Fall 2015, Article 70




Men’s Heath – A Personal Perspective, by Michael D. Lutz, M.D., 2014

In January, 1978 when I was a first year medical student in Chicago I awoke one morning and suddenly realized that I had visible blood in my urine. I knew enough to know this wasn’t normal and after conferring with my dad, an Urologist, I immediately went to see a local Urologist in Chicago. After several tests, the diagnosis was not yet apparent and I was sent back to my apartment to recover. A week went by with no improvement, so I flew back to Detroit and went directly to the Emergency Room at Sinai Hospital. Once there I was met by a nephrologist who informed me that I had developed kidney failure and might require dialysis. Needless to say, I was beyond concerned and thought that life as I knew it was over.

After a kidney biopsy revealed reversible disease, my kidney failure was resolved and dialysis was averted. But now, as a seemingly healthy young adult male, I had developed my “Achilles heel. “

Getting a serious illness at a young age is a genuine wake-up call and definitely transforming. For most men, it’s a triggering event such as this that will initiate a healthful lifestyle that will sustain you for the rest of your life. It truly did that for me. I started running, first around the block, then

a mile, two, and then four miles. I was really out of shape for such an apparently healthy looking young guy. I enjoy riding my bike, but since 1978, I have run multiple races of varying lengths, including a marathon. My innermost circle of friends share the same passions for exercise, healthy eating and enjoying life to the fullest.

So you ask, what does this have to do with Prostate Cancer and survivorship? Everything!

The studies and data on prostate cancer and its interdependence on stress, diet, sleep, exercise, and overall lifestyle are overwhelming. However, that being said, there are some things you just cannot change; your age, race, and family history.

First, let’s discuss things you can’t change.

AGE

The risk of being diagnosed with prostate cancer increases significantly after 50 years of age and also with every passing decade. There is recent data showing a six-fold increase in the development of prostate cancer in younger men over the

past 20 years. The good news is that if you have not been diagnosed by 80 years of age and your PSA is less than 3ng/ml, it will not affect you in your lifetime and you can be spared any further testing.

RACE

Globally, men of African descent are at an increased risk of being diagnosed and dying from prostate cancer at any age relative to their Caucasian counterparts. Black men need to have earlier and perhaps more frequent screenings and more prompt reaction to PSA changes and fluctuations. If you are a man of African descent, you should think twice before considering Active Surveillance as an option and fully understand the risks and benefits of early vs. delayed intervention.

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FAMILY HISTORY

I always say, “You should pick your parents carefully,” however unrealistic this may be. A single first-degree relative confers an approximate two-fold increased risk in a prostate cancer diagnosis. More so, two first-degree family members will yield a four-fold increased risk. It is essential to know your family history in so many aspects upon which it will affect your overall health and survivorship.

Well, now that we have gotten the things we cannot change out of the way, let’s discuss the limitless benefits of being proactive.

STRESS

This is the one lifestyle change that is most difficult to alter, and for obvious reasons. Stress waxes and wanes like the tides of the ocean and are interdependent on so many aspects of life, some of which we are unable to control or effectuate change. This does not mean we should be passive and accept it. But rather, find and develop coping options through daily life modifications. Consider yoga, meditation, or some other self-fulfilling and self-reflecting tool to help overcome the rising tides.

DIET

This is one of the big ones and appears to have one of the greatest impacts on prostate cancer development, risk of recurrence, and overall survival. If it is “Heart Healthy,” then it is most certainly prostate healthy. Consuming certain foods such as cruciferous vegetables, tomatoes and watermelon rich in lycopenes, and salmon with omega-3 fatty acids, should be an easy start. Reducing your BMI plays a crucial role in prostate cancer survivorship and if elevated, might preclude you from being chosen as a candidate for Active Surveillance.

SLEEP

Recent studies on prostate cancer survivorship have demonstrated an advantage for those individuals who obtain 7-9 hours of sleep nightly. Proper sleep habits have significant rollover benefits in stress reduction, weight control, and overall functionality.

EXERCISE

No, I’m not going to tell you to train for a marathon. However,

you do need to start “pumping some blood.” Exercising a minimum of 30 minutes three times weekly will not only improve your overall heart health, it will also reduce your risk of prostate cancer progression and improve your quality of life. Working your way up to daily exercise is the ideal and its benefits will rollover into other aspects of your lifestyle such as weight, sleep, and stress reduction.

Looking back, my kidney disease may have been one of the best things that happened in my life. Although devastating at the time, it has forever changed how I perceive and engage in men’s health advocacy. It is my hope that reading my story will change even one person’s life. For it is written in the Talmud:” To save one life, is as if you have saved the world.”