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Men's Health Month

Women's Work

Yes, this is Men's Health Month, but the responsibility of dragging guys to the doctor usually falls to moms and wives. Knowing the signs of ailments that commonly afflict men can help spare everyone grief.

June 01, 1998|USHA LEE McFARLING | SPECIAL TO THE TIMES

They're as much a part of the Kansas State Fair as the tractor pulls and hog judging: women dragging men, against their will, to Dr. Mark Austenfeld's prostate cancer screening booth. Austenfeld, a clinical associate professor of urology at Kansas University Medical Center, offers blood tests that screen for prostate cancer, a painful disease that kills thousands of American men each year.

The screening is free, quick and simple. But amazingly, most of the men at the fair hurry past the booth without stopping to take the free test.

"It's women who grab the men by the shirt and drag them to the booth," Austenfeld says.

That's how it is in Kansas and in the rest of the country: Women are the gatekeepers of health care for their families. They take care of their own health, their children's health, and the health of the men in their lives.

No, it's not fair. But for many men, a trip to the doctor is like a fate worse than death. That leaves women in a difficult position: Either they cajole their husbands, fathers, brothers, sons and male friends to see doctors, or they risk losing them. Since so many diseases that cut men down in their prime are preventable if detected early, not going to the doctor can be a death sentence.

Women have their work cut out for them.

Why don't men go to the doctor? The reasons are numerous, and it starts when they're just boys.

"We socialize men into invulnerability, and we tell them not to show their emotions," says men's psychology expert William Pollack, co-director of the Center for Men at McLean Hospital in Belmont, Mass. The message they get is to not admit they're vulnerable to anything--including disease.

Men are also stoic. They'd rather just take what comes.

"Men are men," says Dr. LaMar McGinnis, a surgical oncologist and spokesman for the American Cancer Society. "They are busy and tend to push things under the rug."

There's more, experts say: Men don't want to waste the doctor's time. They don't want to waste their own time. They're afraid of the exams. They're afraid of what the doctor might find. Actually, we should give men a bit of a

break. Unlike women, men have never had to succumb to routine annual medical probes--with the expected result of a clean bill of health--that women take for granted.

"Men tend not to see a physician unless they are sick or their job requires it," says Dr. Richard Stein, chief of cardiac prevention and rehabilitation at Lenox Hill Hospital in Manhattan. So it's frequently up to a woman to take the bull by the horns.

A good place to start is by learning about the following six ailments. They're the ones most likely to afflict a man in middle age. Luckily, they're also problems that, if diagnosed early, can usually be treated successfully. Here's what you need to know so he'll be around for you to worry about for a long, long time.

***

Prostate Cancer: There are nearly 200,000 new cases and 40,000 deaths each year in the United States.

Symptoms Women May Notice: The need to urinate interrupts the night's sleep. But most early cancers are symptomless.

Treatment: Surgery and / or radiation.

The words "prostate gland" give men the shivers: They don't want to talk about it. They don't want to think about it, and they certainly don't want a doctor touching it. But quick and simple prostate screening tests are the only way to detect prostate cancer early. It is this simple: When it's caught early, prostate cancer is highly curable. When it's discovered late, it can cause a slow, painful and needless death.

Prostate problems are notoriously difficult to diagnose using symptoms alone. The symptoms--frequent interruption of sleep to urinate and diminished urinary flow--can also be signs of benign prostatic enlargement, which is generally not a problem. On the other hand, cancer can develop without obvious symptoms.

"Whether or not you have symptoms, get an exam," Austenfeld urges.

Here are the facts about rectal prostate exams: A doctor uses his gloved finger to check the prostate gland for irregularities, such as nodules or thickening. This is known as a digital rectal exam. Another test is the PSA (prostate-specific antigen) blood test to detect a substance produced by enlarged or cancerous prostate glands. If nothing is found, the patient is home free. If something is amiss, the doctor will use ultrasound for a closer look. If that exam is irregular, the patient will need a biopsy--an outpatient procedure.

*

Colorectal Cancer: There are more than 136,000 new cases and 55,000 deaths each year in the United States.

Symptoms Women May Notice: You won't. Colorectal cancer can develop without symptoms. For the afflicted, blood in the stool or rectal bleeding can signal advanced disease, but that's often difficult to identify.

Treatment: Surgical removal of cancerous tissue once cancer has developed; removal of benign polyps while they are precancerous.

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