fortunately, we can even watch some less aggressive forms of prostate cancer. If you do need surgery,” Dr. DeCastro adds, “Nowadays with robotic prostatectomies, the side effects are not as bad as they have been in the past. We are seeing quicker recoveries with much better results today. It is extremely important to get your PSA checked yearly.”
Erectile Dysfunction (ED)
Up to 50 percent of guys in their 40s will have some degree of sexual dysfunction. “That’s a huge number,” says Dr. DeCastro. “With each decade you see that number go up. By the time men are in their 70s and 80s, seventy percent may be showing symptoms. Because people are living longer, this is more of an issue for many men. “We have several options to help men with ED that are not just limited to medication,” Dr. DeCastro says.
Low testosterone can happen at any age but is more common as men get older. It is sometimes hard to diagnose as the symptoms are fairly non-specific and men think of them as just a normal part of aging. Symptoms include ED, fatigue, decreased sex drive, and decreased performance at the gym. “A lot of men say they just don’t feel like they have the drive to do things they normally do. The good news is that Low T is extremely treatable with Testosterone Replacement Therapy,” advises Dr. DeCastro.
Enlarged prostate (BPH)
Enlarged prostate is a common condition as men get older, and usually has urinary symptoms such as slow stream, frequency, and night-time urination. There are different ways to treat an enlarged prostate including medication and/or other procedures. Many men suffer silently for decades with bothersome urinary symptoms.
Testicular cancer is the number one cancer in men ages 20-40. It has a 97 percent cure rate if caught early but is much more difficult to treat in later stages. Men should be doing monthly self-exams. Ideally, says Dr. DeCastro, “Men should be taught how to do a self-examination monthly in middle school health class.”
See your doctor or urologist if you:
- Are 50 or older for a PSA screening (40 or older for African American males, or those with a family history)
- Have difficulty urinating or emptying bladder
- Are getting up multiple times a night to visit the bathroom
- Are experiencing sexual dysfunction and/or low sex drive
- Are experiencing extreme fatigue
- Notice any abnormalities during monthly self-examinations
- Notice blood in the urine, even if it goes away (particularly if you are a smoker)
To learn more about these urologic conditions and more, we encourage you to watch Dr. DeCastro’s video lecture series on the Fauquier Health YouTube channel. You can also visit FHDoctors.org/find-a-provider/brian-decastro.