Dear Doc:
I often read about woman cancer issues in the media, but what about us men? I am a 52-year-old male and I’m wondering what cancer screenings should I undergo?
Dear Reader:
Cancer is a significant health concern for both men and woman. Cancer is the second leading cause of death in the US (after heart disease). Women have a 1 in 3 chance of developing some form of cancer and a 1 in 5 chance of dying from cancer. Meanwhile, men have a 1 in 2 chance of developing cancer and a 1 in 4 chance of dying from cancer.
There is no doubt, men and women are different. Besides the obvious differences, women use 7,000 more words per day (20,000 versus men who only use 13,000 words per day), men’s brains are 11 percent bigger (no men, this has nothing to do with smarts but more to do with body size), and women are 3 times more likely to go to the doctor. This may explain why in the 1900s, men and women in the United States had similar life expectancies but today, women live longer. A girl born today is expected to live to 82.8 years-old, while a boy born today is expected to live to 79 years-old. Despite spending the most on health care in the world, the United States currently ranks 42nd in the world in life expectancy! Who says we don’t need some sort of health care reform?
Four cancers account for nearly half of all cancer deaths: lung (27%), colorectal (9%), breast (14%), and prostate (10%).
The US Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer in adults age 50 to 75 years. Screening for colon cancer can be done by checking your stool for microscopic blood, as cancers and precancerous polyps may leak a small amount of blood into your stool. Also, a screening colonoscopy, a scope of your entire colon is done under sedation, is recommended starting at age 50. It is estimated that more than 25% of those eligible for colon cancer screening have never been screened! March is colorectal health awareness month and it is the perfect opportunity for both men and women to talk to his/her healthcare provider about colon cancer screening.
Prostate cancer can be screened by a digital rectal exam where your doctor feels for prostate nodules. The exam should be performed yearly on men over the age of 40. The blood test PSA, prostate specific antigen, has been used in the past to screen for prostate cancer. Over the years however, it has been discovered that many men die WITH prostate cancer instead of FROM prostate cancer. Wide scale PSA testing has led to an increase in the treatment of prostate cancer that may have otherwise not caused any significant decrease in length or quality of life. So, the USPSTF recommends against routine PSA screening, but it is recommended to discuss PSA screening with your doctor. If you have risk factors for prostate cancer (family history, obesity, African American decent) your doctor may advise you to get a PSA test.
Lung cancer will be diagnosed in approximately 6 percent of all Americans. Ninety percent of all lung cancers are due to smoking. In the past chest x-rays were used to screen smokers for lung cancer, but studies have shown that screening chest x-rays show no reduction in lung cancer deaths. Recent studies suggest that a low radiation CAT scan (an x-ray test that shows more detail) of the lungs may detect lung cancers earlier. The USPSTF recommends annual low dose CAT scan screening for significant smokers between 55 and 80 years of age and for significant smokers who have quit within the last 15 years.
So, Mr. 52-year-old male, I could have used some word economy (using fewer words) and answered your question by saying, if you smoke get an annual low dose CAT scan of your lungs, get your prostate checked, discuss a PSA test with your doctor and don’t avoid your colonoscopy for cancer screening; but I have many female readers and wanted them to enjoy the many informative words of this column as well!
Almost all health care plans now cover cancer screening. If you can not afford screening, there are free screening programs available through your county Cancer Services Program. Locally, call the Cancer Services Program of Ontario, Seneca, Wayne and Yates Counties at 315-462-0602 for available screening programs.
Stay healthy, and remember the quote by Albert Einstein, “Men marry women with the hope they will never change. Woman marry men with the hope they will change. Invariably they are both disappointed.”
Dr. Nagpaul is board certified in Internal Medicine. He currently is the Medical Director for Long Term Care for Rochester Regional Health’s Eastern Region including Newark-Wayne Community Hospital, DeMay Living Center, Clifton Springs Hospital & Clinic, Clifton Springs Nursing Home and Wayne County Public Health. This column is meant to be educational and is not intended to be used to make individual treatment decisions. Prior to starting or stopping any treatment, please confer with your own health care provider. To send questions to our medical providers, please email Dr. Nagpaul at Arun.Nagpaul@rochesterregional.org and put “Ask a Doc” in the subject line.
