June is Men's Health Month, and families gathering for Father's Day can nudge the men in their lives to be proactive about their health.
"Father's Day is really the onset of the good weather, and people need to get out and get active," said Dr. Mark Feldner, family practitioner with Community Care Network in St. John.
Feldner said younger men tend to visit the doctor when a problem arises, not for preventive care.
He credits television commercials for opening the lines of communication about sensitive issues such as erectile dysfunction. Erectile dysfunction problems often signal an underlying issue, Feldner said.
When people think of men's health, prostate cancer usually comes to mind, said Dr. Michael Mirochna, who works in family medicine at Lake Porter Primary Care in Valparaiso. All men who live to 100 will develop prostate cancer, but not all will die from it, he said.
In May, the American Urological Association issued new guidelines, stating men between ages 55 and 69 should be screened every two years via a prostate specific antigen test, or PSA, after the doctor and patient discuss it and decide it is the best action.
"One of the biggest things we are seeing in health care is the requirement for physicians to engage in shared decision-making," said Dr. Claude Foreit, president of Franciscan Physician Network.
It attempts to engage the patient in determining the best plan for their health, he said.
Top health concerns for men are cardiovascular disease, tobacco use, obesity, high blood pressure, high BMIs, alcohol intake, mood disorders, cancer and a lack of physical activity, fruit and vegetable consumption and safe sexual practices, Mirochna said.
But the top cause of death for men younger than 44 is unintentional injury. People should wear seat belts and shouldn't drink and drive, or text and drive, Mirochna said. They should wear helmets when appropriate and be careful around guns and dangerous machinery.
Men in their 40s tend to worry about their weight, diabetes and cancer, Feldner said. "The big one is heart disease," he said.
In a typical checkup, physicians do a "systems check," asking about shortness of breath, sleep habits, headaches, dizziness, tobacco and alcohol use and family history updates. An exam includes checks of the eyes, ears, nose, throat, neck, abdomen, heart and lungs, Foreit said.
Doctors also screen for depression using a standard nine-question test.
"If you don't screen for depression, you're not going to catch it sometimes," Foreit said.
Around age 65, men should be checked for fall risk. Older patients also are screened for dementia, he said.
Men between 50 and 75 should have regular colon cancer screenings, whether through a yearly fecal test or a colonoscopy every 10 years, starting at age 50, Foreit said.
Men also should get screened for diabetes and get immunized. A tetanus booster is needed every 10 years, flu shots should be done annually, people who will be near babies should get a whooping cough booster, and a pneumonia vaccine is good for those 65 and older, Mirochna said.
Despite the risk of lung cancer linked to smoking, patients have told Feldner they don't want to quit because they like it and they're going to die from something, anyway. But lung cancer is an ugly death, not only for the patient but also for the family, Feldner said.