Prakash Chandran (Host): Did you know that on average men are 25% less likely than women to visit a doctor annually and that, globally, men typically die about five years earlier than women, largely due to preventable health issues? Today, we're talking about an issue that really doesn't get enough attention, and that is men's health. We'll explore the unique challenges men face in maintaining their health and uncover the reasons behind their hesitation to seek care. I'm thrilled today to welcome Dr. Sanjay Jain, doctor of Family Medicine with Southwest General Medical Group.

Welcome to Southwest General Health Talk, a podcast from the specialists at Southwest General Health Center. My name is Prakash Chandran. So Dr. Jain, really thrilled to have you here today. You know, I think that when it comes to men's health, only recently do men hear about maybe getting a prostate exam in their 40s, and that's probably it. So if you ask a man that's heard anything, it's just like, "Oh, I guess when I turn 40, I have to go get the prostate exam." But that isn't necessarily all that encompasses men's health. So, I would love to ask an expert like yourself, when you think about men's health and when men should start on their health journey, what does that mean to you?

Sanjay Jain, MD: Yeah. Thanks, Prakash. Thanks for having me. And I just like to say, this is kind of an apt month. You know, November is Men's Health Awareness Month and for bringing awareness to things like both prostate cancer, testicular cancer, and something that people don't realize is part of men's health, but also mental health.

 So when talking about men's health, I think you really have to get to preventative health as a whole. As you brought up, you know, men live five years less than women and, along with that, you know, are less likely to seek care. And so, it's important that we realize this and, you know, you mentioned that statistics, 25% less likely. But if you actually look at preventative care, women actually seek care a hundred percent more than men do. So, we're actually pretty behind in those categories.

And so, the other thing I'd like to point, out of the top 10 causes of death in men, almost five or six of those are preventable again, just by going to your doctor, doing annual physicals and talking. And so, I think one of the important points to bring home here as well.

Host: You mentioned the five or six causes of death. Can you cover those just so we're aware?

Sanjay Jain, MD: Yeah. So, the top cause of death in men is actually heart disease, right? And then, comes cancer. And then after that, there are things like diabetes, kidney failure, liver failure. So, cancer is one thing that we can't entirely predict in most cases. But all of these other ones, you know, you can catch these early, right? Heart disease, especially, that's something where if you are doing annual exams, you know, we can catch things like high blood pressure, or if you're having these on and off chest pains, if you're having abnormal heartbeats, right? So, something that if you do see your doctor regularly that we can catch early and is very, very preventable in early stages.

And even the cancer portion, which like I said, we can't entirely predict completely, but still there are early screenings for those as well. And so, again, if you're seeing your doctor regularly and getting checkups, that's something that if you catch early enough, even if you do get cancer in early stages, it's usually very treatable.

Host: So, let's talk about when men should think about being proactive, right? We talked about prevention. I feel like especially for men, and I can maybe speak for myself at this age, you kind of think you're invincible, certainly, like in your 20s. "I don't need to go to the doctor, I'm just going to live my life." And sometimes that mentality persists, even throughout your 30s.  I'm in my mid-40s at this point. Things are hurting a little bit more, I'm a little bit more aware. Now, I have children, so I'm like, okay, I need to start thinking about this. But at what age should men start thinking about going in and getting checked up?

Sanjay Jain, MD: Yeah. I'd say even in your 20s and 30s, it's important. And as you said, I think most men, especially in your 20s and 30s, you have this sense of invincibility, or that you don't want to be vulnerable. And as we mentioned before, sometimes there's also a lack of awareness that there are some things that we should be looking out for, even at an early age.

The other thing that I think isn't on a lot of people's radar or that they don't want to think about is mental health. And I really want to emphasize that as part of men's health, because I would say there's always a fine line between being stressed out, between work and family and other things, and that turning into things like anxiety and depression. And as primary care physicians, we actually see a lot more of that than people think. I see a lot of anxiety and depression in my practice, and it affects people in a lot of different ways that they may not realize, right? And so, again, this is something that can happen at any age, and that's why it's important to even start at a younger age.

I'll even give an example for myself. You know, I'm in my 30s and I'm also a doctor. But for a long time, I also was not seeing a primary care. And until one day I was like, "I really should practice what I preach." And I think that was a great thing for me because even though I know a lot of these things, actually sitting down, talking to a primary care physician about my health I think was great. You know, I've battled with things like my weight and other things like that throughout my life. And I think that was motivation. And also, seeing my lab work and talking, seeing my blood pressure, all of these things that I wasn't necessarily checking before, I think gave me a bit more motivation to kind of, "Okay, I need to really take these steps and be more active." You know, all these things that again we preach to people putting it in practice. I think it's made a huge difference in my life. And so, I would encourage other men to go, even if you think you're healthy, if you think you're invincible, right? There's surely no harm in going to see a doctor and you never know. We may catch something in early stages or other things. Like I said, it's not just going to the doctor when you're sick. It's going there when you're healthy to stay healthy. And so, I think that's important, like I said, even at early ages.

Host: I'm really glad that you mentioned the mental health piece. I think that especially in recent generations, we have kind of like this urgent care culture where, okay, if there are things that are going wrong, I'm just going to pop into urgent care so you never get the time to develop a relationship with your primary care physician. So, they get to know you, they get to know from a mental health perspective, the things that you're going through and what you're trying to optimize for in your life. And so, it feels like that's a great benefit of establishing a relationship with a primary care physician. Would you agree?

Sanjay Jain, MD: Absolutely. I don't think a lot of people give that relationship enough credit because you may not be willing to talk to someone you've just met once about everything that's going on in your life, right? But when you develop a relationship with a physician over two, three, you know, however many visits, right? You get more comfortable and I see that all the time. And people are a little bit more willing to open up about things that are going on in their life, right? And again, I always emphasize the point you're not just coming to the doctor, you know, when you're sick or have a cold, it is just to have these checkups and to develop that relationship. And as we learn more about you, we can also get a better insight and kind of prod a bit more, right? And patients are a little bit more trusting that, "Okay. You know, I trust this person, what he's saying in terms of my health." And so, developing that relationship with a primary care physician, I think, is so important because it allows you again to be a bit more vulnerable with the other person, but also allow us to better know you and see, okay, what is your situation, right? Not just in terms of your physical health, but in terms of your mental health. And I always tell patients, "We're here for you. I'm not here to dictate things to you. I'm here to help you with your health, whatever form that may take."

Host: Yeah. The mental journey is one that is evolving and there throughout your life. But I'm curious as a doctor, when you say checkup, I imagine that what you're looking for, for example, screenings and panels might look different when you're in your 20s and 30s than when you are, for example, over 40. Can you talk to us a little bit about the journey that men go through and what you look for during these checkups?

Sanjay Jain, MD: Yeah. So, I'll start like at a younger age, you know, 20s and 30s, I agree, there's not as many things. You know, we're not necessarily looking for cancer at that age. It is more about developing that relationship, seeing if there are any issues, checking blood pressure, maybe checking lab work, but also developing that relationship so that when things do go wrong, right, that you have someone you trust to come to with that, or if things change, you know, we notice that. If I'm seeing someone on a continual basis, it's easy for us to tell when things are different with patients, which you may not get in an urgent care setting. And I think that's important to develop, like I said, in your 20s and 30s. But also in terms of other aspects, right? It's emphasizing things like how to be healthy in terms of healthy habits, eating, exercise, mental health. So again, at that younger age, it's not just about going in and, okay, this is wrong, that's wrong. It's again about being healthy.

As you start to move up in your 40s and 50s, we touched on, okay, now we do start to do some screenings, right? So generally, prostate cancer screening starts anywhere from your 40s and 50s, again, depending on things like family history and any other personal history you have regarding your prostate health. And hopefully, this gives patients some comfort or people some comfort, is that we no longer do digital rectal exams or screening anymore. So if that's something that's keeping people away, be assured that that's not something that's routinely done anymore. We generally use blood tests as an initial screening and then go from there.

Colon cancer screening is the other big one that starts at even 45 now, just because we used to screen at 50, but 45 is generally when that starts, just because we see more and more incidences of cancer at younger ages, and that number even moves down, again, based on family history. It may even start earlier than that. And again, sometimes people are scared of doing things like colonoscopies, and that doesn't necessarily have to be the first step. There are other options that don't necessarily include doing a procedure. So again, for people that are maybe on the fence about doing some of these things, I think it is easier now than ever to have some of these cancer screenings done.

Again, I think it's important because as we mentioned before, men are just so much less likely to seek care. I think there was a statistic out there that men are just 50% more likely to have cancer. And I think part of that is just because we're just not detecting it early enough or doing these screenings as much as we should. So, I would encourage patients to come out and see your primary care physician.

Host: Yeah. I mean, again, going back to that establishing a relationship with your primary care physician, because everyone is unique, everyone has a different family history. And so, when, for example, you might recommend like there is the, "Okay, 45 or 50, you should get these screenings done, but it's kind of dependent on who you are as an individual." And so, you want to establish that relationship because it is nuanced. But the key thing is going early and often for that prevention. Would you say that's the case? Because there's nuances for each individual.

Sanjay Jain, MD: Absolutely. And that's why it's so important to see because you're right, if you have a very strong family history, if your father or grandfather had prostate cancer, then yes, we're going to say, "Okay, we need to start doing some of these screenings a lot earlier than we may do in someone else." And so, you know, if you think, "Oh, I don't need to do this for a lot longer and come later," then we might already be behind the ball on screenings.

And so, you're exactly right. You know, developing the relationships early so that we can learn that history, right? We know, okay, this is your family history. This is your personal history, and giving us kind of a timeline as, okay, now, that we know all of this, okay, we're going to do this test at that age or this test at this age, again, based on all of those things. And that's going to look different for everyone based on your history.

Host: Now, you've seen a lot of people obviously throughout the year. And as we start to close, I am curious, is there one thing that you wish more men knew, you know, that would inspire them to come and see you? Just like something that has been surprising in all of your time working with men in family medicine.

Sanjay Jain, MD: I think just coming in checkups. And I'll give another story of a patient I think who had great success is that, you know, it was a patient in his 40s that was maybe a little fatigued, noticing that he was urinating a bit more. But as we do, we didn't really think much of it until his wife told him he should have a checkup. You know, and he came and, after doing a thorough evaluation, physical, you know, we got some lab work and it turned out he did have diabetes. And we got him on the proper treatment. And, you know, I think that prompted him to also, again, take a look at other aspects of his life and what he was doing. And I'm very proud to say that right now he's doing so much better. He's actually probably in the best health of his life. Even with the diabetes, he's doing so well in terms of being more active, eating a balanced diet, right? I'm keeping his sugars under control.

And so, you know, we all think we can put this off, but to go, just to go and see a primary care if you haven't seen one in a long time, or have never seen one, and to do those regular checkouts, because you never know what may come up, right? And kind of knowing is half the battle. Then, like I said, we can go from there. I just encourage patients just come in, see us. No matter how small the problem, like I said, we're here to keep you healthy. And we want to make up that five-year gap between that life expectancy between men and women. And not only that you live longer, but live healthier, right? We want you to live healthy for a long time.

Host: Well, I think that is the perfect place to end, Dr. Jain. Thank you so much.

Sanjay Jain, MD: Thank you, Prakash.

Host: To learn more about services at Southwest General Health Center, you can visit swgeneral.com. If you found this podcast to be helpful, consider sharing it on your social channels and check out our full podcast library to find something of interest to you. My name is Prakash Chandran, and this has been another episode of Southwest General Health Talk. Thanks.