Men tend to be reactive rather than proactive when it comes to their health. Unlike their female counterparts, many guys don’t keep a close eye on what ’s happening with their bodies, often choosing to plough on in the face of various ailments and symptoms. Emily Wetzki speaks to four health specialists from some of Singapore’s top clinics about areas of concern in men’s health that might not be at the forefront of most people’s minds, and finds some potentially lifesaving tips along the way.
Many men have an aversion to visiting the doctor, so it’s not surprising that health problems are often overlooked in the hope that they will simply go away. Stress is one such problem. Though it can be one of the biggest causes of disease, especially in men, stress is often ignored due to the stigma related to seeking help. Nancy Ho of Regional Hypnosis Centre says men need to start giving more priority to mental health, before it has a knock-on effect on the rest of the body.
“When you are stressed, cortisol is produced. The more stressed you are, the more cortisol you make,” she says. “It’s like a slow poison, not only affecting your mood but also attacking your cells, your organs and your whole system.”
Men and women differ greatly when it comes to seeking help for mental health issues. Traditionally, society expects men to be strong and to provide for their families, so they’re often reluctant to seek treatment. “Normally, people will come to see me about a particular symptom – for example, a fear of flying or anxiety at work,” Nancy explains. “Women are more likely to come in for help with emotional things like not feeling loved, relationship issues or comfort eating; men for issues relating to confidence or performance.”
Left untreated, stress, anxiety and worry can lead to much more serious health issues. Nancy says she can help her male clients to reduce negative thinking patterns that are prohibiting them from leading normal lives.
“We need to get rid of ‘energetic toxins’,” she says. “When we feel attacked in some way, those toxins get trapped at the base of the ribcage where a lot of the organs are.” Nancy explains that many mental issues stem from childhood, which, in some ways, is a good thing because they’re treatable. “The good news about problems related to your conditioning is that you can be unconditioned,” she says. “You were not born with the problem, so therapy can be used to help get you out of the hole you’re in.”
Nancy works from a triangular principle based on three pillars: mind, consciousness and thoughts. Working on understanding these pillars can help her clients regain balance and control. A main element of the way Nancy treats her clients is through her own method of hypnotherapy: using the sound of her voice, she can help her clients move from a conscious state to what she calls a “let-go” state.
“In a let-go state, you can really feel your feelings,” she says. “One story can flow after another, and the root of the problem can emerge. It’s about processing thoughts – thoughts influence feelings, which, in turn, influence behaviour and actions.” Nancy assesses clients on a case-by-case basis and tailors her treatment plans with each person accordingly.
How can men improve their mental health at home? Nancy says she often gives clients mind and breathing exercises to do in their spare time. She believes that when you have negative thoughts, it’s normally about something from the past; panicky or fearful thoughts, on the other hand, are normally about the future. By acknowledging this and letting go, you can move forward without being a slave to your worries.
Stress can take many forms, but something new for many men in this age of social media is the pressure to look good. We’re increasingly putting our images out there on smartphones, Instagram and Facebook, and it has become common for men to seek treatment for better aesthetics, including problem areas on their legs. Varicose and spider veins have traditionally been more associated with women but, as physical challenges like marathons and triathlons become more popular, vein problems are increasingly becoming a male issue, too.
Dr Imran Nawaz from The Vein Centre explains that both environmental factors and genetics can play a part in the development of varicose veins.
“People are going to the gym, wearing shorts, posting on social media. More and more middle-aged people are doing physically challenging sports that put pressure on their legs. In active men, we are seeing more problems. Twenty years ago, this wasn’t the case.”
While people have been treating varicose veins since the time of the ancient Egyptians, until recently, “stripping” these veins (the traditional treatment in which the offending veins are pulled out) and invasive surgery were the only widely used methods of alleviating the condition. Now, though, technological advances have paved the way for much more accessible (and less painful) treatments for unsightly and uncomfortable vein conditions.
For large, problematic varicose veins, The Vein Centre can administer venous ablation therapy. In this treatment, Dr Nawaz inserts a heating device inside the vein, causing it to shrink. Guided by ultrasound technology, this method ensures that no outside structures are affected; the vein is punctured and small tubes are inserted to do the job.
Ultrasound really plays a key part in the treatment of veins today, helping the surgeon to see how large the veins are and which ones need attention. Dr Nawaz admits it has had a huge impact. “It’s much more accurate than assessing something purely from the surface appearance,” he says, “and we also use it for follow-up care.”
Men vary widely in how severe their vein symptoms are before they seek treatment. Some men are merely concerned with how the veins make their legs look, and Dr Nawaz says he is treating more men to remove spider veins for cosmetic reasons. For a small patch, he usually uses either laser therapy or sclerotherapy (where a solution is injected into the vein, causing it to collapse). This can be very effective for less-severe spider veins.
For those experiencing ongoing problems with spider or varicose veins, Dr Nawaz recommends some “at home” fixes that can help alleviate the symptoms. These include putting your feet up (the higher, the better), wearing compression hosiery, which pushes the blood and pressure back up the leg, and avoiding standing for long periods of time. As with many ailments, losing weight will also help, simply because it reduces the pressure on the legs.
What won’t help, however, is putting off seeing a doctor when there’s a problem; so Dr Nawaz also stresses the importance of seeking help as quickly as possible.
Another doctor who wholeheartedly agrees with this line of thinking is Dr Dennis Lim of Dennis Lim Surgery at Mount Elizabeth Hospital. A general surgeon with expertise in head and neck surgery, he is also a surgical oncologist who specialises in treating skin cancer. Unfortunately, says Dr Lim, he all too often sees male patients who have ignored warning signs and waited too long before seeking treatment. While most people know the dangers associated with sun exposure, in a tropical environment there are higher risks, particularly for expats with fair skin that’s not designed for life near the equator. According to Singapore’s National Cancer Centre, skin cancer currently ranks sixth in the list of the most common cancers occurring in men here.
The chances of successfully treating the most serious form of skin cancer, melanoma, depend greatly on early detection. That’s why men everywhere need to be more aware than ever of changes in their skin. Dr Lim advises that any mole that increases in size or sensitivity, or one that bleeds or changes in any way, should be looked at immediately by a dermatologist. “Around 95 percent of melanoma is low-stage (Stage One or Two), and can be very easily cured,” he explains. “Beyond 90 percent of melanoma patients survive for five years or more.” Many people are unaware that melanoma can result from bruising and blood clots under the skin. Bruising can lead to cell mutation, and this is when cancers can start to form. Most people ignore bruises, but it’s important to monitor them, especially if they aren’t going away. A history of skin cancer, either personally or in your family, is another important reason to monitor your skin. For patients in the very early stages of melanoma, treatment normally involves only minor surgery; the tumour can be removed, and a biopsy can determine whether the disease has travelled to other parts of the body.
Dr Lim’s clinic provides a procedure called sentinel lymph node biopsy. Radioactive material is injected into the patient’s thumb; this material then travels and localises in the sentinel lymph node (under the arm, next to the breast). The theory is that, if the cancer has spread, it will have followed the same path. So, if the sentinel lymph node is removed and analysis shows that it doesn’t contain cancer, there is no need to remove other lymph nodes in the area. This eliminates the need for unnecessary major surgery, and is a huge step forward in skin cancer treatment. Dr Lim explains that, even for those who are diagnosed in the last stage of cancer (Stage Four), there’s still a lot of hope for treatment and recovery. Every year for the past five years, there have been advancements in new methods to combat the disease, and new, effective immunotherapies have become available. Dr Lim puts huge importance on diagnosing and placing his patients in the correct stage of cancer in order to devise and administer the most accurate treatment programme possible.
Perhaps surprisingly, Dr Lim says that avoiding the sun is not the key to evading skin cancer – it’s being careful that counts. He advises being outside in the early morning or late afternoon when the sun is less strong, and wearing sun protection by covering up with clothes, as opposed to creams, which can be sweated off. It’s important for men to change their mindset about taking precautions, particularly when taking part in outdoor activities – and, remember, if it looks abnormal, get it checked.
Play it safe
The issue of mind-set also goes for other cancers that commonly affect men – perhaps the most well known being prostate cancer. Located in front of the rectum, the prostate gland is responsible for producing a fluid found in semen. Dr Neil Forrest, a GP at the International Medical Clinic (IMC), says that prostate cancer is something that all men should be aware of. “We recommend all men discuss screening with their doctor from age 50,” he says. “Many men are reluctant to discuss this issue, and the uptake of screening is poor.” What makes prostate cancer so common? Risk factors include being over 50, having a family history of the disease and having a diet that’s high in fat or alcohol. There is also some evidence to suggest higher rates in those who are overweight, who smoke, or who are of Afro-Caribbean ethnicity. However, says Dr Forrest, there is really no one cause. “Prostate cancer is unusual in that there are no definitively proven ways to prevent it,” he explains.
IMC encourages its patients to be proactive about their health, and is careful to inform them about warning signs. Getting up at night to urinate, difficulty with stopping or starting urine flow, and blood in the urine are all things to be monitored. These symptoms can also be due to a benign enlargement of the prostate, which is very common; so it’s important not to panic, and to discuss things with your doctor before reaching a conclusion. If you’re concerned about changes in your prostate area, or know someone who is, IMC performs routine prostate checks to look for lumps or nodules. “The check will involve a discussion with your doctor, a rectal examination and a blood test,” Dr Forrest explains. “While this may sound unpleasant, it is very quick and safe – and it could save your life!” IMC offers this prostate check as a key service, to encourage men to take the test. But, what happens if something abnormal is found and the results aren’t what you’d hoped for? “If further investigation or treatment is required, you will be referred to a urologist. Singapore has excellent specialists who are skilled in the latest treatments, including robotic prostate surgery,” says Dr Forrest, as well as more well-known methods such as radiotherapy and conventional surgery. However, the biggest challenge for doctors is that current research is undecided about which types of cases need aggressive therapy, and which can be safely monitored without it.
November is a particularly pertinent month for talking about prostate cancer. It’s the time when countless men all over the world grow a moustache as part of “Movember”, a movement that raises awareness and funds for researching and finding a cure for the disease. So, this month, why not get checked, or get the man in your life to do so? You might not be able to prevent prostate cancer, but at least you could catch it early enough to give yourself a fighting chance.
This is an article that first appeared in the November 2016 edition of Expat Living. Subscribe now so you never miss an issue!
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