“It continues to grow over time in most men. Different parts of the prostate can start to have abnormal growths. The big concern is that prostate cancer can form. About one in eight men have a lifetime risk of developing prostate cancer,” Dr. Rinker explains. He adds that prostate cancer is the second-leading cause of cancer death in men.

Genetics, family history, old age, ethnicity, smoking and obesity put you at a higher risk. And Dr. Rinker adds that prostate cancer largely comes with no symptoms, making screenings all the more important. If you do have symptoms, those can mimic traits of an enlarged prostate, such as difficulty urinating, blood in semen or pain around the groin.

Screenings

Dr. Rinker says men should start talking to their primary care provider about prostate cancer screening at age 40. He says the method that most men know – a digital rectal exam – has actually fallen out of favor with medical professionals.

“We really didn’t find that the digital rectal exam was very effective,” Dr. Rinker opines. “There’s a lot of user bias with how well [a provider] is at examining. Maybe they won’t be able to detect a larger, late state lesion as well.”

Instead, the standard is a prostate-specific antigen (PSA) blood test. This measures the level of a protein produced by the prostate in your blood.

“It can be added to your routine bloodwork. Nothing more than that. It could save your life,” Dr. Rinker says.

If the test finds elevated PSA levels, a provider might recommend a prostate MRI (magnetic resonance imaging). As the name suggests, this is noninvasive imaging that gives providers a clear picture of the organ.

“This can lead to a reduction in biopsies that are unnecessary,” Dr. Rinker says.

The bottom line

Dr. Rinker repeats advice that men have heard plenty: know your body, know your family history, choose healthy behaviors and see your provider regularly.

“The whole goal of [educating people on screenings] is catching cancer earlier. If you do that, you have more treatment options. You have a better chance to cure the cancer,” Dr. Rinker says. “In some cases if it’s a low-grade cancer, you may choose to not to treat it at all. We can monitor it. We can re-image it or utilize a PSA test to see if it changes.”

Learn more

Read more about cancer treatment and prevention on the OSF HealthCare website. Cancer care at OSF includes services at local cancer centers and clinics like the one Dr. Rinker works at, plus the OSF Cancer Institute in Peoria, Illinois.

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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.”
 

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September is Prostate Cancer Awareness Month. It's a reminder that the disease is manageable when caught early.

Uwais Zaid, MD, a urologist who provides care at OSF HealthCare, is urging men to get screening appointments on their calendar at the right time. That’s critical, he says, because some people who develop prostate cancer will not show symptoms.

“It is something we certainly do take seriously in urology,” Dr. Zaid says.

What is the prostate?

The prostate is a male gland about the size and shape of a walnut. It surrounds the upper part of the urethra, or the tube that carries urine from the bladder. The prostate makes some of the fluid that’s part of semen.

Risk factors

Dr. Zaid says the risk for prostate cancer increases with age.

Other risks: “African American men are at a higher risk,” Dr. Zaid says. “Certain dietary things like too much red meat and greasy, fatty food. And certain type of exposures such as Agent Orange for some of our veterans.”

And like most other ailments, a family history of prostate cancer should put you on higher alert.

Screening: how and when

Dr. Zaid says prostate cancer screening involves two simple tests. One is a blood test that measures the amount of a hormone produced by your prostate called prostate-specific antigen (PSA). An abnormally high reading might warrant further examination by your health care provider.

The other test is a digital rectal exam, where your provider will feel for lumps on the prostate.

Don’t get that confused with a colonoscopy, the more invasive screening that looks for colon cancer, Dr. Zaid says.

“It doesn’t require any special or horrible bowel prep,” Dr. Zaid says of the prostate exam. “It’s about a 20 second thing we do in the clinic that can save your life.”

You should always see your health care provider anytime something seems off with your body. But the American Urological Association has guidelines for when to get a prostate cancer screening.

“For most men, we want them to start screening with an annual PSA [test] at age 54 to 69,” Dr. Zaid explains. “For certain men, you want to start earlier if you have a risk factor.”

After age 69, Dr. Zaid says you should talk to your primary care provider about what screenings are right for you.

What should you not do?

Don’t think this type of cancer is so common that you should just let it run its course. Dr. Zaid says there are aggressive types of prostate cancer that can be deadly.

Also, Dr. Zaid warns of herbal remedies for cancer in general. He says your best bet is to see a doctor.

Treatment

Dr. Zaid says treatment for prostate cancer depends, in part, on how much the cancer has spread.

If it’s contained to the prostate gland, he says radiation (sending radiation waves to destroy the cancer cells) or surgery to partially or fully remove the gland are options.

“If the prostate cancer has escaped the prostate gland, there are a lot of treatment options,” Dr. Zaid explains. “This is actually a very active area [in medicine] with all sorts of research and new medications.”

Hormone therapy may be an option here, the doctor says.

“It’s very manageable,” Dr. Zaid says on treatment of the disease.

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Previous coverage

OSF HealthCare library: Prostate cancer

OSF HealthCare Newsroom: Urinary incontinence and the link to prostate cancer

June is a time to encourage men to take care of their health and prioritize going in to be seen by a medical professional.

"Men are notoriously difficult to get in for regular checkups, unless there's a problem. Men tend to ignore problems, a lot of time until it's too late or they develop a problem, when they could have avoided it," says Brian Curtis, MD, vice president, chief medical officer of OSF Medical Group.

Dr. Curtis says men need to start regular primary care checkups for blood pressure, cholesterol and weight screenings in their early 20s. At 45, men need to start screening for colon cancer (colonoscopy), along with prostate cancer screening in their 50s. 

While these are all important things to do, Dr. Curtis says it’s also important for men to prioritize their mental well-being.

In terms of mental health, there are two major issues guys run into. 

1: Men tend to not open up and talk about their feelings. 

2: Guys aren't the best at checking in with their buddies about how they're doing. 

"It's OK not to be OK"

"Fine is not always fine," Dr. Curtis points out. While guys might say they're "OK," it's important to ask better, open-ended questions to get a better view of how they're really doing. 

"The markers to look out for are behavior changes. Maybe they're not acting like they normally would," Dr. Curtis says. "So, you can check in and say 'hey, I noticed you seem a little down. Or you usually come out for softball, and you're not doing that lately. I want to see how you're doing.’" 

When it comes to mental health, Dr. Curtis says men don’t always make sleep a priority.

"Most people should be getting six to eight hours of sleep a night," he says. 

Regular exercise is also a big help for people's mental health. 

"You don't have to be a marathon runner. You can just go outside for a walk," Dr. Curtis adds. 

Dr. Curtis says eating ultra-processed foods, which are very "calorie dense" (meaning a lot of calories with a small amount of food), causes your head to take at least 30 minutes to catch up with your stomach. Breaking things down into portions, finishing the meal and then giving your body time to process the food allows you to eat better portion sizes.

Alcohol is another major concern which can impact many aspects of people's lives.

"Alcohol is actually a depressant. So one, people who consume alcohol, it further depresses you. And two, it interferes with your sleep pattern," Dr. Curtis says. "It affects your ability to go into good REM (rapid eye movement) sleep." 

Talk about it 

Whether it's your primary care physician, counselor, family member or close friend, it's important to talk to a person you trust about what's going on in your life. 

Dr. Curtis has seen some improvement over the last few years in men being more vocal about their mental health challenges. Coming out of the COVID-19 pandemic, he says it's become even more apparent that community and socialization are so important for people's overall well-being.

If you need professional help, OSF HealthCare’s Behavioral & Mental Health services can connect you with providers and resources. Services can be provided in an outpatient setting, in the hospital, or online. 

The national suicide hotline is available 24/7. Just dial 9-8-8, choose the option that’s best for you, and speak with a skilled counselor about what’s going on.

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As Saturday Night Live celebrates its 50^th anniversary, one thing it has been known for over the decades is the use of comedy to make a commentary on what’s happening in the world. Recently, 
it was a skit about how the only way to get a young man to an annual physical is to pretend it’s a podcast appearance.

OSF HealthCare primary care physician, Mfowethu Langeni, DO, said he heard about the skit and then watched it with appreciation.

“So hopefully this can help encourage people to change that mindset and change the framing and letting them know that we will see you even if you have no symptoms, no issues. Preventive health is equally as important as any other aspect of health care.”

Nearly 40% of Generation Z men (age 20-29) don’t have a primary care provider and millennial men (age 29-43) make up the second-highest number of men without regular primary care according to one study.

Using comedy to tell hard truths can be an effective tool so Dr. Langeni hopes the skit breaks through the perception of many young men – a feeling they are invincible and therefore don’t need medical attention unless they experience serious symptoms.

Research from the Centers for Disease Control and Prevention also reveals young men have a misperception they are healthier than they are.

“A good portion of men between the age of 18 and 35 are actually in probably fair to poor condition as far as health is concerned. So, I think the first thing we do when you walk in the door in a primary doctor's office, we check your weight, we check your vitals, and we check blood pressure. Those are some really quick things that we can get, but it can tell a lot of information.”

For example, Dr. Langeni says Type 2 diabetes and high blood pressure don’t always have prominent symptoms right away and without an annual exam, they can go undetected for years. That poses the risk of irreversible harm. During an initial primary care visit, Dr. Langeni says he’ll also go over family history because there are some diseases, including cancer, that can be genetically linked.

“And so, if your father or mother or grandmother, uncle had a condition, you could also be predisposed to that condition as well. So, we address these things, we talk about these things, and then we come up with shared decision making and figure out what to do next.”

Research also shows men are increasingly turning to social media platforms such as Instagram and Tik Tok for their health information, often relying on influencers. That’s not all bad, says Dr. Langeni, but he says having a primary care provider as a trusted source is a great way to verify information from social media.

“I promote people getting information, but the big thing is just then take the information and then ask, ‘Hey, what's true? What's not true, or if it is, is this right for me?’ If it's not right for me, because everyone is individually different, having a primary doctor really will help to cater to your individual plan.”

With OSF MyChart, you can also easily access your primary care provider with questions about a variety of concerns, including medications, supplements, or issues that might arise between appointments. If it requires a referral to a specialist, your primary care provider can make that happen. Dr. Langeni suggests thinking of a primary care provider as someone who is a care coordinator and your advocate.

National statistics reveal other health realities men might consider. For example, men die by suicide at twice the rate of women and 40.5% of men over 20 have obesity. A primary care provider can help with lifestyle changes and medication, if necessary, to address obesity. Some mental health challenges can be managed at the primary care level, but Dr. Langeni says having a professional you trust to discuss stress, anxiety, depression or other concerns is crucial. Then, he says, your provider can recommend whether seeing a behavioral health specialist might be the best approach.

Just as you take your car in for a regular oil change, Dr. Langeni strongly suggests regular health maintenance with a primary care provider. Putting it another way, he emphasizes, “primary care is preventive care” and that’s nothing to laugh at. 

Dr. Mfowethu Langeni

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Are you treating your care better than your body?

A gradual drop in testosterone is a normal part of aging and most men don’t experience any real symptoms or problems.

Others may not be so fortunate.

They may notice a lack of sex drive, muscles getting thinner and weaker and a loss of body hair over time. Or the shift can be subtle like mood changes, less energy or a lack of concentration.

Shitladas Pamnani, MD, with OSF HealthCare, says men, like women, experience major hormonal changes, especially in their testosterone levels. Some call it “male menopause.”

“Our energy goes down, sex drive goes down, it’s a natural cycle,” says Dr. Pamnani. “Our skin is not the same as we age, and other body organs, including hormone producing glands, are not functioning as well either as testosterone levels naturally decline.” 

Recently, a study published in the journal Annals of Internal Medicine revealed that low testosterone in men can also lead to an increase in mortality risk.

The study was done by researchers at the University of Western Australia and included more than 24,000 subjects. The researchers reported that low baseline levels of testosterone in men are associated with an increased risk of all-cause mortality (death by any cause) and that very low levels are related to a rise in cardiovascular death.

“As we age, studies have found that 50% of men above the age of 80 will have low testosterone,” says Dr. Pamnani.

While age is a major factor in a drop in testosterone levels, illnesses can play a role, too. Type 2 diabetes, obesity and pituitary gland problems can all affect levels, as can treatments such as radiation therapy, chemotherapy and steroid medicines.

Another problem is sleep apnea.

“Obstructive sleep apnea many times goes undiagnosed, which is also linked to decreased testosterone level as well as fatigue,” Dr. Pamnani says. “Those are common symptoms that middle aged men present with and could be explained as simple as sleep apnea, or even anemia or electrolyte deficiency.”

Low testosterone is usually discovered with a blood test, which is usually scheduled in the morning. According to Dr. Pamnani, normal levels range from 300 to 1,000 ng/DL.

If you test for low blood levels of testosterone and have significant symptoms, your medical provider may prescribe supplemental testosterone. This can boost levels and may help with muscles, protect bones, help improve mood as well as sex drive. Supplements come in different forms including shots, gels, patches and tablets. Possible side effects include sleep apnea, enlarged prostate and acne. However, experts say treating normal aging with testosterone therapy is not recommended.

If you don't have a medical condition that's causing your drop in testosterone levels, Dr. Pamnani says making simple healthy lifestyle changes can help maintain proper hormonal balance, such as regular exercise and eating a healthy diet. That’s because low testosterone can also lead to fat gain. If you’re not building muscle with the calories you take in, your body turns those calories into fat.

Bottom line, he adds, is have a conversation with your doctor about any issues that may be concerning to you. It can save your life.

“When it comes to treatment, there are risks and benefits. But you should always talk to your doctor before deciding to take testosterone supplements.”

 

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