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The Body Audit: Medical Tests Men In Their 50s Should Take

The Body Audit: Medical Tests Men In Their 50s Should Take
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You’ve reached the age where you’ve “learned a thing or two,” as one men’s ad intones, “the age of knowing what needs to be done.” Hopefully this includes checking in with your health care professional regularly to keep you hale and hearty. Whereas for your dad, 50 may have marked the start of a slow decline, there’s no reason you can’t remain healthy and robust for a good long time to come.

The older men get, says Dr. Gary Rogg, an internist at Montefiore Medical Center in Bronx, New York, the more nervous they can be that they’ll see their physician and find out they’ve got some chronic condition that’ll require monitoring and medication -- and who wants that? Instead, he says, think about preventive health care from a more positive, proactive angle: “Men are resistant to taking medication [say, for high blood pressure or cholesterol] because they fear side effects. I tell them to think about the much worse side effect of not finding out what’s going on, and taking care of it.”

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At 50, you should schedule your first colonoscopy, although if you have a family history of the disease (a primary relative with colon cancer) or are African American, you should have begun screening in your 40s. The prep may be icky, but the process is painless and important. Not just for screening, says Dr. David K. Spindell, internal medicine practitioner and divisional vice president of medical affairs at Abbott Diagnostics, but also for the immediate treatment of any polyps that might be found.

If your test is normal, you need only repeat every 10 years, says Rogg, but you still should have a fecal occult blood test as part of your routine checkup. So think of the benefit when your doc inserts a gloved finger in your rectum during your annual exam. This on-the-spot test for fecal occult blood is important, because blood in the stool can be an early indicator of colon cancer.

Heart health check

Although an EKG and a cardiac stress test are not routinely recommended unless you have risk factors such as a family history or are experiencing symptoms, “getting a baseline EKG is reasonable to suggest during this decade,” says Rogg. “One thing that might be picked up on an EKG are tall waves, which can suggest thickened heart muscle, possibly caused by untreated high blood pressure.” This result requires follow-up with a cardiologist, he says.

Ask your doctor if taking a daily low-dose aspirin is right for you -- it is right for most men this age, says Spindell, unless you have any type of bleeding disorder. A study in the heart journal "Circulation" agrees that the therapy is useful and cost-effective. It’s a case of no harm and potentially enormous good: “A low-dose aspirin a day has been shown to decrease the incidence of heart disease,” Spindell says.

Prostate Cancer Screening

If you’re not sure whether to get screened for prostate cancer, you’re not the only one -- there has been recent controversy. The American Cancer Society says that starting at age 50, you should discuss the pros and cons of this test -- do it at 45, if you’re African-American, or your father or brother developed prostate cancer before age 65 -- with your doctor. The reason to have the talk rather than definitely get the test? The standard screen, a blood test called for prostate-specific antigen, can be misinterpreted if not carefully read and lead to a possibly unnecessary biopsy.

“An elevated PSA could mean cancer, or not -- false positives are common,” says Spindell. Even if cancer is detected accurately, it might be indolent, or so slow-growing that it will never become an issue, whereas aggressive treatment can leave you incontinent and impotent.

For that reason, the U.S. Preventive Services Task Force recommended against routine PSA tests for most men, a position that the American Urological Association vigorously disagrees with, saying that oftentimes, signs of prostate cancer are first detected by a physician during a routine check-up. Best thing you can do is speak with your doc about what’s right for you. If you experience any problems urinating, or see blood in your urine or semen, or have painful ejaculation, call your doctor right away.

Vaccine Update

Baby boomers, listen up: The Centers for Disease Control and Prevention recently issued a recommendation that everyone born between 1945 and 1965 get tested for hepatitis C. The CDC notes that 75 percent of adults carrying the virus were born during those years. The reasons why this rate is so high are not completely understood, but what is known for sure is that early detection and treatment will save lives. It was previously recommended that only those with certain risk factors, including IV drug use or getting tattooed in an unclean environment, get tested, but given that so many people are silent carriers, and considering that hepatitis C can lead to deadly diseases including cirrhosis of the liver and liver cancer, screening seems smart.

Check on your tetanus booster, too; you need this vaccine once every 10 years.

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