Men urged not to avoid seeing their doctor

My grandfather was born in Cayman Brac and grew up in Jamaica. As a young boy, I learned from watching him that Caribbean men are tough. We depend on no one and can always do it ourselves; and at the slightest sign of illness we are quick to say “chu, is nutten.” 

The last thing granddad thought he needed was a doctor. Though he lived a relatively long and healthy life, he died fairly suddenly and without a known cause. I cannot help but wonder whether a regular visit to the doctor may have added a few years to his life and also given me and my son some medical family history to guide our own future healthcare screenings. 

Though grandad’s story dates back to over 20 years ago, his kind of attitude remains a reality in countries such as Cayman and Jamaica. Many men do not like to see their doctor, period. 

As a urologic oncologist, I specialize in the treatment of cancer in the urinary system, the best-known of which is prostate cancer. 

It is recommended that men around 50 years old get a blood test, called PSA (prostate specific antigen) to screen for prostate cancer. The main risk factors are: African ancestry, old age and family history. 

It is not a perfect test and cannot tell whether you have prostate cancer, but it is a starting point that can help a doctor decide if you need further testing. In addition, a doctor should perform a digital rectal exam, wherein a finger is placed in the rectum to feel the surface of the prostate for any hard nodules or lumps. Don’t panic, this takes less than 30 seconds and, though mildly “invasive,” is virtually painless. 

Studies have shown that for men, particularly those from groups where prostate cancer is prevalent, this screening may help prevent death from the disease, and/or slow down the spread throughout the body. Fortunately, with treatment, prostate cancer is curable. The most common treatments are surgery to remove the prostate or radiation therapy. Both offer similar cure rates, but it is important to discuss with your urologist which approach they think is best for you. 

Fortunately, with modern technology such as robotic surgery and image guided, intensity modulated radiation therapy, certain side effects are reduced compared to the older modalities. 

Another important sign to look out for is blood in the urine. This applies to both men and women. While prostate cancer can cause blood in the urine, bladder cancer is the more common cancer that presents with this sign. In addition, kidney cancer can occasionally cause blood in the urine. 

These are all treatable when detected at early stages and the key message is to report this finding to your doctor immediately. If you have visible blood in the urine, it is recommended to get a cystoscopy (camera exam of the bladder and urethra) and abdominopelvic imaging such as a computerized tomography (CT) scan or, at the least, an ultrasound. The cystoscopy can show polyps in the bladder that may be cancerous that are otherwise hard to detect and the CT scan or ultrasound can show a tumor in the kidneys or ureters (tubes that connect the kidney to the bladder). 

Another less common cancer to be aware of, particularly for younger men, is testicular cancer. There are no blood tests that can detect this, and it is advised that young men in their teens examine their testicles regularly. This is a simple exam wherein the testicle is rolled between the thumb and forefinger to feel for any lumps. A lump should prompt a visit to the doctor for more testing, specifically an ultrasound of the scrotum and testis. Surgery can treat testicular cancer and it is highly curable, however chemotherapy and/or radiation therapy may be necessary as well. 

Finally, reminiscing back to my grandfather, a “hardened” sailor and carpenter, smoking was a way of life for him from the age of 13 until the day he died. Medical studies have proven, time and time again, that tobacco smoke is strongly associated with certain cancers, and in the urinary system it is the number one associated risk factor for bladder cancer, as well as strongly linked to kidney cancer. 

So, for those who smoke, it is highly encouraged that you quit, or get help from your doctor to stop smoking. It may add a few years to your life, and at the very least save you a few extra dollars in rough economic times. 

Dr. Chad R. Ritch is assistant professor in the Department of Urology at the University of Miami Miller School of Medicine. He is one of the speakers at this week’s Conquering Cancer event.  

Dr. Ritch
Dr. Ritch