Why you should consider an annual doctor visit – a patient story

Men are stubborn.

I’m sure this description applies to many aspects of life, but it’s particularly true as it relates to male health proactivity.

What do I mean?

Well, yesterday I was reminded on the price to pay for not getting an annual check up.

I saw a pleasant 70 year-old retired (banker) male patient with metastatic prostate cancer to the bone. He has refused chemo therapy and radiation ( for this, I probably don’t blame him).

He first found out about his disease 2 years ago when he decided, for the first time in about 30 years, to get a general check-up along with full body MRI in Switzerland.  He had no symptoms and was relatively healthy at that time for a 68 year-old male.

To his and his doctors surprise, he had metastatic cancer on his spine and pelvis. His PSA was 1,022ng/ml. Not 1.022 but One thousand twenty two. I have to admit, I have never seen a PSA higher than 1,000.

When I asked why has he never been to a doctor before 2 years ago he responded, “ I was fine. I figured if I didn’t have to see anyone unless something was wrong.”

His PSA now is 845ng/ml. He is bed-ridden since 2 months ago apparently for a surgical decompression procedure of his spine, with swollen legs.

My take on this and today’s doggy bag:

There are many reasons why men are reluctant to get checked by a doctor – (this list is in no particular order or complete):

1. Fear of being vulnerable or being weak – especially with high-powered alpha-males, ie: executives, entrepreneurs, wealthy, etc.
2. Don’ t have time to see a doctor – probably the # 1 reason. Also the #1 reason why men (and women) don’t exercise.
3. Machismo – “shaking off” pain or unusual symptoms is common among men.

Any others?

Here’s the deal:

I get it. The “if it ain’t broke why fix it” approach makes some sense sometimes. After all, mainstream doctors are trained to find abnormal values and treat them with drugs or other harsh therapies that often result in other health problems that are often treated by more harsh therapies. And, of course, the PSA controversy also comes to mind – should you screen for prostate cancer at all?

Simply, yes, men should screen for prostate cancer. If the above mentioned gentlemen would have gotten a PSA test at 50 or so then his disease would have probably been caught early and treated appropriately.

 What to do:

1. Men should get a PSA test starting at 40 years old. If there’s a first degree family history of prostate cancer (ie, brother or father), screening should start at 35.
2. The trick is what you should do if your PSA seems high (“normal” 0.0 to 4.0ng/ml). The rate in change of PSA is more important than the actual number. However a PSA of let’s say, 3 is high for 40 year old – not so much for a 60 year old.
3. If PSA is “high” it can be an infection. Ask your doctor about that possibility.
4. You need at least three PSA values within 9 months or so to see how it changes with time. Again the how PSA changes with time is likely more valuable than the initial number.
5. Visit at least 3 urologists before a biopsy to make sure that is indeed the right approach.
6. Also, high cholesterol (higher than 200) does not necessarily mean you need a statin drug. Cholesterol ratio is more important than total cholesterol alone – it should be less than 4.  Other blood markers: C-Reactive Protein, homocysteine and Calcium levels are also provide a more complete picture of cardiovascular health.

 

Bottom line: Don’t be stubborn. Get an annual check up. “Bad lab numbers”  do not necessarily mean you need a prescription drug or a surgical procedure. Include a naturopathic doctor as part of your health care team. To find a naturopathic doctor go  here to the AANP website.

 

Does this make sense?