Manning Your Health: Four Topics Worth Discussing at Your Next Appointment

I’ve learned over the years that men, generally speaking, are not big fans of coming to see their clinician. As the prostate exam in particular has been a common source for sitcom material, we find that we have to do a lot of encouraging with men of all ages to get them in the door. But here’s the good news: the frequency of prostate testing and how we conduct those tests have changed. In discussing this along with other key areas of men’s health, I hope that men who have not visited their clinician recently will find the motivation to do so soon.

Prostate Cancer

Depending on your risk at developing prostate cancer, a general exam is not what it used to be. It is far less invasive. Most men do not need to worry about annual or bi-annual screenings unless they see symptoms that might warrant it, including changes to urination frequency or a notable weakness in stream.

For those who do require closer monitoring, the prostate specific antigen (PSA) blood test monitors benign growths in the prostate over a period of time. The PSA test is helpful in select cases as a tool for those who are undergoing post prostate cancer treatment to make sure their PSA levels are not rising. For high-risk men, we screen once a year – both with a PSA blood test and a digital rectal exam to check for lumps or irregularities in the prostate.

Colon Cancer

Colon cancer screening is one of the few tests we have that actually can identify pre-cancerous growths, called polyps, and remove them before they ever turn into cancer. Usually, screening for men and women should start at age 50 and occur every 10 years, but if you have a family history or detect a polyp, you may need to start earlier or be screened more frequently.

Patients who have never had a colonoscopy can be apprehensive, so I counsel men extensively on the fact that you will be sedated and won’t feel anything. The “prep” – the liquid you need to drink to prepare and clean out your colon before the exam – raises further concern. I offer as many tricks as I can; including pouring the prep over ice and adding ginger ale. And if you still aren’t sold, there is a newer procedure called Fecal Immuno Testing (FIT) that was developed to screen for cancer based on a stool sample. Though more comfortable, it is less reliable in detecting polyps.

Coronary Artery Disease

Coronary artery disease (CAD) is the most common type of heart disease and the leading cause of death in the United States for both men and women. CAD happens when the arteries that supply blood to heart muscle harden and become narrow. Prevention of heart disease is crucial, and I review risk factors with my patients: family history, smoking, high blood pressure, high cholesterol, diabetes, obesity, physical inactivity and high stress.

Sexual Health

Thanks to advertisements and popular culture, erectile dysfunction and low testosterone seem to be the most popular topics of conversation when I see men in the office. The myth that higher testosterone helps with sexual function isn’t necessarily true or always the case. In reality, testosterone levels in men drop over time naturally. If levels are low for your age, we do have shots and topical gels that can be used on a case to case basis.

My colleagues and I also offer counseling and treatment for STDs and take time to educate patients about the risk of HIV and AIDS. Harvard Vanguard also has an expert team of dedicated physicians and nurses who care for patients infected with HIV. Comprised of physicians and nurses who specialize in HIV, the HIV Resource Team provides high-quality, focused care for patients who are HIV-positive.

Furthermore, as a leader in LGBT Healthcare Equality for the fourth year in a row, Harvard Vanguard also recognizes acceptance, trust and knowledge as key elements of gay men’s health needs and concerns. This includes providing men with a secure, comfortable place to talk.

Men’s health awareness should be a regular topic of conversation. These issues can affect our friends and family on a daily basis and therefore require year-round attention. In having open discussions with their care providers, men can effectively prevent and manage common problems associated with their health.

Dan Kasuba PA-C, is a Physician Assistant with Harvard Vanguard Medical Associates, a member organization of Atrius Health.