As a young boy growing up, I saw two of my grandfather’s brothers be diagnosed with prostate cancer and develop metastases from it, and ultimately succumb to this disease. This was in the pre-prostate specific antigen (PSA) era. This was at a time when men were still treated with diethylstilbestrol, and treatments for advanced prostate cancer were not available. Had screening been an option at that time, they may have been diagnosed earlier and possibly not suffer the way they did.
PSA is an enzyme that is present in prostatic tissue, and its level in the blood can be measured by simple blood test. It is used to estimate a man’s chances of having prostate cancer based on its level.
On a cool, sunny morning last October, as tens of thousands of runners raced east toward downtown, I was watching the Chicago Marathon from eight floors up, in a hospital room at Rush University Medical Center.
Instead of attempting what would have been my 11th 26.2-miler, I was being treated for atrial fibrillation, a type of irregular heartbeat — or arrhythmia — that made it tough for me to run very fast, or very far.
I was diagnosed the previous spring, after weeks of struggling to run the 8:30-minute-per-mile pace that had become routine for me over the last 10 years. Even during relatively brief, three-mile outings, I had to stop every few minutes to catch my breath.
So I went to see my primary care doctor at Rush, who ordered the electrocardiogram that immediately revealed my arrhythmia. To be honest, I wasn’t all that surprised. I had suspected for several years, particularly after long marathon training runs, that my heartbeat was a little off. But even though I’m pretty health-conscious — maybe even borderline hypochondriac — I failed to appreciate that it could be something serious.
From left: Ivan Salvador, Thomas Amaya, Carlos Olvera, Ricardo Kirgan, Cesar Mendoza and Terence Maynard. Photo by Lauren Anderson.
By Carlos Olvera
It’s a question I get asked a lot these days.
Everyone agrees that the mustache is not the best look for me, but not everyone knows the reason behind it. Every November, also known as Movember, men and women join together to raise awareness and funds for men’s health. The Movember Foundation aims to increase early cancer detection, diagnosis and ultimately reduce the number of preventable deaths.
So what triggered my decision to participate in this campaign? Over 15 years ago, my dad was diagnosed with stage IV colorectal, prostate and bladder cancer. He never went for his routine colonoscopy. For years he experienced rectal bleeding but didn’t think much of it. He thought it was just hemorrhoids and he never mentioned the symptoms to his primary care physician.
At my clinic at Rush University Medical Center, I see more and more men with complaints of lack of energy, diminished sex drive and easy fatigability. This may be a treatable problem caused by suboptimal production of the primary male hormone known as testosterone, which is an important chemical in the health of every man.
Most men think of testosterone as the sex hormone, but in fact it appears to have greater importance in terms of general health, including preservation of muscle mass and bone mineral density, mood and brain function, bone marrow, liver and kidney function as well. Clearly, there is also an important sexual component to testosterone, which supports a man’s libido, and is necessary for satisfactory erectile function as well.
The most common presenting symptoms of low testosterone are loss of energy, easy fatigability, a depressed mood, sleepiness, diminished libido and erectile dysfunction. Recent studies have demonstrated that up to 40 percent of men over the age of 45 have low testosterone. The men who are at highest risk to have low testosterone and can benefit from replacement therapy include men with diabetes, obesity, high blood pressure and elevated cholesterol, and those who require chronic pain medication.
All men with the symptoms noted above or medical problems should undergo evaluation by their primary care physician or urologist with a simple morning blood test. If the testosterone blood test is abnormal and these symptoms exist, testosterone replacement can be offered in a variety of ways, including topical gels or two types of injections.