Preventive Health for Men: Why It Matters
There’s a common perception that men hate to go to the doctor and won’t go, even if they’re feeling sick. This theory has persisted throughout the years and is often the subject of jokes within families. But is it true? Unfortunately, this premise is sound: Men do not go to the doctor if they are feeling well.
A 2019 Cleveland Clinic study found that up to 60% of men don’t go to the doctor regularly, choosing to wait until they are seriously ill. Another study found that 72% of men would rather do household chores, like cleaning the bathroom or mowing the lawn, than go to the doctor. Even for the men who take their health more seriously, some are holding back: 20% admit they have not been completely honest with their doctor before.
“Men struggle with talking with health care professionals and have been conditioned to stay quiet regarding health issues. There is an underlying cultural understanding that all men should just be strong, as if admitting they are feeling unwell is a weakness,” says Mohamedtaki A. Tejani, M.D., medical director of the AdventHealth Gastrointestinal (GI) Oncology Program and the AdventHealth Cancer Institute. “But we need to understand that this expectation of stoic masculinity is putting lives at [risk]—men shouldn’t be bottling these things up.”
Colon Cancer Crisis
The colon, or large intestine, is where the body draws out water and salt from solid waste. The waste then moves through the rectum and exits the body through the anus. Rectal cancer originates in the rectum, the final several inches of the large intestine, closest to the anus. According to the American Cancer Society (ACS), colorectal cancer is the third-most commonly diagnosed cancer in the U.S., aside from skin cancers. In 2023, the ACS estimates that 153,020 people in the U.S. will receive a new diagnosis of colon cancer.
“We expect that number to rise, as we are seeing more and more younger people receiving the diagnosis earlier than in previous years,” explains Tejani. “We believe that diet, stress and environment are playing a large role in the rising cases, which is why early detection is crucial.”
Early Detection
Colon cancer often causes no symptoms in the earliest stages, but symptoms may become more noticeable as the disease progresses. If people do have symptoms in the early stages, they may include: blood in the stool; a change in frequency or type of bowel movements, such as diarrhea, constipation or narrow, ribbon-like stools; the feeling of not emptying the bowels after a bowel movement; and abdominal pain, cramping or bloating. As the disease progresses, the patient may experience nausea and vomiting, anemia (due to intestinal bleeding), fatigue and weakness, or unexplained weight loss.
“Acknowledging those early symptoms is the key to catching the disease in the beginning stages. Just like we own our finances, our car and our homes, it’s just as important to take ownership of our bodies. Getting screened regularly may increase your chances of finding, treating and potentially surviving colon cancer,” Tejani says.
The exact causes of colon cancer are unknown, but several potential risk factors increase one’s susceptibility. Age, diet, habits, polyps and even genetics, especially when having a parent, sibling or child with a history of colon or rectal cancer, are all factors.
The most effective way to test for colon cancer is to have a colonoscopy, within the time frame suggested by your doctor. A person may have to follow a special diet before the procedure, such as a clear liquid diet one to three days beforehand. The colon will also require cleansing with strong laxatives in a process known as bowel prep. If the doctor finds polyps in the colon, a surgeon will remove them and send them for a biopsy. In a biopsy, a pathologist examines the polyps under a microscope to look for cancerous or precancerous cells.
If a patient finds the idea of a colonoscopy too invasive, or is perhaps reluctant to go through the preparations of a typical screening, there is an alternative called Cologuard, which is a non-invasive colon cancer screening test that is good for adults who are at average risk.
“This testing can be done at home through a collection of samples. If the results come back positive, the patient is only then sent for a proper colonoscopy. As physicians, we just want to encourage everyone to get screened and be proactive about taking their health seriously,” Tejani says.
The Danger of Diabetes
In the world of medical practice, it is not uncommon for a specialist to diagnose what could have been detected by a primary care physician, had the patient scheduled regular checkups.
Dr. Matthew Cunningham, a vitreoretinal specialist at Florida Retina Institute, says diabetic retinopathy is the leading cause of blindness among working-age adults in the United States. It causes 8,000 cases annually, in addition to other impairments. “A majority of patients who have diabetes will eventually develop diabetic retinopathy,” Cunningham says.
A staggering 1.4 million people in the United States get diagnosed with diabetes annually and, according to Cunningham, he is often the one to diagnose them. “So often we see patients only because something has gone significantly wrong to lead them to a specialist. Almost daily, I will get patients referred to me with things like hemorrhaging at the back of the eyes or retina that could have been diagnosed earlier if they had just gone to a primary care physician for a yearly exam,” he says.
Just like Tejani stresses in his field of medicine, Cunningham concurs that screening and a proactive approach to one’s health is the key to longevity and quality of life. “The earlier you can catch a disease, the quicker medical professionals can jump on it and get our patients a better outcome. We notice that men tend to be more lax with making and keeping medical appointments, but understanding the importance of early detection should be a message we send to all genders, ages and races.”
Cunningham also strongly suggests that patients who have been diagnosed with diabetes type 1 or 2 receive yearly eye exams. “We often see people waiting until there is a problem to make an appointment; in some scenarios, that can be too late. Even if you have perfect vision, the key word in ‘early detection’ is early.”
The goal for Cunningham is to hopefully elevate public awareness of the connection between diabetes and diabetic retinopathy. “We want to cut down on unnecessary vision loss, not just in men but also in women and children. It’s not exclusive to who is affected by this type of disease and yet like so many other diseases, is avoidable with the right advocacy.”
Modern Medicine
As we slowly climbed out of the pandemic, society has become immensely more apt in getting medical attention than in previous years.
“Following the pandemic, there has been increased attention on preventative care and mental health services. One of the trends that we are seeing is an increase in telehealth options that focus on men’s health care,” says Josh Bell, chief impact officer at 26Health. “We hope that this trend continues, particularly for mental health, to close the gap in men’s participation in primary and wellness care.”
In addition to colon cancer and diabetes, mental health concerns, followed by cardiovascular health, continue to be the additional main threats to men’s health. According to the CDC, the suicide rate among American males is approximately four times higher than the rate among females.
“It is unfortunate to see this disparity that is due in part to the fact that men are still less likely than women to be aware of disease symptoms, and men use primary care services less frequently than women. To address these threats and to close this gap, men’s focused education on the importance of health care and access to quality care will be crucial,” Bell explains.
26Health supports patients with medical care, mental health care, adoption counseling and home studies, rapid HIV, HepC and STD testing and care. “For men, in particular, we pride ourselves in providing a comfortable, non-judgmental environment staffed with providers that are trained in men’s health,” Bell says. “Our specialties in men’s health care include mental health services, prostate care, care for hypogonadism (low testosterone), men’s sexual health, low libido and erectile dysfunction, and initial evaluations for colonoscopies.”
Bell continues, “In addition, access to care is one of the biggest challenges that the LGBTQ+ community is facing right now as legislative efforts at the state level are restricting care. Due to recent legislative changes, transgender men and other men receiving hormone treatments are at increased risks of mental health concerns. Since our founding, we have proudly served our gender diverse community members and continue to provide primary care and mental health services, which are incredibly important during this difficult climate.”