Men’s Health, The Big Picture

Tuesday, April 23, 2013

Men’s Health, The Big Picture

BY MARK SCHOLZ, MD

As a specialist in prostate cancer, I am in constant contact with men who are exerting prodigious efforts to get appropriate treatment for their disease. However, as many people are learning, low-risk forms of prostate cancer rarely lead to death.  Therefore, I am concerned that many men are missing the big picture regarding their overall health.  They have a greater risk of dying from other causes than from prostate cancer (Table 1).  Many of these common diseases are preventable by early detection.
The obvious place to start is with an annual physical with standard blood tests. Testing should include evaluation of liver and kidney function, mineral levels in the blood, evaluation of vitamin and hormone levels and testing for anemia and serum glucose. The specific blood tests are explained in more detail athttp://prostateoncology.com/files/pdf/Standard_Laboratory_Tests.pdf

Heart Disease, the #1 Killer
The root cause of heart disease is cholesterol plaque, otherwise known as “hardening of the arteries” or atherosclerosis. Cholesterol infiltrating the arterial wall causes inflammation and scaring. Over time, scar tissue becomes calcified.  When plaque progresses to arterial blockage, a heart attack occurs. Similarly, a stroke occurs if an artery supplying blood to the brain is blocked.

Only Scans Can Measure Plaque
Cholesterol blood tests answer the question, “How much cholesterol is floating in the blood? ”The real question that needs to be answered is, “How much cholesterol is sticking to the wall of the artery?”  Modern CT scans accurately measure coronary plaque with a dose of radiation similar to a set of dental X-rays. Color Doppler ultrasound measures plaque in the carotid arteries leading to the brain without any radiation exposure at all.

What if Plaque is Detected?
1. Obtain an exercise stress treadmill
2. Lower cholesterol and blood pressure
3. Inhibit blood coagulation with aspirin and fish oil
4. Follow a sensible diet and exercise regularly 

Osteoporosis
With age, bones weaken from calcium loss. Osteoporosis is mistakenly thought to occur only in women.  However, one-third of hip fractures occur in men of advanced age.  Bone fractures have dire consequences associated with shortened survival, chronic pain and loss of height. Causes of osteoporosis include over-actively of the thyroid or parathyroid glands, excessive alcohol, caffeine or tobacco. Cortisone use, excess vitamin A, lack of exercise and vitamin D deficiency are additional potential causes. Hormone therapy used to treat prostate cancer can also cause osteoporosis.

Only Scans Can Detect Osteoporosis
Osteoporosis needs to be identified and treated before a fracture occurs. There are two types of scanning technology used to detect osteoporosis, DEXA and QCT. While both types of scan are accurate in women, only QCT is accurate in men.  In men, DEXA seriously underestimates the degree of osteoporosis. 

Osteoporosis Treatment Protocol 1. Calcium 500 mg with dinner or at bedtime
2. Vitamin D 1,000 units daily.  Adjust dosage according to measured blood levels
3. Weight bearing exercise 4. Consider prescription medication with Fosamax, Boniva or Prolia
  
Colon Cancer 
Colon cancer is easily curable when detected early. Screening can be accomplished with colonoscopy (a scope performed by a physician called a gastroenterologist), or with a CT scan, which is termed a virtual colonoscopy. 

Beware of Sarcopenia Muscle mass and strength automatically decline with age. Studies in otherwise healthy individuals indicate that poor fitness is more dangerous than smoking! Table 2 shows the dramatic difference in predicted 10-year survival of men age 65 depending on their fitness level. Muscle loss can be prevented with regular exercise consisting of weight training for an hour twice a week.

Lung Cancer Smokers who forgo lung scans are taking a huge risk. Lung cancer is almost universally fatal if diagnosed after symptoms such as cough, chest pain, or weight loss appear. CT scans can detect small lung cancers at an early stage when it can still be surgically removed and cured.  Smokers (and any ex-smokers who quit in the last 10-15 years) are crazy not to spring for $300 each year to have a lung scan done. 

Flu and Pneumonia Flu is easily recognized by the sudden onset of fever, sore throat and body aches. Most people know about vaccines but forget that Tamiflu, an antibiotic, is effective if started within 24 hours of initial symptoms. The risk of pneumonia can be reduced by Pneumovax given every ten years. It is recommended for men who are over age 65 or who have a chronic illness. 

Conclusion The screening and early prevention program outlined in this article relies more heavily on scans, vaccines and prescription pharmaceuticals than many men would prefer. However, the serious health conditions listed above have a propensity to incubate silently until the day they suddenly explode on the scene as a full-blown disaster. The old aphorism, “An ounce of prevention is better than a pound of cure” certainly applies when there is an opportunity to detect and prevent life-threatening illness at the earliest possible stage. 

I Love Popcorn!

            I like popcorn, no, I love popcorn. I have the feeling that I am addicted to popcorn. Sometimes I feel that I can’t get enough. I noticed that at a local CVS they sell popcorn for a dollar a box. Well, I purchased a couple of boxes and took them home for a feast. When I opened the box, put it in the microwave, fired it up, I noticed, after it finished popping, the bag was half the size of a regular bag of microwaved popcorn. I was horrified.

            Of course I got over it quite quickly, though I never had more than one bag a day. I am guessing more than that constitutes an addiction, which I don’t, have contrary to anything I might had said prior. Anyway, last year I use to go to Costco and buy those boxes of Orville Redenbacher popcorn, the 48 count kind.       

            The only problem I had with Redenbacher popcorn, it never fully popped all the kernels. So, there’d always be bunch of un-popped kernels in the bag, and I hated that. Could’ve broken a tooth or something. Then I remembered Act II popcorn. That was the popcorn that I ate at work, most of the time because it’s what they sold in the vending machines.

            I knew they sold it at Kroger and I really had to change my mind because it was cheaper than Redenbacher’s popcorn. So, I stuck with Act II for a while but it too seemed to have many of those un-popped kernels in the bag.

            Last year or so I thought I’d try Kroger’s popcorn, only because it was way cheaper than both of the other popcorns they sold. I was truly amazed when I popped it because out of every bag, 99.9 percent of the kernels were popped! I would like to say there are usually one or two kernels in the bag when I finished… but not really, I have a really bad memory most of the time, ok, I never count. In fact, I just counted the kernels in the bag I just finished a few moments ago and there were seven un-popped kernels in it. Really, that is a better count than the expensive popcorns.

            I just noticed today that I still have some old-style popcorn, the kind that you put in a pan, with a touch of oil, and shake it over a flame. I have the feeling that I better use it or it won’t pop. I’ve tried a few times in the past and one time it worked and another time it didn’t pop at all, considering that both of those jars of popcorn are over, well, quite a few years old. But with that type of popcorn you can use all the ingredients you have at hand.

            And I always like to put grated Parmesan cheese and or garlic and or onion salt on my popcorn. But, those were the days. I wonder do they still make Jiffy-pop? Well, I guess they do. I just Googled it and there still is a product called Jiffy-pop, go figure. When I got out on my own, that was my main staple, that and anything Mickey D’s, and beer.

            And, don’t get me started on Movie Popcorn. I go to the movies just to get the popcorn, but to be honest not with a lot of movie butter. I hate the messy, greasy mess. So, I usually get it without the butter. Some movie houses usually have some sort of spice or cheese that you can add to your popcorn. I love those places, but there are none close by my house. With or without, movie popcorn is great!

            Chances are tonight, during the baseball game I am going to have a bag of Kroger popcorn, Kettle corn, heck it was only a dollar a box so I got a couple and I am going to enjoy the baseball with a smile as I snack on my popcorn.