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 at http://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 scarring. 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
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
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
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-activity 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
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.
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
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.
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 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.
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