Ask Us Anything About… Men’s Health Issues

As we know, men require more encouragement to see a physician. But several important health issues loom large for men, including heart disease – the leading cause of death – and other conditions such as stroke, accidental injury and depression.

Dr. Richard Frey, a family medicine physician at Penn State Medical Group-South Lancaster, shares advice about men’s health issues.

December 5, 2017 Penn State Health News
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Transcript

Description – The video begins inside a clinical appointment room at, Penn State Medical Group South – Lancaster. Inside the room are the standard items required for typical check ups and doctors appointments. Two people are standing and looking at the camera. From left to right is Scott Gilbert and Dr. Richard Frey.

Scott Gilbert – From Penn State Health, this is Ask Us Anything About Men’s Health issues. I’m Scott Gilbert. Well as we know, let’s face it guys, we require a little more encouragement to see a physician but several important health issues do loom large for men including heart disease. That’s the leading cause of death for all people and other conditions such as stroke, accidental injury, and depression. We’re going to explore many facets of men’s health today with Dr. Richard Frey. He’s a family physician here at Penn State Medical Group South Lancaster. Dr. Frey, thanks for taking the time today.

Dr. Richard Frey  – My pleasure.

Scott Gilbert – I want to start with the inconvenient truth. I understand it is a real thing. We guys, we’re not that good at getting preventive medical care or even medical attention in general, are you?

Dr. Richard Frey  – No, not very good at all.

Scott Gilbert – Why is that?

Dr. Richard Frey  – I think just men think that they’re healthier. They believe that they’re too tough to go. Minor complaints don’t seem to get dealt with. So they don’t go to the doctor. Actually, we’ve had a little increase maybe with some health policies by insurance companies that make their people go once a year for blood work. So we’re getting to see that a little more frequently.

Scott Gilbert – Well that’s a good sign then. So guys, see your doctor. Don’t put off that checkup. And throughout the course of this conversation, by the way, I want to encourage you to post your questions and comments in the comment field below this Facebook and we’ll pose those to Dr. Frey. Anything is within bounds here because if you’ve seen some of these interviews before, we do tend to specialize on one particular condition. Today, we’re talking about men’s health in general. So we’re going to touch on a variety of topics. Let’s start with a topic, Dr. Frey, that’s very much at the forefront in the month of November, prostate cancer awareness month. Prostate cancer is the second leading cause of cancer death in men right behind lung cancer. So important to get that screening.

Dr. Richard Frey  – Yeah so the only thing I can tel you about the screening though is it’s a little bit controversial. The most important part about it, talk to your doctor. Everybody’s got a different risk for that. Maybe a family history risk and certainly we want to be careful about just randomly ordering PSA tests or getting digital rectal exams that often times will be done to try to detect that. As we know, cancer of the prostate although it’s a leading cancer is not very frequent for a cause of death. It’s very popular prominent cancer for frequency but we don’t want to overplay it. We don’t want to over treat it because there’s a lot of risks in the evaluation and treatment of false positive tests. Elevated PSA that doesn’t really mean you have cancer.

Scott Gilbert – And PSA stands for prostate specific antigen.

Dr. Richard Frey  – Correct.

Scott Gilbert – What is that though?

Dr. Richard Frey  – That’s a blood test that in normal men, you draw blood tests, and it should be between 0 and 4. If that level’s elevated it typically may mean that you’re at increased risk for prostate cancer. Doesn’t mean you have cancer. It’s a test that’s often times used to follow people with prostate cancer but not always a great screening tool.

Scott Gilbert – And a lot of men probably not really too eager to have that DRE or digital rectal exam either. Another test that’s involved, correct?

Dr. Richard Frey  – Correct. And that’s a fairly simple, in office exam but like you said, men kind of avoid the doctor and that isn’t one of the things that they’re really wanting to have.

Scott Gilbert – And that should be starting at age 40?

Dr. Richard Frey  – Typically 40 if you’re at high risk. Fifty would be a more common age to start that if still utilized. So it needs to be discussed with your doctor. Get to your doctor to have that discussion.

Scott Gilbert – That’s the bottom line with this and many of the other topics we talk about today, I’m sure, is continue the dialogue with your physician. This is Ask Us Anything About men’s health issues. I’m Scott Gilbert. We are live today at Penn State Medical Group South Lancaster and Dr. Frey’s the family physician here. We welcome your questions for Dr. Frey. Just put them in the comment field below this Facebook post and we will pose them to him whether you’re watching this video live or on video playback after the fact. We will get your answers, again, in the comment field. Let’s shift to another type of cancer, lung cancer. It is the number one cancer killer for both men and women, correct?

Dr. Richard Frey  – Absolutely.

Scott Gilbert – All right. So talk a little bit about the difficulty with diagnosing that because often it seems like it’s diagnosed too late.

Dr. Richard Frey  – And that is true. There is not really a great screening tool for certain high risk groups like 55 to 80 who have 30 years of smoking. A low dose CT scan is now the screening test of choice. Prior to that there really wasn’t any good mechanism. Regular chest x-rays don’t really show those early. So consequently people present late and they already have metastatic disease or cancer that is already spread outside their lung.

Scott Gilbert – And you mentioned smoking but it’s worth repeating that that is a major cause, perhaps the main cause of this cancer, right?

Dr. Richard Frey  – Actually smoking is probably associated with close to 95% of lung cancers. So absolutely, you got to stop smoking.

Scott Gilbert – A lot of lifestyle choices we’ll be touching on this interview and that’s a big one right there. Try to get away from those cigarettes if you can. The biggest killer is heart disease. It’s responsible for 1 in every 4 deaths in the U.S. It’s the biggest killer of men, of course. So what’s the key to trying to get an early handle on heart disease or better yet preventing it.

Dr. Richard Frey  – Well obviously prevention is the key. So talk about the major risk factors. Cigarette smoking, we keep talking about that. Diabetes and high blood pressure. So if you don’t get to the doctor, you’re not going to know that you have those problems. Consequently if you do, you should have your blood pressure controlled. You should have your diabetes controlled and if you’re smoking, cut back or try to stop.

Scott Gilbert – All right. All good advice there. And more than half of people who die of heart disease, though, have experienced no symptoms. No obvious symptoms at least. That sounds kind of scary.

Dr. Richard Frey  – Well it is and I think that that’s part of the point of trying to do early screening. Telling people look, you’re at risk. You come in for a routine physical exam and you’re a smoker. Well then that’s putting you at risk. And these are not secrets. We know this and so to be at high risk, you’re probably having one of those three things.

Scott Gilbert – And so the importance of monitoring your blood pressure, perhaps, even more important with some new guidelines that just came out from the American Heart Association that lower the threshold for hypertension but I imagine is that going to change anything you do in your office?

Dr. Richard Frey  – Well not directly but these things when they come out, they kind of get sifted through the medical community. We look them over. We work on that and kind of come to a good resolution but it’s clear that better control is important. And blood pressure affects people over a lifetime not necessarily one reading causes a stroke or a heart attack. It’s really year in year out elevations that cause problems. So we just have to be a little bit tighter at following recommendations.

Scott Gilbert – You’re watching Ask Us Anything About men’s health issues from Penn State Health, I’m Scott Gilbert alongside Dr. Richard Frey. We are at Penn State Medical Group South Lancaster and we welcome your questions and comments. Just add them to the comment field below this Facebook post and if you like this content as we hope you do, make sure you share it on your feed so other people will hopefully be able to access it and benefit from it. We were talking about heart disease. I’d like to talk about a very closely related condition, strokes. You touched on that briefly but what are some steps that you encourage patients to take to try to mitigate stroke risks. Is that similar to trying to lower the risk of the heart disease?

Dr. Richard Frey  – Absolutely. All cardiovascular blood vessel problems related to the heart or the brain or to your legs, for instance, are all related to the same risk factors. Stroke occurs in more frequently in people with irregular heartbeats. Atrial fibrillation, certainly a lot of people have heard about that and those people are at higher risk of stroke but in general, it’s the same guidelines. Control your sugar. Quit smoking. Get plenty of exercise which we haven’t really talked about. A good 30 minutes a day of exercise is great for prevention of all these cardiovascular things and including the diabetes which can be helpful as well.

Scott Gilbert – And if people think well 30 minutes a day, that’s a lot. Is a little bit less than still beneficial? More beneficial than none?

Dr. Richard Frey  – Anything better than what you’re doing. Even, you know, 150 minutes a week will take that but if it’s 10 minutes a day we’ll take that as well. Anything better than being a couch potato.

Scott Gilbert – Yeah, put a treadmill in front of the TV and when you’re watching that football game on Sunday, right? You can be moving while they’re running on the screen. I want to shift to something that is actually the third leading cause of death among men and that is accidental injury. People may not realize that it’s that high but what are some types of injury that you see most commonly in your practice and that your patients experience?

Dr. Richard Frey  – Well particularly in men, there’s really two things. One would be work related injuries. Men tend to work with more risky jobs, more machinery, and also burns happen to be a big thing for accidental injuries. Outside of that, it’s just the sports we do. It’s the activities we do. Bicycling. You know we get a lot of bone fractures in men because of things that they do. Maybe that’s inherent in men to be more aggressively risky with activity but it also can be some social pressures that are put on by other people. Yeah you can do that or I can do better. So we kind of put that pressure on ourself and that’s a societal thing. I’m not going to change that necessarily but being careful, being thoughtful. Very important in trying to minimize risks from injuries.

Scott Gilbert – When doing research for this interview, I found it rather surprising that men are actually four times more likely to commit suicide than women. That that’s a staggering statistic and do we have any idea why that’s the case?

Dr. Richard Frey  – Partly because men probably the same type of social behavior, they put it off. I just need to work through this and sometimes dads will tell their young sons the same thing. Oh get over it. You’re depressed. It’s not a problem.

Scott Gilbert – Internalize it.

Dr. Richard Frey  – They internalize it, right, and they don’t know who to go to because they’re embarrassed about it. And encouraging young men, adult men, high school men, and the point is they don’t get the help that they need and medications do work. But if you don’t get to the doctor, you can’t get referred or you can’t be treated.

Scott Gilbert – So it’s not just about heart disease. Not just about cancer but also some of these, perhaps, less visible illnesses such as depression we have to watch out for.

Dr. Richard Frey  – Correct. And it’s being able to admit that and getting comfortable with your provider to feel like hey, I can talk to him about this, him or her about this.

Scott Gilbert – You’re watching Ask Us Anything About men’s health issues from Penn State Health. Dr. Richard Frey’s here to answer your questions. We’re at Penn State Medical Group South Lancaster and we hope you will add your questions to the comment field whether you’re watching this video live or on playback. Let’s talk a little bit about diabetes. Some staggering statistics are out there regarding diabetes and the likelihood that in their lifetime, men will contract that. Tell us about those.

Dr. Richard Frey  – Yeah so we’re seeing an increase and I read something the other day that if you were born in 2000, you have about a 30% chance of developing diabetes as a male. Usually that has to do with increasing numbers of obesity, lack of exercise, poor dietary and exercise habits, and you know as a society, we’re becoming more obese. We’re doing too many, you know, meals at McDonald’s, I think. And so exercise and eating correctly are going to decrease that risk. Exercise being that 150 minutes a week I like.

Scott Gilbert – So we as a society are becoming more obese. That’s leading to more diabetes. And diabetes, in turn, can lead to other health problems, right? It doesn’t exist on its own island.

Dr. Richard Frey  – Correct. And it’s certainly going to contribute to an increased risk of cardiovascular disease. Going back to the heart attack, the stroke concept, and other things like poor vision, peripheral vascular disease, and neuropathy. Things that make you not feel correctly in your toes or your feet all because you have uncontrolled diabetes.

Scott Gilbert – And alcohol and tobacco use, a higher incidence of that among men?

Dr. Richard Frey  – Sadly it still is and they kind of go together. If you drink too much, you’re more likely to smoke. If you smoke too much, you’re more likely to drink. Obviously goals for men, no more than 2 alcoholic drinks per day. If it’s more than that, you probably are over using alcohol. That’s going to be associated with other medical problems as well including heart disease and including neuropathy. So that’s a problem and we’ve already kind of talked about the smoking enough to say that that affects everything.

Scott Gilbert – It’s in that bigger bucket of lifestyle choices. So not smoking. Making sure eating well. Making sure you’re exercising. Not to lecture you guys, but come on we’ve got to stay healthy out there. And we’ve got to go to the doctor too when we think we might have an issue or before that. There is some conditions that are unique to men that men may be especially hesitant to bring up even to their physician in an one-on-one setting such as erectile dysfunction. Yet it’s very common especially for men in certain categories. Tell me a bit about that and the incidence of that.

Dr. Richard Frey  – So it’s becoming more frequent mainly because it’s a early sign of atherosclerosis, hardening of the arteries. It is a blood vessel problem. That’s what occurs. And already we’ve spoken about the risk factors. Diabetes. The other thing is that maybe people should recognize that there’s a lot of medications that are treating some other problem that affect your ability to have an erection. So consequently that can be the problem that men aren’t thinking about. They just come in and say they want a pill to help that problem but really they’re not looking at the underlying cause.

Scott Gilbert – So they want to treat the problem without actually looking at what’s causing it.

Dr. Richard Frey  – Correct. Yes that’s right. So you really need to look at the whole picture and then make an assessment as to whether the medicines are appropriate or you really need to look harder at the cause of the problem.

Scott Gilbert – Do you find that men are somewhat embarrassed to bring up that or even other health issues for that matter? Did you ever get patients in here who you can just tell there’s something on their mind and they’re just not ready to share it?

Dr. Richard Frey  – Yeah. So you kind of leave it open-ended opportunities for people. Is there anything else you’d like to talk about? I sense that there’s a problem maybe that we need to deal with. So if it’s not that visit, sometimes they’ll think about come back to the next time and maybe get to it. But I think it’s just being able to take the time to address men’s needs and they have to express them.

Scott Gilbert – And men, we welcome your questions here. If there’s anything on your mind or ladies, if there’s a man in your life and you’re a little concerned about something with regard to his health, feel free to add your comment or question to this Facebook and we’ll pose it to Dr. Frey. So we’ve really hit on most of the things on my list, Dr. Frey. Any key takeaways that you want men to kind of come away from this interview with.

Dr. Richard Frey  – So the secret of long life is there’s no secret. It’s eat healthy. It’s see the doctors. Take care of your medical problems and don’t be afraid to see us and I think that that’s the takeaway. If you have some bad habits, you need to work on them like smoking. That’s the biggest thing and lack of exercise.

Scott Gilbert – Right but definitely get into the doctor regularly. That preventive care is becoming so important. Like you say it’s a covered benefit under pretty much every insurance plan. Guys just need to get in here and see you.

Dr. Richard Frey  – Yeah absolutely. Once a year you can get in your health maintenance exam usually no co-pay and most insurances take care of it.

Scott Gilbert – All right. Dr. Richard Frey, thanks very much for your time today.

Dr. Richard Frey  – It’s been my pleasure.

Scott Gilbert – And we appreciate you watching. Again, if you’re watching this video on playback, it’s not too late to add your questions and comments to the comment field below this Facebook post. And we have been live at Penn State Medical Group in South Lancaster with Dr. Richard Frey. And we thank you for watching Ask Us Anything About men’s health issues from Penn State Health.

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