Men’s Health: What the Clinicians Are Saying

Following are some tips from the experts in various fields of men’s health, just in time for Father’s Day: Prostate cancer: management vs. treatment “About half of all men over 70 have microscopic evidence of prostate cancer, but this never becomes clinically significant,” says Dr. Peter Albertsen, chief of UConn Health’s Division of Urology. “Most […]

Following are some tips from the experts in various fields of men’s health, just in time for Father’s Day:

Dr. Peter Albertsen. (UConn Health Photo)
Dr. Peter Albertsen, chief of urology (Photo by Janine Gelineau)

Prostate cancer: management vs. treatment

“About half of all men over 70 have microscopic evidence of prostate cancer, but this never becomes clinically significant,” says Dr. Peter Albertsen, chief of UConn Health’s Division of Urology. “Most men with newly diagnosed prostate cancer have low-grade disease (a Gleason score of 3+3). This often can be managed conservatively for many years and may never require more aggressive treatments such as surgery or radiation. Modern imaging techniques such as pelvic MRI and new biomarkers are helping us distinguish between men who have clinically significant disease from those who have indolent disease.”

Dr. Joel Levine, co-founding director, Colon Cancer Prevention Program (Photo by Janine Gelineau)

Take an active role in preventing colon cancer

Patterns are emerging wherein men may contract colon cancer at younger ages than women and located predominantly in the distal colon, or left side, says Dr. Joel Levine, co-founding director of the UConn Health Colon Cancer Prevention Program. Risk also varies by ethnicity, he says. “The principle is, who you are may determine what special approaches are needed as to when to start.”The rates of new cases and deaths are declining, which reflects the success of screening, but it’s not yet universal.

“Colon cancer can be prevented by identifying and changing the lifestyle risks that are so much of the story,” Levine says. “Colon cancer can be detectable at earlier and less lethal stages by a range of available screening tests. Colon cancer, even when present, is more treatable. Do not wait for the ninth inning to score your runs. Get ahead by knowledge, change of lifestyle, and periodic screening.”

Dr. Daniel McNally, medical director, Sleep Disorders Center (Photo by Janine Gelineau)

Make sleep a priority

One in three Americans gets less than six hours of sleep a night, with men averaging less than women by about 20 minutes. The recommendation is at least seven hours. Lack of sleep affects you when you’re awake, even if you don’t realize it, says Dr. Daniel McNally, medical director of UConn Health’s Sleep Disorders Center.

“Individuals who are sleepy, even if they haven’t ‘fallen’ asleep, are functioning at an impaired level,” McNally says. “The classic test for this is a reaction time measurement, where a light turns on and you push a button. The normal response time is about 250 milliseconds. Sleepy people can easily double or triple that.  If you’re driving at 60 miles per hour, 500 milliseconds of delay in your response is 44 feet the other side of that truck’s rear bumper.”

Men are two to three times more likely than women to have obstructive sleep apnea, a condition in which your breathing is interrupted repeatedly during the night, keeping you from achieving the deep, restful sleep your body needs. And it gets worse with age. If you don’t feel rested during the day and are told you snore a lot at night, those are two indicators you may have sleep apnea and should get tested. Left untreated, sleep apnea is linked to increased risk of high blood pressure, stroke, heart failure, diabetes, and depression.

Dr. Mona Shahriari, dermatologist (Photo by Janine Gelineau)

Protect your skin from sun damage

Older men are twice as likely to develop melanoma, the most dangerous form of skin cancer, as women of the same age. Skin cancer risk increases with lifetime accumulation of exposure to sun (or tanning beds). There is no such thing as “a healthy tan.” Sunburns accelerate skin cancer risk.

“In a study, 44 percent of men admitted to never using sunscreen,” says Dr. Mona Shahriari, UConn Health dermatologist. “What we recommend for men in particular is to use broad-rimmed hats (not just baseball caps) and sun protective clothing to protect themselves from the sun. Moreover, the helix of the ears is the most commonly neglected area when sunscreen is used, so do not forgot to treat that area.”

Dr. George Kuchel, director, UConn Center on Aging (Photo by Janine Gelineau)

Healthy aging

“It’s become clear that physical activity and exercise are crucial components of well-being in both older men and women,” says Dr. George Kuchel, director of the UConn Center on Aging. “Many older men tend to be susceptible to cardiovascular problems, mental health/memory disorders, and also declines in mobility and hip fractures typically associated with older women—all things that regular exercise earlier in life can mitigate. This is why we encourage good exercise and general health habits, not only in later life, but throughout the life span.”

Additionally, says Kuchel’s colleague, Dr. Patrick Coll, “It’s important for older men to be socially engaged beyond their wife’s network of contacts. Men whose partners die before them can be socially isolated and this can lead to psychological and physical concerns.”

William B. White, M.D., specializes in clinical pharmacology, hypertension and vascular diseases in the Pat and Jim Calhoun Cardiology Center at the UConn Health Center. (Photo provided by Dr. William White)
Dr. William White, hypertension specialist, Calhoun Cardiology Center. (Photo by Janine Gelineau)

Go to the doctor!

“Men are far less likely than women to see a doctor between the ages of 22 to 50 years old and therefore do not get screening tests such as blood pressure, blood sugar and serum lipids,” says Dr. William White, chief of the Calhoun Cardiology Center’s Division of Hypertension and Clinical Pharmacology. “Hence those men are ‘operating in the dark’ with regard to knowing their cardiovascular risk factors and hence do not practice ‘preventive cardiology.’”

Dr. Rebecca Andrews, primary care physician (Photo by Janine Gelineau)

Dr. Rebecca Andrews, UConn Health primary care physician, says, “You are born with your genetics so you need to modify life to account for that. Screening is prevention, healthy diet and healthy living is prevention, and stress is more detrimental than you think.”

And of course, slim down!

“Most patients ‘know’ they have to lose weight, and that weight loss would benefit them in innumerable ways, but very few are able to achieve long term success,” says Dr. Thomas Manger, UConn Health primary care physician. “I think critical to that issue is regular daily activity, and of course limiting caloric intake.”

Dr. Thomas Manger, primary care physician (Photo by Janine Gelineau)

The American adult obesity rate has more than doubled since the early 1960s. Today nearly three in four American men are either overweight or obese.

“One thing I wish all my patients really understood was impact of modest exercise and weight reduction on their overall health,” Manger says. “Benefits include less fatigue, better sleep, less stress, better sex and increased libido, not to mention the known cardiovascular and metabolic benefits.”

Brad Biskup, physician assistant, Lifestyle Medicine Program (Photo by Janine Gelineau)

Brad Biskup, a physician assistant who runs the Calhoun Cardiology Center’s Lifestyle Medicine Program, offers two simple concepts:

“First, increase the activities that are good for us, such as standing, walking, taking stairs, and decrease the activities that are bad for us, such as sitting. Second, increase the good foods, such as fruits/vegetables, and nuts, to help decrease the unhealthy foods, such as processed foods and high animal fats.”

Weight loss helps more than the heart

In addition to improving cholesterol and blood pressure and reducing the risk of type 2 diabetes, heart disease, stroke, kidney disease, and certain cancers, maintaining a healthy weight has been shown to help with cognitive function later in life.

Dr. Kristina Zdanys, geriatric psychiatrist at UConn Health.
Dr. Kristina Zdanys, geriatric psychiatrist at UConn Health.

“We like to say that heart health is brain health,” says Dr. Kristina Zdanys, UConn Health geriatric psychiatrist. “Maintaining a balanced diet, getting regular exercise, and staying socially connected are helpful for overall health.”

Additionally, shedding pounds takes stress off of the knees. Each pound of weight lost relieves about four pounds of pressure on the knees. Weight loss also has been shown to improve sleep apnea by reducing obstructions that can interrupt breathing during sleep.