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“If I’d known I was going to live this long, I would have taken better care of myself.”
That quote has been attributed to comedian George Burns who lived to be 100, jazz musician Eubie Blake who died at 96, writer Mark Twain who saw 74, and baseball great Mickey Mantle who only made it to 63. Wherever the quote actually originated may never be known for sure, but the sentiment behind it surely rings true for anyone middle age and beyond, particularly when they are faced with a health-related challenge.
According to the Social Security Administration, a man who reaches the age of 65 today (e.g., doesn’t die prematurely as the result of an accident or catastrophic health event) can expect to live, on average, until age 84. June is national Men’s Health Month, the aim of which is to increase awareness about preventable health problems and encourage early detection of treatment of disease among men of all ages. We spoke with Cortez internal medicine specialist Andrew McAlpin, MD, to get his take on what men can and should do to stay as healthy as they can for as long as they can.
“When we look at what men die from the big ones are heart disease, cancer, and diabetes,” said McAlpin. All of those are, in part, lifestyle related and may be prevented with proper diet, regular exercise, maintaining a healthy weight, and not smoking. “Diet, exercise, diet, exercise . . . we say it all the time because it’s so important,” said McAlpin.
Preventive healthcare is key for any man intent on living a long, active life. “Men tend to see their healthcare providers somewhat less often than women because they don’t come in for routinely for screenings like pap smears,” said McAlpin. “I personally request that all my patients come to see me at least every three years, and after age 50 they should come in once a year.
To keep on top of cardiovascular issues, McAlpin recommends that everyone – men and women – have their blood pressure checked every year or two even if they have no cardiac symptoms or family history. Hypertension is sometimes called the “silent killer” which is unfortunate because having ones blood pressure checked is so simple.
Monitoring cholesterol is also important and McAlpin recommends that patients have this screening blood test every three to five years starting at age 35. “High cholesterol is a risk factor for heart disease. While genetics is the largest risk factor for high cholesterol, diet changes and increasing exercise can bring levels down in some people,” said McAlpin. If these measures are not effective after a period of time or if someone’s cholesterol is high even if they already exercise regularly, don’t smoke, and maintain a healthy weight, then cholesterol-lowering medications (called “statins”) may be indicated.
Type 2 diabetes is becoming more prevalent with each passing year in the United States, in part due to poor eating habits. “Cheap, high-carb diets and obesity are a real problem,” said McAlpin. He recommends screening for diabetes at age 45 or sooner in patients who are significantly overweight or have more than one other risk factor for diabetes such as high blood pressure or a family history of the disease.
In men, the most common types of cancer that lead to death are lung, prostate, and colon. The bottom line in lung cancer prevention is obvious: don’t smoke, and if you do smoke, stop.
Prostate cancer has been making headlines lately because the recommendations for PSA (prostate-specific antigen) screening have changed. “Based on the most recent evidence and guidelines from the United States Preventive Services Task Force, I no longer recommend routine PSA testing for men of any age,” said McAlpin. If you are a man who has routinely, faithfully undergone PSA screening this might come as a surprise.
“The vast majority of prostate cancers do not cause symptoms or death,” said McAlpin. “Too many men were undergoing unnecessary biopsies and surgery for cancers that were never going to cause them a problem. The chances of harm such as urinary incontinence, erectile dysfunction, and infections related to treating non-life threating cancers outweigh the potential benefit of screening.” It’s now clear that routine PSA screening does not save lives and likely does more harm than good. Screening for prostate cancer is ultimately a decision for a man to make with his physician.
Many men experience non-cancerous prostate issues later in life due to benign enlargement of the gland. “The symptoms are usually difficulty urinating or having to go frequently,” said McAlpin. The good news is that, unlike in years past when men by the thousands had prostate surgery every year, medications are now available that are very effective at treating prostate enlargement.
It’s well-documented that early detection of colon cancer is critical in preventing death from the disease. “The average man with no family history of colon cancer or other risk factors should have a screening colonoscopy at age 50. If nothing is found then he won’t need another one until age 60,” said McAlpin. “If a polyp is found or a relative is newly diagnosed with colon cancer – both risk factors – then we’d recommend that the procedure be repeated sooner than ten years.”
When it comes to routine health maintenance, often overlooked is the importance of keeping up on routine vaccinations. “Men should get a tetanus shot every ten years, a shingles vaccine starting at age 60, and the pneumonia vaccine at 65. We recommend a flu shot every year for patients 65 and older and for anyone with a chronic medical condition,” said McAlpin.
Common sense plays a role in good health for men of all ages. McAlpin recommends the following: use your seatbelt, don’t drink and drive, wear a helmet, practice gun safety, don’t smoke, use alcohol only in moderation, take medications as prescribed, talk to your primary care provider if you suspect you might be depressed, and get regular exercise.
“Patients will tell me that they get their exercise by working. I know pushing a side roll around a pasture is hard work, but that doesn’t take the place of a cardio workout,” said McAlpin. He recommends at least 30 minutes of brisk walking, hiking, cycling, or swimming at least five days a week to maintain optimum health. “All of these are easy, inexpensive ways to stay healthy. Take advantage of the Rec Center here is Cortez. It’s a great facility,” said McAlpin.
Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal healthcare provider.