“Thousands of men will die from stubbornness this year,” reads a large, red billboard on the side of Illinois Route 57. The ad campaign by the US Government Agency for Healthcare Research and Quality (AHRQ) aims to encourage men to take an active approach in their health care by getting proper screenings.
According to the AHRQ, men are 24 percent less likely than women to have visited a doctor within the past year. The statistics continue with men ranking higher than women in many preventable diseases.
“It’s a common notion that men are reluctant patients,” says Kevin McVary, MD. “Often it’s the spouse or family member who brings them in. In fact, most men’s appointments are made by their spouses.” Dr. McVary, who specializes in men’s health, is professor and chair of the Division of Urology.
The behavior is recognized by general practitioners as well. SIU internal medicine physician Gary Rull, MD, says, “I think that we as primary care providers need to do whatever we can to make men comfortable with the idea of coming to the doctor and sharing their concerns. This can be particularly challenging when their ailments involve sensitive areas such as prostate issues, erectile dysfunction and low testosterone,” he says. “But it can also have serious implications when their concerns involve other bodily systems, such as the cardiovascular system.”
SIU School of Medicine physicians and psychotherapists are taking an inter-disciplinary approach to addressing the needs of the men in central and southern Illinois. From oncology and urology to primary care and psychotherapy, SIU can bring numerous forces to bear on men’s health.
Clinicians must make serious efforts to counteract typical male behavior. According to the National Institutes of Health, men are more likely than women to smoke, drink alcohol and make other unhealthy choices. It’s these poor lifestyle and physical activity choices that can lead to health problems in men such as diabetes, infertility and erectile dysfunction. Despite advice from medical professionals, men are also less likely to adopt preventative measures to avoid certain health risks. The result of these bad behaviors: cancer and heart disease rank as the top two killers of American men, while unintentional injury is third.
Men also face multiple challenges when it comes to understanding their risks of urologic diseases. They may not recognize the symptoms; what constitutes a clear warning sign to some gets classified by others as part of the normal aging process – akin to hearing loss or gray hair. Some men may ignore them outright, at their own peril. (See page 16.)
Tobias Köhler, MD, considers the penis to be “the canary in the coal mine;” that is, a barometer of general male cardiovascular health. A circulatory problem in one part of the body can be indicative of blockage elsewhere. The lack of educational literacy on erectile dysfunction among men contributes to the confusion. (See page 20.)
Unfortunately, when things start to go south in a man’s southern region, stigmas can rise to the forebrain. Ron Kanwischer, LCPC, CADC, assistant professor emeritus of psychiatry at SIU, says men very often tie their identities to their sexuality. “For a man who might be experiencing issues with sexual health, it’s a very serious topic. They’ll buy something from a Mexican pharmacy rather than go see their doctor,” he says. “They are afraid and embarrassed.”
Like Dr. Rull, Kanwischer believes that physicians can better serve their male patients by educating themselves about these embarrassing subjects. “Clinicians have to work harder with men and adapt their approach to address these gender tendencies,” he says.
His primary suggestion for clinicians: “Don’t be afraid to ask. Physicians are afraid of things, just like patients. The topic of sexuality is always difficult, but with practice we can get comfortable with it.” He thinks each physician can customize questions that work best for them. “Find something you’re comfortable asking with every encounter.”
It’s better to let the patient know this is normal stuff, Kanwischer says. “We all experience this to one degree or another. It’s a shared human experience.”
It may indeed take something wrong with the penis to get a man to see a doctor, but men who take greater control of their lifestyle and pay attention to their bodies’ signals can have a dramatic, positive influence on their health — long before it reaches a level of emergency.
Read on to learn more about the ways SIU is helping men toward optimum health by addressing and treating their urological problems, prostate cancer and sexual health. Continue to next story
Urologists scarce in rural Illinois
A man who lives in rural Illinois will be hard pressed to find a urologist. Of the 102 Illinois counties, 55 have no urologist, and of those few who are practicing in these areas, none are under the age of 45, according to Kevin McVary, MD, professor and chair of the Division of Urology. “Access to care in rural Illinois areas is of critical concern,” Dr. McVary says. “Part of the mission of SIU is to address that concern.”
Mortality and urologic disease are a great deal higher where the urology physician density is low. SIU’s Division of Urology has devised methods to meet the needs of those needing urologic care in these areas. Dr. McVary is studying mortality rates for bladder, prostate and kidney cancers in downstate rural areas. Prostate cancer is the most common male cancer and the second most common cancer death among men.
The Division of Urology has addressed two other underserved areas of Illinois. In 2013 the division opened clinics at St. Mary’s Hospital in Decatur. Each of the six physicians and two nurse practitioners visit the clinic at least once a week. A recent, pilot telemedicine project with Hamilton Memorial Hospital in McLeansboro lets the SIU urologists consult on cases with the physicians in McLeansboro via their laptop, desktop computer or iPad.