Weekend House Call: Men's Health
RENAY SAN MIGUEL, CNN ANCHOR: And welcome to WEEKEND HOUSE CALL. Today, a Father's Day special. We'll spend the next half hour focusing on men's health. But this isn't just a show for men. Research shows it's the women in the family who make the most health care decisions. And it's usually the woman that gets her man to go to the doctor. So our WEEKEND HOUSE CALL is for everyone in the house. And, Elizabeth Cohen, good morning to you.</s>ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Good morning, Renay. Since you're the closest male to me at this moment right here.</s>SAN MIGUEL: OK.</s>COHEN: We'll start with you. Do you go to the doctor for regular check-ups? Or do you just go when you're sick?</s>SAN MIGUEL: OK, here's where I take one for the team here, folks. I have to admit that I have not started doing regular check- ups until the last couple of years. But I had a very good reason because I had a regular blood test. And it turns out that I had a high PSA count, prostate specific antigen. And there is a history of prostate cancer in my family. So the summer of 2001 was spent getting a lot of blood tests and I guess becoming aware just how important regular check-ups are. And I had just turned 41 years old. So that's the time when you start to thinking about things like that.</s>COHEN: Absolutely.</s>SAN MIGUEL: So I am all for the reason to go ahead and go and get the regular check-ups, not just when you know, you feel like you're -- you have something wrong with you, or there's an illness, or there's an injury or something. Make them regular. I'm a big proponent of that.</s>COHEN: Absolutely. What if you hadn't done that, you wouldn't know.</s>SAN MIGUEL: I wouldn't know. And I ended up -- did having to have a prostate biopsy because the PSAs were high throughout the -they were up near 5.0 throughout the summer. Everything turned out negative, though. And that's one of the things that you can kind of check off the worry list is not having to worry about that. I just have a high PSA count.</s>COHEN: There you go. Here's our real-life example.</s>SAN MIGUEL: There you go. You asked. You're probably sorry you asked now, but there it is. Now you know.</s>COHEN: There you go. Well, one main reason experts believe that women live longer than men on average is that men don't go to the doctor for check-ups. So illnesses like heart disease and cancer aren't caught early enough. Our Christy Feig brings us that story.</s>CHRISTY FEIG, CNN CORRESPONDENT (voice-over): As David Neal says he started annual doctors visits about five years ago, when he was in his early 50s.</s>DAVID NEAL: I got real concerned about colon cancer. My family, my wife did, too.</s>FEIG: So far, his tests have come up normal, but since he sees his doctor every year, if it happens, he'll catch it early.</s>NEAL: Real important now. I went to live. And I've seen a lot of my friends pass away because of that.</s>FEIG: But Neal is unusual. Government studies continue to show in general, men tend to go to the doctor only when they're sick. And experts say that increases the chance of missing the top killers early.</s>ELMER HUERTA, DR., WASHINGTON HOSPITAL CENTER: None of those three problems, heart disease, cancer or diabetes, give you symptoms when they are starting.</s>FEIG (on camera): Experts say the numbers back it up. Men have a higher mortality rate than women for the 10 leading causes of death and on average, die 5.5 years before women. (voice-over): So why don't men take their bodies in for a routine check-up, like they do their cars? Experts say men believe it makes them look weak.</s>DAVID GREMILLION, MEN'S HEALTH NETWORK: An annual physical is the dream. We would hope for that. We would hope that they would go for a simple check, whether it be blood pressure check, screening for routine chemistries including blood sugars.</s>FEIG: Adding tests for heart disease, colon and prostate cancer, at the appropriate age. In Washington, I'm Christy Feig.</s>COHEN: So what are the main health threats that men face? Well, the top five are heart disease, cancer, stroke, accidents and chronic lung conditions. If you have questions about these topics or any other men's health concerns, we invite you to call us now. Our number is 1-800-807-2620. International charges do apply to our overseas callers. Joining us in our discussion in our -- to help us answer our questions is Dr. David Gremillion from Men's Health Network, a non- profit organization dedicated to improving the health and well-being of men, boys and families. He's coming to us today from Raleigh, North Carolina. Good morning. Let's start -- show our audience some statistics that I'm sure you're familiar with. Only 43 percent of men get a complete physical once a year. Just 42 percent have their cholesterol checked annually. And for that all important PSA test to detect prostate cancer, only 53 percent of men over age 55 say they see a doctor for that. This, according to a poll in "Newsweek," which leads me to our first e-mail. Paul in Connecticut writes, "my dad refuses to go see his doctor. How do we get him the medical attention he needs? He is 77 years young." A great way to say it. Doctor, any advice for Paul?</s>DAVID GREMILLION, MEN'S HEALTH NETWORK: Seventy-seven years young. He really needs to see his doctor. Usually a gentle encouragement by family members, people who love and really care for this individual, is going to make the difference. At age 77, he is very likely to have a number of potentially complicating illnesses. And I would encourage him to have a PSA test, just like your co-host had recently. It's a very simple blood test but can lead to very early detection. He certainly needs to have a blood sugar check, blood pressure check, and a routine, overall health physical, but getting him there is the challenge. I would encourage a loving member of the family, a daughter perhaps, perhaps his spouse to encourage him to visit their doctor to familiarize himself with the health care setting.</s>SAN MIGUEL: We want to start answering some of our viewer phone calls now. The first one is from Rob in Pittsburgh. Rob, thanks for joining us on HOUSE CALL. What's your question?</s>CALLER: I was just wondering. I heard you talking about a PSA test, and I've had a PSA test done over the past two years. And my PSA test was up around 20.</s>SAN MIGUEL: Whoa.</s>CALLER: And they had done three or four biopsies on me. And they've all become -- they've all been negative. So how often is a high PSA test a false positive like that?</s>SAN MIGUEL: Doctor, what do you think?</s>GREMILLION: Rob, how old are you?</s>CALLER: I'm 52.</s>GREMILLION: Rob, at your age, a PSA test in that range requires very careful follow up. We heard a wonderful story a few minutes ago from Renay, the co-host, about his high PSA. And we're reassured by that. But occasionally, an elevated PSA test is not very meaningful, but it does need follow up. At age 52 with a PSA in the range of 20, you should have repeat PSA tests periodically. And you probably should visit your doctor for what we call a digital rectal exam to determine if there are lumps or elevation in size of your prostate. And this may, in fact, lead to a biopsy. And I would encourage you not to be too concerned about the biopsy. It sounds ominous, but it's something that really should be on the horizon for you.</s>SAN MIGUEL: And you know -- and I'll second that. You know, it took about 45 minutes for mine. And you know, it's walk in, walk out kind of surgery. But I do want to say that when I did get the PSA, I was given an original PSA. Then my urologist gave what was I think a more extended PSA, but there are other factors that can raise a PSA level or a PSA count. Aren't there, doctor?</s>GREMILLION: There are indeed. Certainly, inflammation of the prostate gland, prostatitis, we call it, is relatively common in men, occurring about one in three. And when that prostatitis occurs, it can elevate the PSA test. Certainly, sports activities, like riding a bicycle for extended periods of time can place extra pressure on the prostate and perhaps release extra</s>PSA. SAN MIGUEL: Well, we have talked about why men don't want to go in for checkups when they are well, but there are many who still refuse to see a doctor even when they get sick or they've got an injury of some kind. We'll take up that issue next.</s>COHEN: Call us with your questions at 1-800-807-2620 or e-mail us at housecall@cnn.com. We'll be right back with more of WEEKEND HOUSE CALL.</s>SAN MIGUEL: In last week's poll from Harvard and "Newsweek," 83 percent of men said they considered their health to be good to excellent. Only 5 percent answered poor. And 90 percent are satisfied with their appearance. 9 percent said they wouldn't change anything. 11 percent said would like to have -- well, here's a shocker, they'd like to have a bit more hair. And 22 percent want to lose a little fat. You are watching CNN's WEEKEND HOUSE CALL. And we are taking your questions on men's health. Please call us at (800) 807-2620. Or e-mail us at housecall@cnn.com.</s>COHEN: Now before we go to the break, let's check our daily dose health quiz. On average, at what age do men go in for their first annual physical exam? We'll have that answer in 30 seconds. Stay with us.</s>COHEN: Welcome back to CNN's WEEKEND HOUSE CALL. In the race for a healthier lifestyle, women appear to be out in front of the men. Men are more likely than women to smoke and abuse alcohol. Men are less likely to have health insurance, see a doctor annually, or go to a doctor early in an illness. And with that in mind, we go to our next e-mail. Susie from California writes, "Why do men act like babies when they get sick and women don't?"</s>SAN MIGUEL: Oh, man.</s>COHEN: Doctor, could you answer that question? I know many women have that question.</s>GREMILLION: I can relate to my own experience. I try to avoid a doctor. And again, men try to avoid appearing weak and vulnerable. They don't want to project that image. What we need to change is we need to show going to the doctor as a sign of strength, actually. Just as getting your car taken care of for a periodic checkup is really a sign of strength. But in fact, men are very, very much babies just like your e- mailers suggest. We don't like pain anymore than anyone else, but sometimes that's necessary to preserve good health.</s>SAN MIGUEL: All right. We're going to go to a phone call now from Jim in South Bend, Indiana. Jim, welcome. What's your question?</s>CALLER: Thank you. I was wondering how many of these diseases that pop up in men are inherited? And how much just come up individually?</s>SAN MIGUEL: Doctor?</s>GREMILLION: It's extremely variable, of course. Diabetes is an inherited condition, a prevalence to inheritance. In fact, I learned just this week that my brother was diagnosed with diabetes. So I'm going to have to have screening this next week for diabetes. Prostate cancer, we think, has a family predilection. And for African-American males in particular, there is a genetic component to earlier presentation and more severe disease upon presentation. Other illnesses, like hypertension, severe anxiety, chronic depression, which may lead to suicide in men, and it does more frequently than in women, these often have a genetic component. These are, of course, things that we can't alter. The genetics of an individual are basically unalterable. We can change how we respond to that by presenting earlier, going to see a doctor for screening, and by avoiding unhealthy lifestyles that may prevent those diseases from emerging earlier.</s>COHEN: We now have a phone call from Kelly in Mississippi. Kelly, what's your question for the doctor?</s>CALLER: Good morning, doctor.</s>GREMILLION: Good morning.</s>CALLER: My question is my husband -- his legs consistently are</s>GREMILLION: Leg cramping during the evening could be what we call restless leg syndrome. And there are excellent treatments for that, but I would worry a little bit more about clotication. What is your husband's age?</s>CALLER: Sixty-eight.</s>GREMILLION: Sixty-eight. He's very likely to have some vascular compromise to the large muscles of his legs. That vascular compromise can lead to cramping during the evening hours. That cramping can cause pain and just the types of symptoms your husband is presenting with. I would encourage him to describe those symptoms carefully to his doctor. There's some excellent treatments available for lowering his cholesterol and reducing his risk for stroke or further damage to his legs.</s>SAN MIGUEL: We are talking with David Gremillion of the Men's Health Network. And Ella from Delaware has a phone call. Ella, what's your question?</s>CALLER: Well, my husband's older brother has prostate cancer and had surgery. And his father which is 90 years old still has prostate cancer. Of course, they won't do anything at his age, but I'd like for my husband to take it more seriously. How do I do that?</s>GREMILLION: I think you have every good reason to encourage your husband to go in. You have a strong family history. And even though both of these other two gentlemen in your life have had a reasonably good outcome, certainly, the 90-year-old father has a good survival with this illness. And that's not uncommon, by the way, with early detection. I would encourage your husband to get careful screening done early. And he can enter that group that has an excellent outcome.</s>SAN MIGUEL: Doctor, stay with us, please. We've got some more questions for you, including this one. Do men go through any type of menopause or mid life change? That's one of the questions we'll tackle when we come back. If you have a questions about men's health on this Father's Day, please give us a call. The number is 1-800-807- 2620. We'll be right back with more house calls.</s>SAN MIGUEL: Welcome back to WEEKEND HOUSE CALL. And Happy Father's Day, especially to my dad who has survived colon cancer, two angioplasties, and a quadruple bypass. And he's probably going to spend the day golfing.</s>COHEN: Oh, my goodness.</s>SAN MIGUEL: At 72 years old.</s>COHEN: Wow.</s>SAN MIGUEL: And he is, I believe now, shooting his age in terms of his game. So we're talking about men's health this morning.</s>COHEN: We've got lots of e-mails and calls coming in. So let's go right to our next e-mail from California. A viewer writes, "is there such a thing as male menopause? Are there any treatments? Is there hormone replacement therapy for men?" Dr. Gremillion?</s>GREMILLION: Well, there is what's called andropause. Unlike menopause, it's called andropause in the male. And during this era of our lives, we often have a reduced testosterone level. It can present with depression, with weakness, loss of muscle mass, and general inattentiveness. Now these symptoms, of course, can be caused by many other illnesses. So you would need to have a testosterone level checked. But beginning about the age of 40 to early 50s, it's very common for men to have that. Now interestingly, it is not described in the literature very well and there's been very little research on the whole topic of andropause. One of the things we do with programs like this is to try to encourage a greater level of investigation for men's health issues.</s>SAN MIGUEL: Let's go to the phones now. Barry from Washington, D.C. has a question for Dr. Gremillion. Barry, what's your question?</s>CALLER: Good morning, doctor. I had a question about seriactive protein. I had a physical recently. All of my blood work was perfect. The cholesterol, the triglycerides, etcetera. And my EKG was fine. However, my CRP was 3. And the doctor talked about having additional readings, but also, perhaps having a test to measure the amount of calcium in my arteries. And I was wondering what you thought about that. Was it necessary at my age?</s>GREMILLION: The C-reactive protein story is one of the biggest stories of recent month. Basically for the rest of the viewing audience, when the C-reactive protein is elevated, one is at a greater risk of a sudden cardiac event. Because a lot of what happens in the coronary arteries is in fact inflammatory. It's not just atherosclerotic. So we have begun to measure C-reactive proteins. Unfortunately, it's not reimbursed yet because it's authentic long term value hasn't been proven to the people who pay the bill. It sounds like you're doing a great job in keeping your cholesterol down and in maintaining your risk factors. I would recommend that you have a repeat C- reactive protein and that you work closely with your doctor to follow up on that.</s>COHEN: We have a question now from Roger in Illinois. Roger, go ahead with your question for the doctor.</s>CALLER: Good morning.</s>GREMILLION: Good morning, Roger.</s>CALLER: I'm 67. No history of PSA or colon cancer in my family. PSA levels are good. The hemacults have always been negative. And what's your opinion on colonoscopies?</s>GREMILLION: A male should generally have their first colonoscopy in their mid 50s. Earlier if there's a family history, which there is none in your case, and certainly earlier if you have symptoms such as blood in the stool, progressive constipation, decrease in the size or caliber of the stool. Those would all be worrisome symptoms and signs that would have you get that colonoscopy earlier. But Roger, I think you're about ready. At age 67, a colonoscopy is probably the right thing to do at this time.</s>SAN MIGUEL: Doctor, we talk a lot about, you know, you get to a certain age, you should start thinking about regular visits, colonoscopies or PSA tests, or things like that. Does a man's view of his body, you know, change as he gets older? I'm wondering if we're -- maybe we're sending the wrong messages to 20 and 30-somethings out there, you know, who should always, you know, think about regular checkups?</s>GREMILLION: You made a good point, Renay. In fact, men need to have regular check-ups throughout their life span. Your poll, as you started up this segment, showing that men have checkups beginning in their 40s to 50s, is of course different in the military where they get annual checkups as part of their military life. And interestingly, even during those check-ups early in life, a lot of significant disease is detected and treated early because of that. But we don't want to propose the false image that we don't need to have check-ups early simply because most of the callers and most of our attention is directed at late stage screening. I would encourage your viewers to go to menshealthweek.org and click on the screening icon, which will give them a nice list of things to do throughout the life span, in fact, beginning in the 20s.</s>COHEN: I actually have here that list, Dr. Gremillion. There's a list of about a dozen tests that men are supposed to be getting. Even from a pretty early age, I think many of them don't get it. So it's a terrific list to remind men and their families of screening tests that should be getting. When we come back, final thoughts about men's health.</s>COHEN: So a reminder, again, men get your regular checkups and the women in your life, I'm sure, will remind you to do that. Many thanks to our guest, Dr. Gremillion, for joining us to talk about men's health. Happy Father's Day to Dr. Gremillion. Also to my own dad, who's watching from Massachusetts. Thanks everyone, for joining us. That's all we have time for today. Our Dr. Sanjay Gupta will bring you health news every day at 8:30 a.m. Eastern time on "AMERICAN MORNING." And be sure to join me for more health news, as we bring you "DAILY DOSE" each weekday at 11:30 a.m. Eastern, right here on CNN. Remember, this is the place for the answers to your medical questions. Thanks for watching. I'm Elizabeth Cohen. "CNN SUNDAY MORNING" continues now. TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com