The Truth about Men

Men – powerful, strong, virile,protecting and providing for the family.

But are men really stronger? It is now common knowledge that men’s life expectancy is lower than women’s. According to the UN World Population Prospects 2011 Revision released by the United Nations Department of Economic and Social Affairs,Population Division, the average life expectancy of Malaysian men is about 71 years, while in women it is closer to 76 years.

“One of the biggest problems is that men don’t tend to use healthcare, even if it is just consultation with their GP,” says Dr Peter Ng Eng Pin, consultant urological surgeon at Sime Darby Medical Centre Subang Jaya. “Men’s attitudes tend to be ‘I have to be really ill before I see the doctor’ or ‘it’s just a minor illness, I can fight it off myself’. But men must realise that they are not invulnerable.

”It seems that taking care of their health is just not part of the big picture when it comes to men. Dr Ng compares this with women, who are more detail orientated and thus notice the little changes and problems that can crop up from time to time. Unfortunately for men, health is all about the little details, and so they tend to lose out by not paying attention.

In Malaysia, men above the age of 45 years do tend to have the awareness that they should go for general checkups and screenings. In a normal clinical assessment, the doctor will note down your bio metrics, take your health and family history, check on current complaints and do a general systems review of your body.

If there are symptoms or risk factors present, the doctor will recommend screenings for heart disease, hypertension,diabetes or osteoporosis (in older men).

Men below the age of 45 years usually do not require annual screenings,unless they lead an excessive lifestyle,or there is family history of a disease.For example, if your father had a heart attack in his 40s, it is a good idea for you to get a full check up and screen for heart disease, cholesterol or hypertension before you reach that age. It is highly likely that you have the same health problems that your father had, even if the symptoms are not yet present.

This article was contributed to Tab A Doctor by,
Dr Peter Ng Eng Pin, Urologist, Sime Darby Medical Centre

Aesthetic Procedures Amongst Singaporean Men

I have had male patients from the age of 19 to 55 years old. The most common however are patients between 30 to 40 years old. They are from varied walks of life and are representative of middle-class Singapore society. They are often white collar workers and professionals. High powered executives, bankers and businessmen are not uncommon, but so are conservative civil servants, and even a smattering of students. They are often very well groomed and take much effort to upkeep themselves well.

They often come because their busy work schedules and hectic lives have started taking a toll on their faces and bodies. Wrinkles on the face, sagging cheeks are very common. Some also want to have a stronger and more defined chin or jawline. Some come because they need help losing weight, as I provide specialised weight loss programs for my patients. In fact, I have lost 12 kg in the last 2-3 months following this programme myself (without surgery). Of course the most often asked about issue is the flabby bulges on their tummies and assorted bits and bobs. The second most sought after treatment is what we affectionately call 'moobs' or 'male boobs'. Often my male patients actually do work out regularly at the gym but can't see results. In some cases, they come seeking my expertise in a very special procedure called Hi-definition liposculpture that not too many doctors in the world can perform. This is where i precisely & artistically emphasise the guy's six-pack abdominal muscles and v-shaped torso.

One or two patients were quite unusual cos they came asking for their bums to be reduced in size cos they wanted to fit into swim pants and not look like a J.Lo wannabe. Another fellow was quite a funny because wanted his penis to be bigger and asked me to transfer fat from his tummy to his penis (I turned him down flat, as that is not a good treatment, and I practice quite mainstream conservative safe surgery). They mostly come themselves and are doing this for their own satisfaction.

I find that men in general, are actually MORE upfront about their procedures done than the women. Men are open and willing to speak about what they have done and often don't try to hide it from their family members or friends. In fact they often bring their wives or partners along for subsequent visits once they have tried one treatment and had good results. I have quite a number of male couples who do lipo as a pair in fact.

I think only a handful has tried to hide their treatments from the wife of girlfriend. As we often keep close contact with our patients & give them a follow-up phone call post-procedure, we had one male patient request us not to call his home at all because he didn't tell his wife. He would quietly come when his wife didn't know. I hope his wife didn't think he was having a clandestine affair!

That fellow was a rare exception, and I like many of my male patients because they are very open. They are also decisive when deciding on a treatment, and are often more motivated than the ladies to make sure they follow medical instructions. They are appreciative of the care that goes into their treatment and aim hard to maintain their results for the long-term.

Top three most popular procedures that men in their 20s and 30s request at the clinic:

• Hi definition VASER liposculpture for six-pack abs
• Chin enhancement
• Male breast reduction

This article was contributed to Tab A Doctor by:

Dr Kevin Teh, Medical Director
Singapore Lipo, Body & Face Centre, a subsidiary of the Singapore Medical Group
10 Sinaran Drive, #08-05/06, Novena Medical Centre, Singapore 307506

Prostate Cancer

"Prostate cancer is the 3rd most common cancer among Singaporean men. Prostate specific tumor antigen (PSA) blood testing can be done in men with symptoms suggestive of prostate cancer or in men at high risk of developing prostate cancer."

Causes

The cause prostate cancer is not clear.
A combination of factors may play a role in prostate cancer such as family history, ethnicity, hormones, diet and the environment.

Risk factors

The main risk factors include:

• Age. The risk of prostate cancer increases after the age of 50 years.
• Race or ethnicity. Dark skinned men have a higher risk of developing and dying of prostate cancer.
• Family history of prostate cancer increases the risk of prostate cancer.
• Diet. A high-fat diet and obesity may increase your risk of prostate cancer.
• High testosterone levels in men who use testosterone therapy.

Symptoms

In the early stages of prostate cancer, there may be no symptoms.
In the later stages, symptoms of prostate cancer may include urinary symptoms such as:

• Difficulty passing urine or slowing of the flow of urine to a trickle
• Decreased force in the stream of urine
• Blood in your urine or semen

Advanced prostate cancer which has spread to:

• Bones may cause bone pain, fractures and compression of the spine.
• Lymph nodes may cause swelling of the leg or discomfort.

Diagnosis

These include:

• Digital rectal examination (DRE) to detect any abnormalities in the texture, shape or size of the prostate gland.
• Prostate-specific antigen (PSA) test involves taking a blood sample from a vein and testing for PSA, a substance that is naturally produced by the prostate gland to help liquefy semen. High levels will warrant further investigation.
• Tran rectal ultrasound to detect any abnormalities in the prostate gland.
• Prostate biopsy involves taking thin sections of tissue from the prostate gland.

Additional tests include:

• Bone scan
• Ultrasound
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Lymph node biopsy

Complications

The typical complications of prostate cancer and its treatments include:

• Spread of cancer to nearby organs or travel through the bloodstream or lymphatic system affecting the bones or other organs.
• Pain when the cancer spreads to bones it can cause excruciating pain.
• Difficulty urinating (urinary incontinence).
• Erectile dysfunction (ED) or impotence.
• Depression after a diagnosis of prostate cancer or after trying to cope with the side effects of treatment.

Treatment

The most common treatments for prostate cancer include the following:

• External beam radiation therapy: uses high-powered X-rays to kill cancer cells.
• Radioactive seed implant: also known as brachytherapy, deliver a higher dose of radiation than do external beams.
• Hormone therapy: using drugs to stop the body from producing the male sex hormones testosterone, which can stimulate the growth of cancer cells.
• Radical prostatectomy: surgical removal of prostate gland is used to treat cancer that is confined to the prostate gland.
• Chemotherapy: uses drugs to destroy rapidly growing cancer cells.

Prevention

Prostate cancer cannot be prevented. In general, men are advised to make choices that benefit their overall health such as regular exercise, avoiding high-fat diets, and consuming fruits and vegetables rich in antioxidants.

The established risk factors are increasing age (>50 years), family history and ethnicity (African). So, men aged over 50 years with a normal risk of prostate cancer should discuss with their doctors the risks and benefits of prostate cancer screening. Men who have a strong family history, for example, a brother or father with prostate cancer should be aware of the symptoms of prostate cancer, and discuss management options with their doctor.

This article was originally published on http://www.hpb.gov.sg