We all know some men who’d rather fight off sharks than deal with issues that affect their health. They don’t like talking about it, they put symptoms on the back burner, and they don’t see a health care provider unless it’s at the urging of a persistent wife who might schedule the appointment.

June is National Men’s Health Month. It’s a time to encourage men to take their health seriously, make necessary lifestyle changes and get established with a primary care provider, if they don’t have one.

According to Ben Guth, an advanced practice nurse with OSF HealthCare, the reasons for putting off medical care vary. For some men, they’re too busy working to find the time to book, for example, an eye exam or dentist appointment. Some are willing to wait out a nagging pain or a lingering headache. And for others it’s simply a case of “‘if it ain’t broke, don’t fix it.’”

“Men will often tell me, ‘I don't have any problems. Everything feels fine. I don't need to see you,’” Guth says. “Unfortunately, all issues won't really present as a symptom until they're in the more moderate to severe stages.” For example, most people with high blood pressure or diabetes won’t know they have it until they get checked at the provider’s office.

In 2018, Cleveland Clinic surveyed a small sample of men ages 18 to 70 and found that only three in five men get an annual physical, and just over 40% go to the doctor only when they fear they have a serious medical condition.

Guth says the statistics aren’t surprising. “No one wants to be told that they have high blood pressure, that they have diabetes,” he says. “But I would counter that by saying it's better to go early to get screened, to have your doctor as your health consultant, to check in once a year to make sure that everything's OK. So that when you do go, you have a better idea of how it's going to turn out.”

Scheduling an annual physical exam 

Guth strongly recommends all adult men, even those in their late teens, 20s and 30s, have an annual physical.

“We all have our financial consultants. We all have a car that needs regular oil changes. We all have taxes that need to be filed,” Guth says. “We all have a body that needs to be taken care of. So come in once a year to have a good once over. And what's nice about those visits is you'll get some blood work done. We'll be able to do a lot of different screenings, and you'll get that checkup.”

Men should have annual screenings for diabetes, hypertension and cholesterol, as well as certain cancers. Prostate cancer screening is done with a simple blood test.

“The recommendation for any healthy man is to start at age 50,” Guth says about prostate cancer screening. “Typically, we will screen sooner if there are certain risk factors, or you're in a population that has a higher chance of developing prostate cancer. In my practice, I usually start the conversation with men in between 40 and 45 for prostate cancer.”

Colon cancer screening begins at age 45 and is repeated every five or 10 years, depending on findings and family history. Also, regular self-exams are important when it comes to issues such as testicular cancer, which is more than 90% curable if caught early enough.

Coping with stress 

Another issue affecting men that isn’t always talked about is stress. Whether it is job or family related, or it stems from health or financial issues, everyone has reason to worry from time to time. Guth recommends several options for dealing with stress, which, if not handled properly, can cause major health problems such as heart disease, depression and sleep disorders. Guth suggests first finding ways to relive stress in a healthy way such as exercising, reading and spending time with loved ones. Men can also consider talking to a therapist or counselor if daily stress becomes too much to handle.

As a husband and father who works 10 hours or more a day, Guth understands some of the obstacles that his male patients face in staying on top of their health needs. However, it’s imperative to make time for the basics – listening to our bodies, not smoking and limiting alcohol consumption.

“I think all men should have a primary care provider. It's important to see them annually, to have those checkups, so that you have the peace of mind to know that everything is good,” Guth says. “I can go about my day-to-day life, doing what I need to do, whether that's working, taking care of family, taking the kids to sporting events. You want to have that peace of mind to know that I'm going to be there for them for a long time.”
 

Interview Clips 

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For many people, turning 50 is a landmark birthday. It not only means reaching a half a century, but it’s often a time to reflect. It’s an opportunity to think back on your life up to that point, while also looking to your future.

From a health standpoint, reaching your 50s could bring on seismic changes, especially if you haven’t always taken care of yourself. It means increased risks for chronic conditions like heart disease, diabetes, high cholesterol and some cancers.

It also means developing other changes like slower metabolism and bone density loss. That’s why experts say now is the time to make your health a high priority – getting annual physicals and screenings, paying attention to your mental health, re-evaluating what you eat and carving out more time for exercise. 

For Travis Swink, DO, a family medicine provider with OSF HealthCare, having these important conversations with patients centers on physical activity. According to Dr. Swink, we start losing muscle strength in our 30s and the trend continues from there. That’s why physical activity is so important by the time we reach our 50s.

“The problem is that when we get into our 50s, we get kind of complacent,” he says. “We stop exercising, we stop taking care of ourselves, and we're getting into the limelight part of our career. So, we tend to slow down. We need to find out where their activity level is at at that point.” 

Dr. Swink says starting in our 40s, people tend to gain about five pounds a year. This can be chalked up to poor eating habits and lack of activity. By the time 50 rolls around, many Americans are 20 to 30 pounds heavier than we should be.

Get moving 

The physical activity doesn’t have to be anything rigorous, like training for a marathon. Unless that’s your motivation. Dr. Swink says the simpler, the better. But you should do something seven days a week.

“What I tell people is, when we get into our 50s, it's not about running, it's not about cross training, pickleball even, it is about walking,” he says. “And if we can do 15 minutes twice a day, that's your best activity.”

Dr. Swink adds that walking is the second-best activity behind jumping rope, which most people probably won’t do in their 50s. He says the key is to dedicate time and purpose to walking. Walking from one job site to another doesn’t count. If you work in an office, take a break or use part of your lunchtime to get in one of your walks. But remember to stretch first to warm up your muscles before heading out the door.

When it comes to strength training, Dr. Swink recommends using free weights instead of machines. And repetition is more important than the amount of weight.

“I don't want them to do any machines with heavy weights,” he says. “I find that doesn't do very well for certain joints, because as we age, we lose some of our flexibility and range of motion, and a free weight allows you to manipulate that. And so do bands. Bands really limit how much you're going to lift, and they’re very good to use.”

As far as diet goes, Dr. Swink says the best way to track what we eat is by writing it down or using a calorie-counting app.

“The problem is that we have become a very carb generated society, and so most of the time I have people actually write a diet diary, even if they're not overweight, and we sit down and we look at it, because most of them will have a 70 to 80% carb ratio, and that, in itself, is going to be very poor for their health. So that's where I approach it, first.” 

Instead of bread and pastas, Dr. Swink recommends choosing proteins like meat, fish, eggs, nuts and non-starchy vegetables (leafy greens, broccoli, cauliflower, peppers, mushrooms) for low-carb options.

Dr. Swink says, for those over 50, that intermittent fasting should not be included in your lifestyle. By fasting you’re putting yourself in slight starvation, which slows your metabolism. “I'd rather have 6 a.m. to 6 p.m. and eating three meals a day and not eating past six o'clock,” he says. “Then doing your exercise after your last meal, where then you're taking and breaking down any extra storage before you go to bed.” 

Dr. Swink adds that the key is everything in moderation. And making changes like curbing alcohol use and making a pact to give up tobacco use could lead to your best decade yet. 

 

Interview Clips 

Introducing the Intuitive Ion Robot, a minimally invasive way to biopsy a patient’s lungs and get them answers more efficiently.

"Robotic bronchoscopy has really become the way of the future in terms of lung nodule diagnosis. It allows us to biopsy very small nodules (dense areas of tissue, or spots)," says Rachael Davis, MD, a pulmonologist with OSF HealthCare. "We can biopsy lung nodules that were not able to be biopsied previously because they were so small. It also allows us to biopsy nodules that are far out on the edge of the lungs that were unreachable before."

The goal of the Ion technology is primarily to diagnose lung cancer early. However, it also gives patients with non-cancerous lung nodules peace of mind. The Ion Robot can stage lung cancer as well. 

"We are hoping to diagnose lung cancer while it is very small, at a very early stage, and provide people the opportunity for either surgical or radiation cure of their cancer. That's our number one goal," Dr. Davis says. "But we do have quite a few patients who have lung nodules, and we don't know what they are. So, we're able to provide them with an answer that says, 'this is what your lung nodule is, and it's not cancer.’”

If a person has a history of smoking or one of their family members has received a lung cancer diagnosis, Dr. Davis says it’s important to get screened.

"Early-stage lung cancer often is asymptomatic. They have no cough, no shortness of breath or anything else. The most important thing we can do about lung cancer is to encourage people to get screened," Dr. Davis says. "Anyone who has a smoking history should talk with their primary care provider or lung doctor about whether they qualify for lung cancer screening. With that, we can find very small lung nodules and diagnose them early."

Screening remains the greatest tool to cure lung cancer. Some nodules used to be biopsied using a needle from outside the body. The robotic bronchoscopy allows the team to biopsy it from the inside in a much safer way, preventing possible complications. When a lung nodule is diagnosed at an earlier stage, it's much more likely to cure the patient. 

"A lung cancer screening is very simple. It's a low-dose CAT scan of the lungs. Most lung cancer screenings are covered by insurance. It's a two-minute procedure," Dr. Davis says. "You get scheduled for a CAT scan. You come in and there's no contrast or IV required. You come in, get your CAT scan, and it's read within 24 hours." 

The OSF Lung & Pulmonology team has doubled the number of patients they see each week since launching the technology one year ago at OSF Saint Francis Medical Center. While the team currently does six biopsies a week, the plan is to perform three to four biopsies five days a week by mid-2025. 

Initially, most patients are cared for at the OSF HealthCare Cancer Institute. The medical team will then refer patients for the Ion Robot biopsy, keeping the patient on one hospital campus. 

If cancerous nodules are found in the patient's lungs, they will be referred to the OSF multi-disciplinary team for further treatment. This includes a surgeon who decides if the lung nodule can be surgically removed and cured. There is also a medical oncologist who can advise if chemotherapy or immunotherapy is needed. Lastly, a radiation oncologist is part of the team. They can provide radiation treatment if necessary. 

Dr. Davis says as the OSF Cancer Institute impact grows across the OSF Ministry, the Ion Robot technology will spread to other markets. According to the Society of Thoracic Surgeons, OSF HealthCare ranks in the 99.2 percentile in quality outcomes after lung cancer surgery for all lung surgery programs in the United States.

OSF Cancer Institute offers lung cancer screening events throughout the year. To learn more about lung cancer prevention, and how to get connected with OSF Lung & Pulmonology, visit the OSF HealthCare website.

Video Interview Clips

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A colonoscopy at age 15

But why? Those at an average risk of colorectal cancer are recommended to start getting colonoscopies once every ten years, starting at 45 years of age.

"My dad was diagnosed after just turning 26. Because it was colon cancer, they recommended I be seen ten years before. The doctors said when I turned 15 to get a colonoscopy," Jaxson says. He was just a baby when his father passed away.

Jaxson’s father, Michael, was an avid runner in great shape. Angie Brown, Michael’s wife and Jaxson’s mother, says Michael had no family history of colon cancer, and never drank or smoked. At the age of 26, Michael was diagnosed with stage 3 colon cancer. He underwent six months of chemotherapy and was in remission for almost four years. In 2013, Michael was diagnosed with a rare form of stage 4 colon cancer called signet ring cell adenocarcinoma.

“If he can do it, I can do it!”

Angie says for years, she has helped prepare her sons to know the importance of cancer screening, and that they’d have to undergo a colonoscopy from a young age.

“He figured that if he could go out there and show people that a 15-year-old boy is willing to go through a colonoscopy, without having any symptoms, then anybody can do it,” Angie says. “We had a good amount of people who sent messages and said, ‘if he can do it, I can do it!’”

Jaxson says it helped to know from a young age that the day was coming. Afterwards, he said it “wasn’t that bad.”

"They have you roll over on your side, then they inject the stuff in, and it works like a charm. You're out and don't remember a thing. Best sleep you'll ever get," Jaxson laughs. 

Jaxson’s bravery can inspire others

Daniel Martin, MD, a gastroenterologist with OSF HealthCare, oversaw Jaxson’s treatment. He says Jaxson’s bravery to undergo something uncomfortable, yet potentially lifesaving, should be inspiration for everyone.

"Colon cancer, if caught early (even if not caught at a polyp stage), is a very treatable condition. Where in the early stages of disease, greater than 90% of those patients are going to be disease free at five years," Dr. Martin says. "One of the advantages of colorectal cancer screening is that we can prevent the disease. With colorectal cancer, in a colonoscopy, you can identify the precursor lesions called polyps and remove them during the exam."

Colon cancer is the third-most diagnosed form of cancer in both men and women.

“Lung is first for both, breast cancer is second for women, then colorectal cancer is third. For men, prostate is second, colorectal cancer is third. Colon cancer is the second-leading cause of cancer mortality in this country,” Dr. Martin explains.

The prevalence of colon cancer, along with the rareness of Michael’s signet ring colon cancer, led Angie and Michael to launch the Michael P. Brown Colon Cancer Foundation which lives by the motto “Get Busy Living.”

“A lot of people think you’re guaranteed a long life, especially if they’ve had parents who lived into their 80s and 90s,” Angie says. “You just never know what’s going to happen. If you have a bucket list, start doing those things. Don’t wait until you’re retired.”

The Foundation hosts Michael’s 5K Run for Life each year, raising money for signet ring research

“We try to be an outlet for people to get information about signet ring colon cancer. My husband used to field most of those calls, but now I do. My boys are getting involved too,” Angie says. “If there’s a parent who has cancer, they’re willing to talk to kids about that.”

Signs and symptoms of colon cancer

"The most common concern would be bleeding in your stool. But that would also include abdominal pain that's new or different," Dr. Martin says. "Or changes in the frequency or caliber of your stools."

This was mainly the case with Michael, Angie says.

“Initially, my husband’s symptom was belly pain. He was put on a couple of different medications because it was thought to be a stomach ulcer,” Angie says. “It didn’t work. He started having constipation, diarrhea and vomiting. We went into the emergency department, and he got the diagnosis of colon cancer.”

Traditionally, colon cancer is seen in people in their 60s and 70s. However, more younger people are starting to be diagnosed with colon cancer, Dr. Martin says.

"Specific to colorectal cancer, there are various options available now for screening. We recommend procedural screening with colonoscopy whenever possible. But with the advent of stool studies that are readily available and have been covered by insurance, that has helped increase the pool of patients who are receiving appropriate screening," Dr. Martin says. These readily available options are so important, Dr. Martin says, because most colon cancer patients are getting diagnosed at a later stage in the disease.

In the past, things like smoking, obesity and unhealthy lifestyle choices have been thought to cause colon cancer. Dr. Martin says in addition to that, more recent studies have shown processed foods to be a concern as well, adding that our gut's microbiome may show early indicators of cancer. A study done by Harvard Medical School investigators found that certain types of gut bacteria could lead to the development of precancerous colon polyps. 

Dr. Martin credits the OSF HealthCare cancer tumor boards and medical teams for creating a more organized process over the last five to 10 years that takes care of patients from diagnosis to treatment. 

Jaxson says now that it’s all said and done, the colonoscopy process was not as bad as most people think. This is on par with what most patients say, Dr. Martin adds. His word of caution? Many of his patients undergoing a colon cancer diagnosis wish they would have gotten colonoscopies earlier on.

To schedule a screening, speak with your primary care provider first and get a referral. You can find more information about colonoscopies on the OSF HealthCare website.

Jaxson Brown Video Interview Clips

Angie Brown Video Interview Clips

Dr. Daniel Martin Video Interview Clips

Cancer can impact anyone, and the numbers show cases skewing younger.

Recently, the American Cancer Society reported that for the first time colon and rectal cancers have become leading causes of cancer deaths in younger adults. 

Overall, lung cancer remains the leading cause of cancer death among men and women of all ages. Prostate cancer is second for men, and breast cancer is second for women. Colorectal cancer is third for both men and women. 

Another study suggests that certain cancers are being diagnosed more often in younger adults in the U.S., and the spike is due, in part, to adults and especially women in their 30s.

The study published in the journal JAMA Network Open, looked at 17 National Cancer Institute registries with more than 500,000 cases of early-onset cancer, or cancers diagnosed in patients under age 50, between 2010 and 2019. The study showed early-onset cancers increased during that time by an average of just over a quarter of a percent (.28).  

In 2019, breast cancer had the highest number of incidences of early-onset cases. Gastrointestinal cancers and cancers of the urinary system and the female reproductive system are right up there as well.  

Peggy Rogers is a nurse practitioner in genetics and medical oncology for OSF HealthCare. She sees similar trends among her patients.

“For women, they are the caregivers in the family, and they tend to worry about everyone else besides themselves, and maybe put off seeking care sooner," says Rogers. "But women also encourage their husbands to seek and visit with their provider. So that’s a positive. But in general, I would say we have to keep talking.”

 Among gastrointestinal cancers, the most common early-onset cancers were found in the colon, rectum, stomach and pancreas. The fastest-growing incidence rates were found in the appendix, bile duct and pancreas.

“I think the nuance that we found is it's more common to find gastric cancers, which I don't think people realize, and I don't think people are aware of, the signs for gastric cancer can be as simple as abdominal pain and nausea or feeling full quickly, and they may need medical attention sooner," says Rogers. 

Some of the reasons for increased cancer rates in adults under age 50 include:

·         Drinking alcohol in excess

·         Smoking tobacco

·         Eating a Western diet (prepackaged foods, fried foods, processed meats, high-sugar drinks)

·         Being obese or overweight

·         Being exposed to environmental toxins

“We are concerned that obesity is an epidemic, and it's not just overconsumption of food and inactivity," says Rogers. "It’s the types of foods that people are eating, which is processed, it's quick, it's easy, but it's not the most beneficial.”

To lower your overall cancer risk, Rogers recommends maintaining a healthy weight, increasing your exercise, trying to eat five to nine servings of fruits and vegetables each day, limiting processed foods, not smoking and drinking in moderation.

Colonoscopy screening is usually recommended starting at age 45. People with family history may have to start earlier.  And pay attention to potential symptoms such as blood in the stool, abdominal pain, changes in bowel habits and unexplained weight loss. 

Rogers also recommends having conversations with your physician about your health. And for younger people who don’t have a provider, it’s important to find one. 

“I think working towards having a visit at least once a year to establish with a provider – establish goals for their health care – is very important and sometimes family history is contributory and why people get cancers," she says. "So those are discussions that you can have with your primary care provider. Maybe they need a referral or their family member that's been affected with cancer should consider a genetic risk assessment to further look at what may be contributing to some of the cancers in the family, even at early onset.”

For more information about cancer, visit OSF HealthCare. 
 

Interview Clips 

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Colonoscopies have been considered the gold standard for colorectal cancer screening and prevention for decades. Now, however, a new study seems to call that belief into question, but health professionals argue the research can be easily misinterpreted.

The study, published in the New England Journal of Medicine, followed 85,000 participants over a ten year period. Trial participants were either invited to undergo a single colonoscopy screening or to receive their usual physician care with no colonoscopy.

Of those who were invited to have colonoscopies – whether they got one or not – there was an 18% reduction in developing the disease, and no significant reduction in the likelihood of colon cancer death.

Dr. Omar Khokhar is an OSF HealthCare gastroenterologist in Bloomington, Illinois. He says there is a sticking point in this study, which can be easily overlooked: Less than half (42%) of the group invited to get a colonoscopy actually went through with the screening. If you concentrate on those individuals only, the benefits of screenings are more apparent.

“The 42% of people who accepted the invitation for the colonoscopy arm of this study had a 31% reduction in colon cancer incidents, and a 50% mortality reduction from colon cancer,” Dr. Khokhar explains. “So I think if anything, this study tells us that if you get screened, if you get a colonoscopy, you will have a reduction in your risk of colon cancer, and death from colon cancer.”

The new study has gotten quite a bit of media attention, and the major concern from physicians is that prospective patients will see the headlines and then possibly not pursue screenings if they believe there is no significant benefit.

Dr. Khokhar says he and his colleagues welcome patients’ questions, especially from those who have concerns. He says part of his job is to explain the ins and outs of screenings, and allow patients to decide what type of care they prefer.

“There are things that we're experts on and we're not experts on, and I'm fully open to an informed patient. I encourage that conversation. Come to me armed with your data. I'll come with my data. And let's talk about it and then you can decide which risks you want to live with,” he says.

“It's simple to say I don't want to get it done. Then you're choosing the risk of not getting it done, and with 52,000 colon cancer deaths every year in this country, and the chance of getting colon cancer one in 25, which is 4% - it's not insignificant - then you choose to live with that risk. But ultimately, as a patient, you get to decide to at least have the conversation.”

The American Cancer Society recommends that all people at average risk of colorectal cancer start regular screening at age 45. However not all colorectal cancer screenings are created equally, and according to Dr. Khokhar, there is a reason the colonoscopy is considered the gold standard. Colonoscopies allow physicians to view the entire colon and both detect and remove polyps, small clumps of cells that can develop into cancer, during the same procedure.

“This is the only test where we can find a precancerous lesion and remove it at the same time,” says Dr. Khokhar. “The stool based tests, if they're negative, you have a clean bill for one to three years depending on which one you choose. If they are positive that needs to be followed up with a colonoscopy to make sure you don't have a precancerous polyp that we can address and get rid of during this colonoscopy.”

Lower risk patients may be eligible for one of several other non-invasive tests, including at-home stool tests Dr. Khokhar mentioned. These tests, including Cologuard, can be done outside of a physician’s office and can detect blood in the stool or abnormal DNA that may suggest cancer. 

Colorectal polyps and colorectal cancer don’t always cause symptoms, especially at first. That is why getting screened regularly for colorectal cancer is so important. If you do experience symptoms, they may include a change in bowel habits, blood in or on your stool (bowel movement), abdominal pain, aches, or cramps that don’t go away or unexplained weight loss. If you have any of these symptoms, talk to your doctor.

Interview Clips - Dr. Omar Khokhar (pronounced COE-car)