Men's Health and Health Care Center

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C. Colon Cancer

The large intestine is the second most common cancer site. Colo-rectal cancer accounts for about 20 percent of all cancer deaths in the USA. Symptoms are non- existent in the early stages again requiring education and screening. This is a preventable disease with screening.

What you can do:

Reduce meats and fatty foods in the diet.
Eat more fiber (or take fibercon 2 tabs/d), fruits, and vegetables
Insist on a complete colonoscopy by a Gastroenterologist beginning age 50 and repeated every 5 yrs. if negative, or every 3 yrs. if premalignant polyps (adenomatous) are found by biopsy.
Baby aspirin daily cuts colon cancer by 50% (cox 2 inhibitor)

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D. Heart Disease

Positive risk factors for coronary heart disease (CHD) include:

Age (> 45 in males, > age 55 in female)
Family history of premature CHD (before age 55 in first degree male relatives, before age 65 in female first-degree relatives)
Current cigarette smoking
Hypertension (blood pressure > 140/90 or taking anti-hypertensive medication)
High LDL cholesterol (>130mg/dl)
diabetes mellitus
High HDL cholesterol (> 60 mg/dl) is considered a negative risk factor (good).

Total Cholesterol - The likelihood of developing coronary heart disease, or CHD (a narrowing and blockage of the arteries that supply blood to the heart muscle), is directly related to the amount of cholesterol in the blood. The higher the level of blood cholesterol, the greater the risk of CHD.

Less than 200 mg/dl Desirable level
200 - 239 mg/dl Borderline high
240 mg/dl or more High risk range

Desirable Level (cholesterol less than 200 mg/dl) - Risk is relatively low, barring other risk factors. It is still a good idea to eat a diet low in cholesterol and saturated fat.

Borderline High (cholesterol between 200 mg/dl and 239 mg/dl) - Risk is doubled. Modify other risk factors if any. Change diet to reduce cholesterol to below 200; recheck in 6 months. Trust your doctor to interpret your particular results; each case is different.

High Risk (cholesterol greater than 240 mg/dl) - May need further testing because risk is higher. Consult your doctor within 4 weeks.

LDL Cholesterol - Ideally, it should be below 130. However, as with total cholesterol, the lower the level, the lower the risk. If the level is over 160 mg/dl, risk is higher. When it is between 130-160, you are at borderline high-risk range. If above 130, reduce the saturated fat in the diet and consult your doctor.

HDL Cholesterol - Below 35 mg/dl is considered to be abnormally low and increases the risk of heart disease. The average man has a range of 35-80; the average woman, 50-60 mg/dl. Not smoking, maintaining ideal body weight and being physically active regularly will improve your HDL levels.

Triglycerides - To get an accurate measurement you will need to fast overnight for 12 hours. Levels above 250 mg/dl are abnormally high. Being overweight, drinking large amounts of alcohol, or having diabetes can also cause high blood triglycerides. Consult your doctor for treatment.

Cholesterol/HDL Ratio - Less than 5

Glucose - Elevated glucose may indicate a diabetic or pre-diabetic condition. Low levels usually require additional tests to determine if a basic metabolic disorder exists. Dietary changes often restore normal values.

Homocysteine - This is a new risk factor for heart disease. This amino acid can damage arterial walls if it reaches high concentrations in the blood. An ideal level is 6-10 micromoles per deciliter of blood for pre-menopausal women and 8-12 micromoles for men and post-menopausal women. If elevated, treatment includes three B vitamins (B6 at 2 milligrams/day, folic acid at 200 micrograms/day, and B12 at 15 micrograms per day). These dosages are found in routine multivitamins.

What you sould do:

Check blood cholesterol yearly (goal is less than 200 mg/dl) AND Homocysteine yearly (goal is less than 12)
Diet if cholesterol is less than 240 mg.% but greater than 200 mg/dl
Diet plus Lipitor if cholesterol is greater than 240 mg/dl
Weight loss
Exercise (daily walk)
B Vitamins if homocysteine elevated (greater than 12)
Further work up if two or more risk factors present (Stress test, rapid CT for calcium, & Cardiology consult)