Men: Make Sure These Screenings Get Done

By Mark Newton, MD
UnityPoint Health – Waterloo

It’s a well-known fact that men don’t like to go to the doctor. Don’t worry, providers knew that already.

However, that doesn’t make the visits any less important. In fact, as men, perhaps we’re good at facing the facts. So, here’s one you should know – over half of the premature deaths in men are preventable.

This where we need guys to be proactive, and that begins with regular screenings. Here’s some stuff we want you to know:

• Haven’t been to the doctor in a while? That’s OK. The COVID-19 pandemic led many guys to keep their distance from healthcare facilities, and we appreciate the gesture. However, we’re safe and ready to see you now, so it’s time to get scheduled so we can catch small issues before they become big ones.
• Digital rectal exams aren’t standard testing anymore. One big reason men avoid the screenings is the Digital Rectal Exam (DRE). However, the United States Preventative Services Task Force recommends against annual DREs, so don’t avoid the doctor’s office for something that isn’t even part of a standard exam anymore.
• Men’s screenings are best viewed through age groups:
  • Ages 20-45: No matter your age, it’s always good to have your blood pressure and cholesterol checked. In addition, you should start colon cancer screenings near the end of this range, do self-checks for testicular cancer, report any urologic issues and consider whether it’s time for a vasectomy to control reproduction.
  • Ages 46-60: You may start to have issues with an enlarged prostate and erectile dysfunction. And if you’re a smoker, cancer just might line the urinary tract and produce blood in your urine. Consider a prostate cancer screening through a PSA test.
  • Ages 60-plus: Prostate cancer is most common in this group, and you’ll want to continue those colon cancer screenings through at least age 75. In addition, urinary symptoms or incontinence (loss of bladder control) worsen, so don’t put off getting seen. Finally, you may see blood in your urine, and this is never normal.
• When we talk about screenings for men, we typically mean annual physical exams, blood pressure checks, blood and urine tests, prostate screenings, testosterone screenings, colonoscopies and fecal occult blood tests. Some of these occur during an in-person checkup with a provider, and others involve a lab draw.
• How to do a self-check for testicular cancer. Yep, men can check themselves for this form of cancer. Really, you’re just looking for a testicular lump. If you find anything, let your doctor know, and we’ll investigate it further.
• What can you expect in a colonoscopy? It’s a common procedure performed every 5-10 years to check for cancer. After you’re mildly sedated, a doctor inserts a small, flexible tube into your rectum and checks for polyps or cancer both there and in the colon. In fact, a doctor can find and remove most polyps and some cancers during the exam. This procedure is also used as a follow-up if something odd was detected in an earlier screening. Do not miss this one, guys. It’s relatively easy to get done, and it’s saved countless lives.
• PSA tests and why they’re important. This is how we screen for cancer in the prostate, which is a small gland just below the bladder in men. The PSA is a blood test that measures the amount of Prostate-Specific Antigen, a protein produced by cancerous and noncancerous tissues. High levels of PSA may indicate prostate cancer or an enlarge/inflamed prostate.
• When you list “urinary problems,” what symptoms should a guy look for? There are several common things men experience as they age:
  • Benign Prostatic Hyperplasia (BPH) – this can result in a frequent urge to urinate, a weak stream or a feeling the bladder isn’t empty
  • Urinary incontinence – a loss of bladder control
  • Hematuria – blood in the urine, which can signal an issue such as cancer, BPH, kidney/bladder stones or infections

If you experience any of the issues in this article, be sure to contact your primary care provider, and they’ll refer you to a specialist when the time is right.