Men suffering high-risk diseases – for example, heart, lung, colon, and disorders of the liver – far outnumber women in the relative age groups. There is widespread ignorance of preventive measures and the “it won’t happen to me,” syndrome is prevalent, especially among young men.
Some doctors believe that women have a built-in protection against disease, an immunity derived from female hormones. There is some evidence that this theory could be true because postmenopausal women appear more prone to illness after middle age when their female sex hormones are decreasing.
But many medical experts believe that a great deal of sickness among men is due to behavioral related diseases caused by smoking, drinking, and over-eating. “If cigarettes and alcohol were unobtainable,” said one heart surgeon, “more than half the beds in this hospital would be empty!”
Heart disease is the most common cause of death among American men. In some cases it is believed to be hereditary and men in certain families are definitely more susceptible than others but obesity is a factor, so is high cholesterol (excess of fats in the blood) and experiments have proved that blood fats increase after smoking one cigarette. Excess drinking of alcohol is responsible, too, for high-fat levels in the blood.
Even young men today are at risk from what is commonly known as a heart attack or coronary thrombosis. The medical term is myocardial infarction and it means the formation of a blood clot within a coronary artery which shuts off the blood flow to a section of the heart muscle. The faulty artery is caused by deposited fats and other substances (such as cholesterol) in the vessel wall and this process is part of arterial degeneration common to modern Western civilization.
A heart attack can occur as a result of several different diseases, for example, diabetes mellitus or gout, but the most frequent cause is hypertension (raised blood pressure).
Symptoms of a coronary thrombosis are pain in the chest (which can spread to arms, neck, and jaw) often accompanied by nausea, dizziness and by sweating.
Three-quarters of cases admitted to hospital recover but heart disease, at one time considered a risk of late middle age, is steadily increasing in the 30 and upward age group.
“Survival rate for the older man is better than for the young patient who tends to return to his previous life-style after hospital discharge,” a heart consultant told us.
Treatment of a coronary thrombosis consists of relieving the heart of as much work as possible so that it can repair itself. Diet is low in animal fats, carbohydrates (such as refined sugar) and salt. Healing of damaged heart tissue is watched carefully by electrocardiograms and treatment can include drug therapy.
Most dramatic advances have been made in heart surgery. Grafts of human vessels or synthetic materials are used to replace blocked segments of arteries or to bypass the obstruction, resulting in the restoration of normal circulation of blood to the heart.
Cerebral vascular accident or stroke is also caused by diseased arteries. A stroke is a blockage in a blood vessel bringing blood to the brain. Unconsciousness and sometimes paralysis results.
A severe headache can be a warning of stroke and sometimes tingling or clumsiness of a limb, difficulty in speech, and mental confusion. Or a stroke can just “happen” without any warning.
The site of the obstruction or the blockage in the arteries can be pinpointed by X-ray. If the blockage is found in the four main arteries to the brain (on the side and back of the neck) it is possible to open up the artery and clean out the blockage. Until recently obstructions inside the skull were inaccessible but, with today’s developments in microsurgery, surgeons can reach a blockage within the skull and clear it.
A new development for patients at risk (known cases of diseased arteries, high blood pressure, patients with a history of strokes in their families or people who have already had a minor stroke) is the cleaning out or “reconstruction” of arteries before a stroke occurs.
Hypertension (high blood pressure) is strongly linked to heart attack, stroke, angina pectoris, peripheral vascular disease; in fact, to all disorders of the arteries. Although hypertension can be the result of a congenital defect or some organic cause – for example, faulty functioning of the kidneys – stress, obesity, excessive alcohol consumption, and smoking are all factors.
Excitement, anger, intense emotion, or exposure to sudden cold can cause a temporary rise in blood pressure but if the elevation is prolonged, an investigation is necessary to find the root cause.
Raised blood pressure as a primary condition is more common today than it has ever been. Twelve-and-a-half percent of American men over 50 suffer hypertension and many don’t know they have it. Every medical check-up includes a blood pressure check. Hypertension can be treated. Ignored, it can result in serious disease.
Medical experts emphasize that increasing cases of hypertension are the result of the rich, high-cholesterol diet and abundant alcohol enjoyed by an affluent society. Americans eat and drink too much. They eat too much of the wrong food. Unfortunately, the “good life” is affecting young men, many of whom are overweight.
Results of regular self-indulgence are obvious if you look around the beaches. Good living has resulted in flabby midriffs and beer guts among men in their 20s.
Alarmingly high on the list of diseases attacking men is cirrhosis of the liver, marked by a degeneration of liver cells and thickening of surrounding tissue. Once associated only with men of middle age who had a history of heavy drinking, it is now quite common in young men. In the U.S., the incidence has risen over the last 10 years with the increase of alcohol consumption.
Cirrhosis of the liver is a disease listed under “behavioral” factors because high alcohol consumption is in most cases the cause and drinking is an accepted social pastime. Poor diet is a contributing factor because alcohol is a food substitute. Heavy drinkers rarely worry about food, while alcohol deprives their bodies of the B vitamins essential for normal health.
Sometimes cirrhosis of the liver shows no symptoms and evidence is found only after death but often heavy drinkers complain of vague ill health, nausea, swelling up of the ankles, impotence, and vomiting due to alcoholic gastritis.
The cure is to cut out alcohol – with psychiatric help, if necessary. Then, if the disease is not too advanced, the damaged liver cells will gradually return to normal.
The prostate is part of the male reproductive organs. Nobody knows the cause of the disease of this gland, so no preventive measure can be taken. If malignancy occurs it is usually confined to the 70-and-over age group but it is not unusual for benign prostate to develop in men of 50 upwards.
The prostate is a gland next to and under the bladder which surrounds the urethra, the canal extending from the bladder that opens outside the body.
The size of a walnut, this gland secretes a thin fluid that flows through the ducts to the urethra, a secretion that increases during sexual stimulation and contributes to the bulk of semen (sperm). Excess of this fluid passes into the urine.
Enlargement of the prostate causes pain, difficulty in urinating, and an uncomfortable feeling of fullness even after the bladder has been emptied. If the enlargement is marked, chronic constipation results, too.
Inflammation of the gland is able to be checked and responds to antibiotics but if untreated may develop into an abscess. Then, excision is necessary so that the abscess is able to be drained surgically.
If the prostate becomes blocked so that no urine can pass through the urethra, the gland must be removed, either by an open operation through the lower abdominal wall or by a closed operation – a method preferred for most cases with less risk of complications. A cystoscope (hollow metal tube) is introduced through the urethra into the bladder.
This instrument has an electric bulb at its end which illuminates the interior of the bladder so that part of the enlarged gland can be cut away by diathermy, which is the use of high-frequency electric current.
Another uncomfortable condition resulting from chronic inflammation is stones in the prostate gland. If these cause discomfort the whole or part of the gland may be removed, again either by open surgery or through the operating cystoscope.
Recovery rate after removal of the prostate is good and normal sexual functions are maintained although fertility is sometimes reduced.
Cancer of the prostate attacks the older man but malignancy is slow to develop. This form of cancer is now being treated with low doses of female hormones and a new drug, cisplatinum, has recently proved successful, in conjunction with other drugs, in arresting some rare cancers found in the testes.
Any form of the prostate disorder caught early, can be treated. Thousands of men undergo treatment or surgery and most of them regain good health afterward.
A hernia results when an organ of the body protrudes from the compartment normally containing it. It is called, incorrectly, a rupture by the layman which is misleading. Rupture implies tearing and, with a hernia, nothing is torn. Chronic coughing or lifting heavy weights can result in some forms of hernia, especially if the muscles of the abdominal wall are weak. Then, symptoms include swelling and aching in the groin. Surgery for reduction and repair is the answer. If for physical reasons or age, this is inadvisable, a truss is used.
About 95 percent of gout occurs in men but the first attack is rarely seen before the age of 30. It is a disease in which uric acid, usually expelled in urine, is retained in the blood and becomes deposited in joints and tissues. Symptoms are swollen, inflamed, and painful joints with pain frequently concentrated in the big toe.
Gout can follow an infection or surgery or even a minor irritation such as tight shoes. Often gout sufferers complain of headaches, run a fever, and find walking painful. Medications can relieve pain and swelling.
In 10 to 20 percent of chronic gout, there is damage to the renal tubes and stones in the kidneys.
Medication is necessary to promote excretion of the cause – the uric acid – and a diet limiting some foods including sweetbreads, kidney, liver, sardines, anchovies, meat extracts and gravies is advisable. Weight must be kept down and liquids increased. Allopurinol, a drug now used to prevent the retention of uric acid, has proved successful in the long-term treatment of gout.
Emphysema, the abnormal presence of air in the lungs, is often found in sufferers of asthma and chronic bronchitis. Chronic emphysema is on the increase among men in the Western world and reasons are not fully known although, along with other respiratory complaints, increasing cigarette smoking is a known factor and there is more evidence of emphysema among smokers than non-smokers.
The disease is caused by gradual loss of elasticity in the tissue of the lungs. With age, the condition can result in real disability, especially if it is continually irritated by cigarettes.
Nothing can be done to improve the changes in the lung tissue but if a patient stops smoking, gets plenty of clean, fresh air, and does deep-breathing exercises discomfort can be relieved. Bronchodilators or “puffers” relieve bronchial muscle spasms and dilate the bronchi.
Obesity sometimes causes complications, for example, heart failure. Bronchial sufferers should be sure to watch their weight.
A warning from Dr. Denis Smith at the Concord Repatriation Hospital: “A persistent cough – what people refer to as a smoker’s cough – is abnormal. Sputum (phlegm) is abnormal. Any coughing of blood is abnormal. Coughing is an abnormal reflex and it is serious until proven otherwise.”
Colon and Rectum
Disorders of the colon (large intestine or bowel) and rectum are high in men. The colon is a muscular tube beginning at the abdomen and running downward toward the pelvis where it forms the sigmoid (terminal of the tube) and rectum, extending to the opening (anus). Its function is to absorb fluid and gradually propel the body’s waste matter until it becomes a mass, which is evacuated.
Cancer of the colon shows a sharp rise after the age of 40 but if caught in time it is one of the most curable of cancers. Symptoms are blood in stools, either frequent bowel movements or increasing constipation, abdominal distention, and cramp-type pains. As a tumor grows in the colon it tends to constrict the bowel opening.
A tumor of the colon can be removed completely and the prognosis is good provided malignancy has not spread. After surgery, normal bowel function is restored and the patient notices no difference. When a tumor is found in the rectum it can still be removed but the end of the colon is implanted in the abdominal wall, forming what is called a colostomy. In this case, evacuation of waste matter comes through an artificial opening in the abdominal wall.
A colostomy frightens patients. They dread both discomfort and the unpleasantness associated with an artificial opening but while nobody would choose a colostomy as a type of treatment it is far better than eventual death from cancer of the rectum.
These days there is no need for a colostomy bag to be worn except in the early postoperative period.
Gradually a patient learns control of evacuation and is taught to empty the colon by irrigation (washing out a body cavity). Between irrigations, a pad is worn over the colostomy under an elastic belt. There is no leakage and coping with a colostomy has become a minor problem.
Risk during surgery for removal of cancers of the colon and rectum is minimal considering the nature of the operation and the hard fact that unless the tumor is removed death is inevitable. Any symptoms, even occasional rectal bleeding which most likely will prove to be nothing more than hemorrhoids (piles), should be investigated immediately by a doctor.
Cancer of the colon and bowel is believed by many experts to be associated with constipation caused by a lack of fiber in the modern diet.
A high fiber diet is advisable for everybody all through life – natural bran, fruit, vegetables, wholemeal bread, unpolished rice – instead of a diet based on meat and processed foods. One heaped tablespoon of natural bran every day should be sufficient for most people to combat constipation.
It is interesting to note that in poorer countries where unprocessed cereals form a large proportion of the diet, cancer of the colon and bowel is rare.