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HOUSE CALL WITH DR. SANJAY GUPTA

Father's Day Special HOUSE CALL on Men's Health

Aired June 19, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DR. SANJAY GUPTA, SR. CNN CORRESPONDENT: Good morning and welcome to HOUSE CALL. Happy Father's Day weekend to all the dads out there.
We have got a special show for you. This is the end of Men's Health Week, and that's what we are talking about today. The old adage goes like this that men take better care of their cars, than they do their bodies. Unfortunately though, that's not always too far from the truth.

Christy Feig takes a look at the effect that's having on men and what they need do about it.

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): When he was younger, Reverend Herbert Chambers never went to the doctor unless something was wrong. Then he had a stroke, one that might have been prevented if he had been having regular check-ups.

REV. HERBERT CHAMBERS, STROKE SURVIVOR: There's a thing about men, that macho concept, that we can whip anything. And that's not true.

FEIG: Government studies show men die about six years before women. In part, they say, it's because men only go to the doctor when they're sick.

(on camera): But that could be too late because in the early stages, when they can be most easily treated, many of the top killers don't show any symptoms.

(voice-over): Doctors say there are a few diseases men should be checked for every year. Like heart disease, the No. 1 killer can be prevented with regular cholesterol and blood pressure checks, as well as monitoring blood sugar levels for signs of diabetes.

DR. PATRICIA DAVIDSON, WASH. HOSPITAL CTR.: Diabetes is probably one of the deadliest, most devastating diseases that we have, because it ravishes just about every organ.

FEIG: The early signs of prostate cancer can now be measured with a blood test, called the Prostate Specific Antigen test or PSA. And starting at age 50, you should have regular checks for colon cancer. DAVIDSON: When you have symptoms from colon cancer, you have a very large mass by that time.

FEIG: Experts say catching these diseases early could add extra years to your life.

In Washington, I'm Christy Feig.

(END VIDEOTAPE)

GUPTA: Christy Feig, thank you.

Let's take a look at some numbers now. On average, men have a higher death rate for every one of the top 10 leading causes of death in this country. And men go to health professionals 100 percent less often than women. In a recent survey, 84 percent of men said they had their car serviced in the past year. But in that same year, only 66 percent had an annual check-up.

Here to help us understand this and how to get men more informed about their health is Dr. Elmer Huerta. He's founder and director of the Cancer Risk Assessment and Screening Center at the Washington Hospital Center. He also has his own radio and televisions show, educating the public about really important stuff, staying healthy and prevention.

Welcome, doctor. Thanks for spending some time with us.

DR. ELMER HUERTA, WASH. HOSPITAL CTR.: Thank you very much for your invitation.

GUPTA: A very interesting survey. Men aren't getting to the doctors office nearly enough. Why is that in your experience?

HUERTA: Well, it seems that men -- we have been raised to think that we are indestructible. We are super man. When you are a little boy and you fell down and your mother tells you don't you cry. Please don't cry because men don't cry. Men are strong. So when we ache, we think that nothing will happen to us. That we are still strong. We have these kinds of visions to resolve the problems in the next day or next week, when I'm going to work. Where I'm going to get the money to support my family, things like that. It seems that is part of the thing. We that think we are indestructible. And we are not.

GUPTA: And people are focused so much more on fixing it when it's a problem, as opposed to prevention. We're going to talk a lot more about that as well. Let's get to some more questions, lots of questions coming in on this.

We sent our camera out to get questions from some men on the topic. Take a listen to this one.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: At what age now -- I'm 38 now, at what I'm should I start really being concerned about my health? (END VIDEO CLIP)

GUPTA: Now first of all, do African-American men or Latino men have any special health concerns?

HUERTA: I think they do. There are some disparities. What we call disparities; there are some conditions that disproportionately effect men of Latino or African-American heritage.

But I think the question of the caller is very good. And I would say I would refer the question to the parents. I think the health of a person needs to be taken care of since birth. Now, before that maybe, when the kid is a little kid, he or she should have a pediatrician to take care of the kid. When the kid is an adolescent, he or she should have a doctor who takes care of adolescent problems. When you are in your 20s, 30s, your primary care provider should have a conversation with you at least once a year. Of course, when you get older, you need to have check-ups. But I think these problems of maintaining overall health is a situation that needs to be taken care of all your life.

GUPTA: It's interesting because I think a lot of people, men and women; they certainly have pediatricians when they're children. But it's that adolescent phase, where I think a lot of people sort of lose a primary care doctor. Unless they pick it up later on in life they may not have one. And I think this next question sort of speaks to that. Another question from our roving camera.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: As far as physicals, I have not gotten a physical recently. So As I start to get up in age I want to know what would be better for me to do to start getting an annual check-up, or semiannual, or quarterly. And what are some of the tests that I need to be taking to make sure I'm in good, physical health?

(END VIDEO CLIP)

HUERTA: There is some controversy regarding the frequency of healthy, check-up examinations. Some of the guidelines that we have in this country say, oh, if you are younger than 20, maybe once every five years. If you are over 30, maybe every two years would be fine. But I disagree with that, because I think, I'm convinced the health of a human being is not only physical, Dr. Gupta. It is also mental health and it's also spiritual health.

So, maybe your body may not show any signs of distress when you go every two years or every three years, but what about your mental health: depression, anxieties? What about your spiritual health? That's what I think. Every year a person should see their physician for a conversation.

GUPTA: The health -- your health is the most important thing in your life. And it's complicated. And it's important to invest some time in it. One thing I was going to tell you, Dr. Huerta. I just got married. And as we know, it's often the women in our lives who get us -- get ourselves to the doctor. And there's an e-mail on that topic. This comes from Diana in Washington, who asks, "How do I get my husband to go to the doctor for health problems without it being a battle," she asks? "Also, how do I get him to start taking preventative steps to care for his health, rather than a fix-it approach?"

And Doctor, I should point out that for 10 years now, you have been involved with something called the Cancer Preventorium. Sort of like a play on words with "insanitorium." But you really focused on prevention. What is your advice for Diana?

HUERTA: For Diana, I would like to advise her to, see if it's possible to educate the husband in two key concepts, Dr. Gupta. No. 1 is early death or premature death. And the other one is quality of life. Premature death means that somebody is going to die before the life expectancy in the United States. In the United States men, I think, we are in the 74 years of life expectancy. Anyone who dies before that time is having early death. And it is a shame when that early death is due to something that can be avoided. So, if she can talk to him about that.

And the other one is quality of life. If you work hard, if you have a life, it's because you want to enjoy, be proud of your work in your later years. But what if you don't have quality of life because you smoke; you don't take care of yourself, et cetera, et cetera? So, quality of life and early death or premature death, are two important concepts here. That's important concepts here.

GUPTA: And I think that's important. Lots of these issues coming in. You're doing really good work, Dr. Huerta.

Coming up, we're going to continue our discussion, this time, prostate cancer. We're going to talk about the controversy surrounding those PSA tests. Stay tuned.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): To test or not to test? That's the question on many experts' minds. Are PSA tests unreliable or the best way to prevent prostate cancer?

Plus...

ROBERT ROTH, LOW TESTOSTERONE PATIENT: It sort of gave me my life back.

UNIDENTIFIED FEMALE: What has this man discover? We will tell you his secret.

But first, take today's "Daily Dose" quiz. What is the most common form of cancer in men? The answer when we come back.

(END VIDEO CLIP) (COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Checking the "Daily Dose" quiz. We asked what is the most common form of cancer in men? The answer is skin cancer. According to the American Cancer Society, skin cancer is the most common, but lung cancer is the most deadly to men.

(END VIDEO CLIP)

GUPTA: Always worth remembering those numbers.

According to the Men's Health Network, men's life expectancy in the U.S. is more than 10 percent lower than women's. As we've said, the second leading cause of death for men is cancer. And lung cancer is the deadliest. Prostate cancer and colo-rectal cancer are equally as dangerous to men, followed by pancreatic cancer and then leukemia.

Although lung cancer kills more men each year, prostate cancer is actually more common. One in six men will develop it in their lifetime, if they live long enough. The biggest risk factor is your age, followed finally by your family history and race. African- American men are twice as likely to die from prostate cancer. Why is that?

Well, we are talking with Dr. Elmer Huerta. He's founder and director of the Cancer Risk Assessment and Screening Center at the Washington Hospital Center.

Doctor, first of all, interesting statistic about African- American men much more likely to die of prostate cancer. Any thoughts on that?

HUERTA: Well, we don't know the cause. I think that's one of the gaps that we have in our research enterprise in this country. We need more research in this kind of disparities. We don't know that. The same way we don't really know why African-American women, for example, have more aggressive and early cancers than Anglo women. So it is important to know we don't have a clue regarding that yet.

GUPTA: It's difficult issue. And I want to try to work through this. We've all heard of the PSA test are one of the ways to catch prostate cancer early. But there's some controversy surrounding the test as well. The National Cancer Institute says of every hundred men that are tested, 15 will have elevated PSA levels. Which could mean they have prostate cancer. But of those 15 who go on to have further testing, only three usually end up with cancer. Now, that's a pretty high false/positive rate. It's known as a false/positive rate, it leads to some confusion.

Let's take a question on this topic from our roving camera.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: There seems to be some controversy about whether or not the prostate cancer test gives information that is useful. So, what is the right answer to that?

(END VIDEO CLIP)

GUPTA: So, Doctor what do you say to those who are unsure whether or not they should be taking that test?

HUERTA: It is true there is a big controversy. And what I suggest to viewers is that they should really have a good conversation, a very good conversation with their doctors. And if they feel that their doctor cannot get the point across, they should get a second opinion. It is extremely important for men to understand this controversy. A group of doctors think that they should have screening; other groups of doctors think that they shouldn't have. So, it's important for a man to be informed.

GUPTA: And what do you tell your patients, Dr. Huerta? This is your area of expertise. Let's say a man who's just retired. You know, he's starting to think about his health, 65 or so, is going to go get this PSA test. What do you tell -- should he get it, first of all? And what should he do with that information?

HUERTA: What I tell them, listen, you are coming for a PSA. Do you know what kind of problem are you getting into? They say what do you mean? Well, then I start with the controversy. Then I explain them that in order for a test to be really effective and be used everywhere, it needs to fulfill one condition, Dr. Gupta. It means that it needs to decrease the mortality. In other words, if you find a cancer because of the test, you need to demonstrate that finding early cancer it going to make this man live longer. Unfortunately we don't have that data yet.

So, it is very sad. But we have this controversy. And my experience tells me, Dr. Gupta there are two kinds of men. Men that said OK, thank you for explaining me this, Dr. Huerta. I think I'm going to wait. I'm going to be back next year, great. But other men they say, you know what? I don't even want to think that I have cancer. That word really scares me. Please do it. I'm going to take my decision after you do it. And that's informed...

GUPTA: Some men would just rather not know, right?

HUERTA: Exactly. Informed decision, I think that's extremely important that men talk to doctors, instead of just putting their arm out for some blood to get drawn.

GUPTA: Right.

Let's get to another question now. Larry in Maryland writing -- excuse me. "I heard recently that some doctors are performing prostate surgery in some way that does not cause erectile dysfunction." Which is a big concern about this operation. "Is that true? And if so, how is it done?"

HUERTA: Yes. It is true. It is true we have to remember that the little nerve that controls the erection are very close to the prostate gland. When doctors go and remove the prostate gland, they do need to spare these nerves and do a very careful surgery. There are some centers in the country that perform what they call Nerve- Pairing Surgery. And so, if a man is interested, they should ask the doctor do you do this? How much experience do you have at doing this? And the dialogue needs to start right there.

GUPTA: Good thing to talk to your doctor about, no question.

Next on HOUSE CALL, some are calling it male menopause. We'll tell you what that means after the break.

(BEGIN VIDEO CLIP)

DR. ANTHONY KARPAS, ENDOCRINOLOGIST: You do have people who think they are depressed or think they have a problem. And it turns out to be low testosterone.

UNIDENTIFIED FEMALE (voice-over): Testosterone therapy, is it safe for everyone? We'll show you the pros and cons.

But first, here's a tip from our health conscious "Bod Squad." GUPTA (voice-over): It only takes a few simple items: a stability ball, rubber tubing, a few mats. And you have got yourself a home gym. Personal trainer Sabrina Newton says resist the urge to buy expensive machines.

SABRINA NEWTON, PERSONAL TRAINER: Go about the most inexpensive ways first.

GUPTA: Start off by purchasing a stability ball for crunches and lower bodywork.

NEWTON: Basically for resistance.

GUPTA: Rubber tubing also provides resistance and it's good for squads. NEWTON: It doesn't look like it raise much, but it does.

GUPTA: Medicine balls work out the upper body.

NEWTON: Stepping, basically, up a notch. Just step.

GUPTA: While a step bench works the legs. And a few small hand weights round out your home gym. The price tag for this home gym: around $100. Of course, prior to starting any exercise regimen pay a visit to your physician.

Dr. Sanjay Gupta, CNN, New York.

(END VIDEO CLIP)

GUPTA: Welcome back to HOUSE CALL. Well, we are talking about men's health, a really important topic. Millions of men suffer from something known as low testosterone and don't even know it. Through the end of July, doctors are recommending a testosterone tune-up for men over 40.

(BEGIN VIDEOTAPE) KARPAS: Hi. How is it going?

Hello, Dr. Karpas. Good to see you again.

GUPTA (voice-over): Robert Roth is 55. He was feeling tired, depressed, and wasn't interested in sex.

ROTH: You just kind of drag around, you don't feel well. Your stomach kind of hurts.

GUPTA: He went to the doctor thinking he had stomach problems, but was tested for and diagnosed with low testosterone. It's estimated 5 million American men suffer from low testosterone. Hormone levels drop, as men get older, usually after age 30. Doctors normally start to see problems in men at age 40 to 50.

KARPAS: It's a gradual thing in men. In other words, tends to get worse as you get older.

GUPTA: Sometimes called male menopause, doctors are diagnosing low testosterone more often.

KARPAS: You do have people who, you know, think they are depressed. Or think they have a problem; and it turns out to be low testosterone.

GUPTA: Warning signs to look for: low sex drive, erectile dysfunction, depression, fatigue and reduced muscle mass and strength. ROTH: I've even had friends that have described symptoms to me that sounded very much like the ones I had. And as soon as I suggest that maybe they should get a testosterone test, they immediately go into denial over the whole thing.

GUPTA: But finding out if you have low testosterone is not complicated. It can be diagnosed with a simple blood test. And treatment includes: injections, patches or gels.

KARPAS: The gel gives you a very even effect. And you can actually follow the levels to make sure the amount that is getting in is exactly what you want it to be.

GUPTA: Some of the side effects of treatment could be: sleep problems, infertility, excess blood production, which could cause increase risk of stroke and increased prostrate size.

After testosterone therapy, Robert feels more energetic and focused.

ROTH: I hate to say it sounds corny, but it sort of gave me my life back.

(END VIDEOTAPE)

GUPTA: Hormone therapy is recommended for men diagnosed with low testosterone. But more and more older men are taking testosterone to combat the inevitable effect of aging, from low sex drives to decreasing strength. Now, the National Institutes of Health last July, last year, recommended testosterone therapy not be used to relieve the effects of aging. Specifically saying more studies needs to be done showing the safety of its long-term use in healthy men.

We are talking to the Dr. Elmer Huerta about this. He is the host of a radio and television show focused on health education and prevention.

Doctor, first of all, is there any such thing as male menopause?

HUERTA: Yes, it seems that there is some male menopause. It's called "andropause." And there are symptoms that are present in men after 55 to 60 years of age.

GUPTA: Lots of questions coming in on this topic. Testosterone again, for low testosterone and people who have -- want to combat aging.

Let's go to Chris in California, who asks, "Is testosterone replacement therapy safe for 40-year-old men?"

So Doctor, like Chris, millions suffer from the condition of low testosterone. First of all, is the therapy safe for them?

HUERTA: Absolutely not. I would say not. We just talked about prostate cancer controversy. There's a big controversy regarding the use of testosterone. I would warn men that please do not jump on using these products, because we don't know the safety of this treatment. We just learned for estrogens, Dr. Gupta, how we used for 40 years plus, 40 years the estrogens to know that there may be some dangerous benefit. So, please don't jump on this. It is not proven that it is safe.

GUPTA: Not for everyone, just for people who have possible low testosterone level. Good advice there.

When HOUSE CALL continues, this week's top medical stories from eating for better vision to teens eating too much. Stay tuned.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): We know eating fruit is heart healthy but vision friendly? We'll bring you the detail.

Plus, we'll show you where to surf for more information on men's health and give you a quiz to test what you learned. That's coming up on HOUSE CALL.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

FEIG: Eating fruit can reduce your risk of macular degeneration, the leading cause of blindness in people over 65. The study in the "Archives of Ophthalmology" found those who ate three or more servings of fruit a day had a 36 percent risk for the disease, than those who ate less than one and a half servings daily.

And a study in the "Journal of the American Medical Association" estimates 75 percent of adolescents eat fast food at least once a week. All in the study were more likely to overeat when served fast food. But those who were lean balanced it out by eating less at other meals. Overweight youngsters did not.

Christy Feig, CNN.

(END VIDEO CLIP)

GUPTA: Well, we've covered a lot of topics today. If you want more information on men's health, click on to www.mayoclinic.com. And on the left side of the screen scroll down to "Men's Health." You can take a quiz on how well you know your body and find information on issues ranging from sexual dysfunction and prostate cancer, to fitness and weight control.

We have been talking to the Dr. Elmer Huerta today. Very good information today.

Thank you for joining us. What is one final message you would like to leave with viewers today?

HUERTA: Well, I think we should do some basic things: eat well, exercise maintain healthy weight, do not smoke, and please visit your doctor every year to have a conversation. I think they are basic, basic, basic things we have to do to for to maintain our health, Dr. Gupta.

GUPTA: Basic, basic, basic, prevention, prevention, prevention. Thank you so much, sir.

We are out of time, everybody. Thank you Dr. Huerta for answering all of our questions. Thank you all at home as well for all of your e-mails. Make sure to click on cnn.com every Tuesday for our weekly topic. You will also find a link there where you can e-mail us your questions.

Remember, this is the place for the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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