What is it with men and doctors?
The last time Bryan Wilson had a physical was with his pediatrician. He was 18, couldn’t legally drink and cruised around in his parents’ champagne-coloured 1999 Dodge Stratus. That was 12 years ago.
The Toronto-based financial analyst, now 29, seemed to be on the right track in 2014 when he met with a new general practitioner for an initial consultation, but he ended up never going back for a checkup.
Since then, Wilson has been to a walk-in clinic for a possible case of strep throat and on one occasion, landed in the emergency room for stitches in his hand, but that’s been the extent of his visits to the doctor.
“I’m busy and and going to the doctor is at the bottom of my priority list,” he says. “My health – like going to the gym and eating right – isn’t always in the forefront of my mind. So I feel like a doctor would just tell what I already know I should be doing.”
That may be, but according to Dr. Dean Elterman, a urologic surgeon at Toronto Western Hospital, it’s tough to get men to go to their doctors for a host of reasons, including the risk of seeming vulnerable and society’s expectations for men to be resilient.
Traditional expectations of masculinity are ingrained in men early in life, he says, including the idea that being “tough” means shaking off health concerns. Historically, there were expectations of family life as well. “Men focused on being the bread winners who provided for their families and neglected to listen to their bodies at the detriment of their health,” says Dr. Elterman. “There’s also the fear that their doctor might find something – which could mean they’d have to take time off work and would have to depend on others.”
Some of these issues, such as bladder control problems, come with easy, non-invasive fixes
Then there’s the self-consciousness some guys still feel around dropping trow for the rectal exam (or “finger test”), which checks the prostate.
“Women are tougher than men,” says Dr. Elterman. “They’re used to invasive exams by doctors, including pap smears and childbirth. Women are also more likely to get checkups in their 20s and 30s because they’re in the childbearing years. There’s really nothing pushing men to go to the doctor after their pediatrician years.”
Wilson agrees that there’s a certain stigma around guys getting routine checkups without a seemingly good reason or something seriously wrong. “There’s a ‘what doesn’t kill you makes you stronger’ kind of mentality,” he says.
The truth is, says Dr. Elterman, men at every age need regular doctor’s visits to maintain their health.
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For younger men, the most common health issues to monitor are weight, testicular cancer, mental health issues such as stress and depression, and quitting smoking. “In the 50s and 60s,” says Dr. Elterman, “we’re looking for enlarged prostates; erectile dysfunction, which can be a precursor to cardiovascular disease; urologic issues, including incontinence, slow stream and frequency; and prostate and bladder cancers.”
Some of these issues, such as bladder control problems, come with easy, non-invasive fixes – TENA Men’s leak-protection guards and underwear, for example, can help men who have overactive bladders. And what Dr. Elterman calls a “general unfitness” – weight, diabetes, high blood pressure and cholesterol – can be managed with special diets and medications.
As for the “c-word,” it’s something to be concerned about, but Dr. Elterman says it’s not a death sentence.
“Prostate cancer is actually incredibly treatable if caught early with regular PSA blood tests and rectal exams,” he says. “Men should know that not every case of prostate cancer will need to be treated.”
Dr. Elterman’s advice is to make informed decisions about treatment and options, “instead of burying your head in the sand.”
“Canada is a leader in active surveillance of prostate cancer,” he adds. “ In the majority of cases, we can keep an eye on it without treating it.”
Less common in men than prostate cancer is bladder cancer, which can increase in risk 10 times for people who smoke. The main sign is an easy one to detect: blood in the urine.
“There could be other reasons for the blood, including infection and prostate overgrowth, but if you see it one time, that’s enough to tell your doctor,” says Dr. Elterman.
This content was produced by The Globe and Mail’s Globe Edge Content Studio, in consultation with Robinsons.