Okay, let’s be honest. Most men tend to avoid the doctor – even when they’re not feeling well. But to stay our healthiest, we all need a good dose of preventive care, which includes periodic tests and screenings.
When is the right time to screen, and just what health tests do men really need? To get the most current perspective, MyLifeStages consulted with Sacramento internist Drew Factor, M.D., M.P.H., of Sutter Medical GroupOpens new window, and Gary Furness, M.D., a family medicine physician with Sutter Medical Group of the Redwoods in Santa RosaOpens new window.
To begin, let’s note that 50 percent of all deaths for men result from cancer or cardiovascular disease (heart attacks and stroke.) While we all fear cancer, it’s wise to keep an eye on other diseases that can sneak up on us, unnoticed. Following is a summary of advice for each phase of a man’s life.
The Human Papillomavirus (HPV) vaccine has been recommended for teen girls as a way to prevent the HPV infection that can lead to cervical cancer and possibly throat cancer. But since it takes two to tango, young men are also offered the HPV vaccine. It's also an easy way to prevent a very preventable disease in their future partners.
Becoming clear on safe sex practices and the dangers of HIV and other sexually transmitted diseases is a good lesson for teens to learn. (Sutter Health's Palo Alto Medical Foundation has created this popular teen health websiteOpens new window to help teens educate themselves about safe sex and other important health matters.)
Young Men – 20s and 30s
Frankly, guys in this age range are probably okay, health wise. In the peak of their vitality, only a visit to the doctor for some baseline blood work is in order. Knowing your baseline lipid (cholesterol) and glucose levels, as well as blood pressure, is smart. (See Four Health Numbers You Should Know – at any age.)
All men should also know their family health history. If a relative had an early heart attack, or if relatives have had certain cancers, early screening tests might be in order. Use our Medical Family Tree to gather this information – and keep it handy.
One cancer that tends to strike younger men in particular is testicular cancer – think Lance Armstrong. Although testicular cancer is very rare, our doctors recommend that all males in their 20s and 30s do testicular self exams, feeling for an unusual lump or change.
30s and 40s
Dr. Furness recommends that men in this age range see their doctor every three years. Blood tests for cholesterol, fasting blood sugar, kidney and liver function, and a urinalysis will give a broad picture of general health. A physical exam by the doctor will include a review of family health history and, based on that, certain early screening tests might be considered.
Men whose father had prostate cancer before the age of 50 may need to begin PSA screening tests in their 40s. Early development of colon cancer in a relative is also a warning sign. So, again, know the facts about diseases that run in your family – see What to Ask Your Parents.
The Mature Man - 50s, 60s and Beyond
This is where it gets more interesting. After age 50, most men should see their doctor each year for a checkup, particularly if any signs of cardiovascular disease have arisen. With good management, cardiovascular disease doesn’t have to result in a heart attack or stroke. Measuring blood glucose levels can help identify if you are in the danger zone for developing diabetes. Take our prediabetes quiz to assess your risk.
At age 50, a colonoscopy is recommended to screen for colon cancer. Perhaps the most invasive screening test, it only needs to happen each decade after the first exam at age 50. Learn more about Colon Cancer Symptoms and Options for Colon Cancer Screening.
At 50, talk with your doctor about PSA screening and digital rectal exams for prostate cancer. This is the era where the prostate gland can begin to make itself known – with changes in patterns of urination. Not all changes indicate cancer, but it’s time to start checking.
Dr. Factor notes that there has been controversy recently over the efficacy of PSA screening for prostate cancer. "This is a topic to review with your doctor," notes Dr. Factor. "I think most men would want to know if cancer cells are present. Then they can engage in an informed discussion with their doctor about which treatment option might be best – including watchful waiting with regular testing." Learn more about Prostate Health.
Men in their 50s also fall into the recent recommendations by the CDC (Centers for Disease Control and Prevention) that those born between 1945 and 1965 be screened for Hepatitis C. This infectious disease can remain in the body, silently doing damage to the liver. A simple blood test can reveal evidence of exposure to Hep C , so treatment options can be discussed. (See Hepatitis C – Should All Boomers Be Tested? )
Dr. Factor notes that not every test you may have heard of is actually recommended for good health. With the very real fear of cancer, some patient will request a "cancer test" like CA 125 or CEA. "These tests are tumor markers, and are used to monitor the status of a patient already diagnosed with a particular cancer, and to evaluate their response to treatment," he says. "These tumor markers are not great screening tests and are not considered appropriate cancer test for the general public."
He also explained that testing a man’s testosterone level is not necessarily required. "Testosterone will naturally decline some as a man ages," says Dr. Factor. "But a man with a truly abnormal testosterone level will usually have severe symptoms – and that situation is pretty uncommon." If a man is fatigued, or having sexual problems, a visit to the doctor for a physical exam and careful history is the best place to start. Stress, poor diet, sleep apnea or other conditions are far more likely culprits than a dropping level of testosterone. (For more, see our article on testosterone loss in men.)
While screening tests can help detect diseases, Dr. Factor reminds men of the six laws of good health – these can be done every day; no doctor visit needed.
The Six Laws of Health
How Healthy Are You?
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