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MEN: DON’T BLOW OFF THOSE HEALTH SCREENING REMINDERS

DEAR MAYO CLINIC:

I just turned 45, and I think guys my age are due for some health screenings. Which ones should I prioritize, and how often should I get them?

ANSWER:

Congratulations for getting these important health checks on your radar. Historically, men have been hesitant to seek medical attention when something seems wrong with their health. Also, they aren’t as likely as women to have preventive screenings and checkups. This is a problem because early detection is the best way to effectively treat and manage a medical issue.

Why should you reconsider your reluctance about seeing a health care professional? Delaying or avoiding a checkup or screening could lead to a treatable situation turning deadly. Here are the exams and screenings to add to your to-do list for a healthy life.

REGULAR PHYSICAL EXAMS

Males older than 50 should have a yearly physical exam, and those younger than 50 should have a physical exam every three to five years. Even if you’re feeling healthy, a regular checkup with your health care team is an excellent way to validate your health or identify a problem in its early

Mohammed Solaiman, M.D., Mayo Foundation for Medical Education and Research, Premium Health News Service

Vaccines are also essential to prevent infectious diseases. Vaccinations for men are administered at different intervals throughout adulthood.

Another thing to think about is that health isn’t only physical. Talk to your health care team about your mental and emotional health. If you’re struggling in those areas, effective help is available.

SCREENINGS

While you only need to get some screenings once, such as HIV and hepatitis C, you should have other screenings for certain conditions and cancers regularly, including:

• ABDOMINAL AORTIC ANEURYSM. For men between 65 and 75 who have smoked more than 100 cigarettes in their lifetime, the U.S. Preventive Services Task Force recommends a one-time abdominal aortic aneurysm screening ultrasound.

An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. Because the aorta is the body’s main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding. Men over 60 with a family history of abdominal aortic aneurysm should consider repeat screening at regular intervals.

• COLON CANCER. Colon cancer screening should begin at age 45 or 10 years prior to the age at which an immediate relative was diagnosed with colon cancer. For example, get screened at age 36 if your mother was diagnosed at age 46. A colonoscopy is a traditional, effective procedure to identify colon cancer or precancerous polyps. A noninvasive option available is a take-home test to screen for colon cancer. Talk with your health care professional about which option is best for you.

• DIABETES. If you’re older than 45 or have a body mass index above 25 — no matter your age — the American Diabetes Association recommends screening for diabetes. Type 2 diabetes and prediabetes symptoms can develop slowly and may not be noticeable, so staying aware of your blood sugar levels and risk of developing diabetes is essential.

• HIGH BLOOD PRESSURE. A blood pressure reading is a good indication of many aspects of your health. High blood pressure can lead to other physical problems, especially those associated with the heart.

You should have your blood pressure checked at least every two years. Talk to your health care professional about having it checked more frequently if you have high blood pressure or are at risk of developing high blood pressure.

• HIGH CHOLESTEROL. Like high blood pressure, high cholesterol may pose serious risks to your health and well-being. Starting at age 18, men at average risk for heart disease should have a cholesterol screening every five years. If you have a family history of high cholesterol or heart attacks, smoke, eat a poor diet, are overweight, have diabetes, are physically inactive or are older than 45, you may need more frequent testing.

• PROSTATE CANCER. Many organizations advise men to be screened for prostate cancer starting at age 50. However, the subject is somewhat controversial, so the best course of action is to discuss what’s best for you with your health care team.

• LUNG CANCER. The U.S. Preventative Services Task Force recommends annual screening for lung cancer with a low-dose CT for adults ages 50 to 80 who have a 20-pack-per-year smoking history, currently smoke or have quit within the past 15 years. Screening can be stopped when a person hasn’t smoked for 15 years or develops a health problem that substantially limits life expectancy.

Do yourself and your family a favor by protecting your health with regular checkups and screenings. Add to that exercise and managing your body weight, mental health and stress, which are all part of keeping you healthy.

—Mohammed Solaiman, M.D., Family Medicine, Mayo Clinic Health System, St. Peter, Minnesota

Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. This Mayo Clinic Q&A represents inquiries this healthcare expert has received from patients. For more information, visit www.mayoclinic.org.

WHAT IS PROSTATITIS AND HOW IS IT TREATED?

C.W.

Schmidt, Harvard Health Blog, Premium Health News Service

Prostatitis, or inflammation of the prostate, is more common than you might think — it accounts for roughly two million doctor visits every year. The troubling symptoms include burning or painful urination, an urgent need to go — especially at night — painful ejaculations, and also pain in the lower back and perineum, the space between the scrotum and anus.

PROSTATITIS OVERVIEW

There are four general categories of prostatitis:

1. Acute bacterial prostatitis comes on suddenly and is often caused by infections with bacteria such as Escherichia coli that normally live in the colon. Men can suffer muscle aches, fever and blood in semen or urine, as well as urogenital symptoms. Acute inflammation can cause the prostate to swell and block urinary outflow from the bladder. A complete blockage is a medical emergency that requires immediate treatment. Depending on symptom severity, hospitalization may be necessary.

2. Chronic bacterial prostatitis results from milder infections that sometimes linger for months. It occurs more often in older men and the symptoms typically wax and wane in severity, sometimes becoming barely noticeable.

3. Chronic nonbacterial prostatitis, also called chronic pelvic pain syndrome (CPPS), is the most common type. CPPS can be triggered by stress, urinary tract infections or physical trauma causing inflammation or nerve damage in the genitourinary area. In some men, the cause is never identified. CPPS can affect the entire pelvic floor, meaning all the muscles, nerves and tissues that support organs involved in bowel, bladder and sexual functioning.

4. Asymptomatic inflammatory prostatitis is diagnosed when doctors detect white blood cells in prostate tissues or secretions in men being evaluated for other conditions. It generally requires no treatment.

Both acute and chronic bacterial prostatitis can cause blood levels of prostate-specific antigen (PSA) to spike. This can be alarming, since high PSA is also indicative of prostate cancer. But if a man has prostatitis, then that condition — and not prostate cancer — may very well be the reason for the rise in PSA.

PROSTATITIS TREATMENTS

Fortunately, research advances are leading to some encouraging developments for men suffering from this condition.

Antibiotics called fluoroquinolones are effective treatments for acute and chronic bacterial prostatitis. A four-to sixweek course of the drugs typically does the trick. However, bacterial resistance to fluoroquinolones is a growing problem. An older drug called fosfomycin can help if other drugs stop working. PSA levels will decline with treatment, although that process may take three to six months.

CPPS is treated in other ways. Since it is not caused by a bacterial infection, CPPS will not respond to antibiotics. Medical treatments include nonsteroidal antiinflammatory drugs such as ibuprofen, alpha blockers including tamsulosin (Flomax) that loosen tight muscles in the prostate and bladder neck, and drugs called PDEF inhibitors such as tadalafil (Cialis) that improve blood flow to the prostate.

Specialized types of physical therapy can provide some relief. One method called trigger point therapy, for instance, targets tender areas in muscles that tighten up and spasm. With another method called myofascial release, physical therapists can reduce tension in the connective tissues surrounding muscles and organs. Men should avoid Kegel exercises, however, which can tighten the pelvic floor and cause worsening symptoms.

Acupuncture has shown promise in clinical trials. One study published in 2023 showed significant improvements in CPPS symptoms lasting up to six months after the acupuncture treatments were finished. Mounting evidence suggest that CPPS should be treated with holistic strategies that also consider psychological factors.

Men with CPPS often suffer from depression, anxiety and other mental health issues that can exacerbate pain perception. Techniques such as mindfulness and cognitive behavioral therapy for CPPS can help CPPS sufferers develop effective coping strategies.

BOTTOM LINE

“An accurate diagnosis is important given differences in how each of the four categories of prostatitis is treated,” said Dr. Boris Gershman, a urologist at Beth Israel Deaconess Medical Center and assistant professor of surgery at Harvard Medical School. PSA should also be retested after treating bacterial forms of prostatitis, Gershman added, to ensure that the levels go back to normal. If the PSA stays elevated after antibiotic treatment, or if abnormal levels are detected in men with nonbacterial prostatitis, then the PSA “should be evaluated in accordance with standard diagnostic approaches,” Gershman said.

C.W. Schmidt is editor of the Harvard Medical School Annual Report on Prostate Diseases.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.

WHAT ARE THE SYMPTOMS OF PROSTATE CANCER?

Screening with the prostate-specific antigen (PSA) test can detect early-stage prostate cancer while it’s still asymptomatic. But some men are diagnosed with prostate cancer only after symptoms appear.

For insights into how doctors distinguish prostate cancer from other noncancerous problems affecting the prostate, we spoke with Dr. Marc B. Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of the “Harvard Medical School Guide to Prostate Diseases.”

Q: What are the first symptoms a man might notice if he has early-stage prostate cancer?

A: I first want to mention that most men who are diagnosed with prostate cancer — including many with advanced forms of the disease — do not present with symptoms. When symptoms do appear in a man with early-stage disease, they affect his ability to urinate. Lower urinary tract symptoms (LUTS), as we call them, include urinary frequency, urgency, difficulty starting or stopping a stream, getting up repeatedly at night to pee, or feeling like you’re never able to fully empty your bladder. LUTS can develop if a tumor grows large enough to physically obstruct the urethra, which is the tube that carries urine

out of the body. The diseased prostate can also push up against the bladder, thereby lessening its capacity to hold fluid.

But more often than not, urinary symptoms result from other problems with the prostate. Benign prostatic hyperplasia (BPH), for instance, is a natural enlargement of the prostate that affects most men as they get older. Some men develop LUTS if the prostate and surrounding tissues become inflamed; this is called prostatitis. And if a man experiences burning sensations while urinating, then he likely has a problem with his bladder, not his prostate. Men who experience any of these urinary symptoms should be evaluated by a doctor.

Q: How would a doctor begin to narrow down the diagnosis?

A: Assuming prostatitis and bladder disease have been ruled out, the next step is to differentiate between prostate cancer and BPH. Men with BPH typically have two kinds of urinary symptoms.

Voiding symptoms caused by obstruction at the bladder outlet: they include a weak or intermittent stream and incomplete emptying.

C.W. Schmidt, Harvard Health Blog, Premium Health News Service

Storage symptoms caused by an overactive and sensitive bladder: these symptoms include a sudden urge to urinate, or needing to urinate more often during the day and night.

A red flag for prostate cancer would be having storage symptoms only, or urinary symptoms that develop very rapidly. That would be unusual for LUTS caused by BPH. These symptoms can be assessed by having men fill out a questionnaire called American Urological Association Symptom Score.

The doctor can also do a digital rectal examination (DRE). If the prostate feels symmetrically enlarged — meaning the gland is bigger but in a uniform and evenly distributed way — then that helps to establish a BPH diagnosis. If there’s asymmetry in the gland, or if the doctor feels a hard nodule, then the patient needs to be referred to a urologist for further evaluation. DREs are performed less often now than they used to be, and many doctors have no training in the procedure. That’s unfortunate, since in my view a DRE is one of the most important components of a physical examination.

Another thing people need to recognize is that BPH can eventually lead to kidney failure, or to a medical emergency called acute urinary retention, which is a sudden inability to urinate at all. So, BPH should really be treated to avoid these serious complications.

Q: Can PSA help doctors differentiate between BPH and prostate cancer?

A: It can. PSA levels rise in men with BPH as they also do in men with prostate cancer, simply because a larger, more irritated prostate gland releases more PSA into blood than a normal prostate does. Usually, we start patients on BPH drugs that can make it easier to urinate while also lowering PSA. Then after six weeks or so, we test the PSA again. If the levels come back high, then the next step is typically a magnetic resonance imaging (MRI) scan of the prostate. If the MRI is normal and the PSA is proportionate to the size of the prostate, then that helps to rule out cancer. In such cases, we can consider avoiding a prostate biopsy — at least temporarily — and continue to monitor PSA instead.

Q: What are the symptoms of more advanced prostate cancer that’s begun to metastasize or spread?

A: Even with advanced prostate cancer, many patients are still completely asymptomatic. Fortunately, we’ve gotten much better at treating advanced disease, especially now that we have better scans to identify small deposits of cancer and methods to eliminate them. When symptoms do appear, especially if the cancer has spread to the bones, men typically show up with back or shoulder

pain — basically pain where metastases grow near bone surfaces where nerves are located. Men who present with persistent back pain that’s getting worse despite treatment interventions should be considered for further evaluations such as X-ray or MRI.

Q: What about fatigue and weight loss?

A: These sorts of symptoms are more common in other cancers such as colon cancer, lung cancer and lymphoma. You typically don’t see them in prostate cancer unless the cancer is very advanced with widespread metastases.

Q: Thanks for walking us through this complex topic.

A: You’re welcome! The challenge for patients and physicians alike is to identify the causes of overlapping urinary symptoms, which are so common among men with either prostate cancer or BPH. Hopefully this discussion was helpful.

C.W. Schmidt is editor of the Harvard Medical School Annual Report on Prostate Diseases.

FOODS COMMONLY MISTAKEN FOR BEING HIGH IN PROTEIN

Leah Goggins, EatingWell.com, Premium Health News Service

Protein is needed for critical processes such as building muscle, immune response, and creating hormones and neurotransmitters. Adding protein-rich foods to meals and snacks can also support weight loss, improve your body composition and support blood sugar regulation.

Many high-protein foods and drinks can help you meet and exceed your daily protein needs. However, some foods and beverages promoted as high in protein actually might not contain as much protein as you think.

1. PEANUT BUTTER

Peanut butter is a good source of several nutrients, such as vitamin E and folate. However, though it’s often considered a high-protein food, it only contains a small amount.

Peanut butter provides 8 grams of protein per 2 tablespoons (32 grams), which isn’t enough to be considered “high” in protein. The same serving packs 200 calories, so you’d need to consume several hundred calories to get a decent amount of protein from peanut butter.

2. REGULAR YOGURT

Yogurt is a popular breakfast and snack option. Though some types of yogurt are high in protein, regular yogurt isn’t the best source.

Greek yogurt is a better option if you’re trying to increase your protein intake. It provides nearly twice the amount of protein regular yogurt does. A 6-ounce container of plain, regular yogurt contains just 8.92 grams of protein, while the same serving of plain Greek yogurt contains 17.3 grams.

3. SOME PROTEIN BARS AND BITES

Many items marketed as “protein bars” or “protein bites” only contain a few grams of protein per serving.

For example, Kind PB Banana Dark Chocolate Breakfast Protein Bars contain 8 grams of protein per two-bar serving. You can more than double your protein intake by swapping these bars for a breakfast of two eggs, a piece of cheese, and some fresh fruit.

Choose protein bars with at least 12 grams of protein per serving.

4. SMOOTHIES

Smoothies are generally not a good source of protein unless they’re made with high-protein ingredients. They can also be high in added sugar.

When shopping for premade smoothies, choose products advertised as high in protein — for example, 15-30 grams of protein per 15.2-ounce serving.

5. GRANOLA BARS

Granola bars are a convenient snack option that many people use as an easy snack. While granola bars typically provide carbohydrates and fiber, they’re often low in protein.

Many granola bars contain only a few grams of protein. Choosing high-protein bars, like those with at least 12 grams of protein per serving, can help you stay satiated.

6. NUT MILK

Cow’s milk is a good source of protein, providing around 9.68 grams per cup. However, many people have stopped consuming it due to dietary preferences, health concerns or environmental concerns.

Real Simple magazine provides smart, realistic solutions to everyday challenges. Online at www.realsimple.com.

EatingWell is a magazine and website devoted to healthy eating as a way of life. Online at www.eatingwell.com.

150 MINUTES OF AEROBIC EXERCISE PER WEEK WHY WE AIM FOR

Howard LeWine, M.D., Harvard Health Publishing, Premium Health News Service

Q: The goal of 150 minutes of moderate-intensity exercise per week seems arbitrary. Who came up with this number and why has it stuck?

The Physical Activity Guidelines for Americans, issued by the U.S. Department of Health and Human Services, recommend a minimum of 150 minutes, or 2.5 hours, of moderate-intensity physical activity or as well as two muscle-strengthening workouts per week. Organizations like the American College of Sports Medicine and the American Heart Association

However, it is important to remember that these guidelines are meant for a broad population, and for many older adults, hitting just 150 minutes per week

Until recently, more emphasis had been placed on the 150 minutes per week compared to muscle training. That made sense because it helps keep people active and less sedentary. Now experts emphasize the importance of both aerobic exercise and resistance training.

So where did the number 150 come from? When scientific advisory committees and other experts combed the body of evidence linking exercise with chronic conditions like diabetes, cancer and heart disease, a minimum of 150 minutes per week of moderate-intensity activity was repeatedly seen as the threshold for offering health benefits.

But the key word here is minimum. The guidelines set the low end at 150 minutes, and research has found that going beyond this number offers additional benefits. The 150-minute target is good to aim for, but your best regimen ultimately depends on your physical condition and goals.

Everyone is built differently and has different health concerns, which can dictate what is an effective and safe amount of activity. Your fitness goals also play a role. You may need to focus more on strength training — doing more than the recommended two days per week — to help offset sarcopenia, the natural loss of muscle mass. Or you may want to do more stretching, flexibility and balance exercises to address range-of-motion and mobility issues.

While the 150 weekly minutes is still a mark older adults should strive for, the number can feel daunting. Instead of focusing on the entire 150 minutes, break it down into manageable segments.

The bottom line is that while it is good to be mindful about reaching 150 weekly minutes, don’t focus on the number itself, but rather on living a healthier lifestyle. If necessary, begin with doing a smaller amount, like 50 minutes per week, and progress from there. Ultimately, it is about reducing sedentary time, staying active and enjoying what you do. If you focus on that, you’ll gradually reach the 150 minutes consistently and likely even exceed it.

The 7 healthiest drinks (that aren’t water)

Lisa Milbrand, RealSimple.com, Premium Health News Service

Hydration is essential for good health, but maybe you’re not a fan of gulping down plain old tap water. Fortunately, if you’re bored with water, there are plenty of other healthy beverages you can drink to stay hydrated — and they can even provide you with things that water can’t, like potent antioxidants and vitamins.

While you shouldn’t go overboard with any of these drink options — no one needs 10 cups of coffee per day! — by including a few of these in your daily drink menu, in between your glasses of water, you’ll ensure that you stay hydrated and maybe get a few other health boosts, too.

SMOOTHIES

Smoothies can be a quick and easy way to get nutrients fast and serve as a meal substitute when you’re busy and on the go. But you just have to be a bit cautious that you don’t go overboard with the add-ons, says Theresa Gentile, MS, RD, CDN, spokesperson for the Academy of Nutrition and Dietetics.

She guides her clients to the following ratios for a good smoothie:

• 1 1/2 to 2 cups frozen fruit

• 1/2 to 1 cup raw veggies

• a serving of a thickening protein (think 1 tablespoon nut butter, 1/2 cup Greek yogurt or kefir, 1/4 of an avocado)

• liquid of your preference — such as milk or plant-based milk

COFFEE

Beyond the caffeine, coffee has some definite health benefits. Studies have shown three cups of coffee per day can reduce your risk of developing cardiometabolic morbidities like cardiovascular disease and Type 2 diabetes. And if you’re a fan of black coffee, the drink can help reduce inflammation; adding goodies into your coffee, like milk or sugar, can actually cause inflammation.

Coffee consumption: Keep your coffee intake to the morning hours to help get a longevity boost from your favorite beverage.

TEA

Whether you like green, black or herbal teas, tea provides plenty of benefits in every sip. For instance, green tea offers potent antioxidants called polyphenols that help your body fight off disease and inflammation, while black tea contains flavonoids that support heart health. Peppermint and ginger teas are great for helping settle nausea and aiding digestion.

KOMBUCHA

Kombucha has been a popular addition to many people’s beverage repertoire, as this lightly fermented tea features the gut health benefits of fermented foods, along with the antiinflammatory boost of tea. Keep in mind that kombucha does contain trace amounts of alcohol and eight grams of sugar per cup, so keeping it to about four ounces per day is best.

MILK OR PLANT-BASED MILKS

Low-fat dairy or plant-based milks can be a healthy addition to your beverage repertoire. Gentile recommends sticking with unsweetened cow’s milk, almond, soy, oat or coconut milk.

COCONUT WATER

Coconut water is a nutrient-packed superfood that’ll help keep you hydrated and boost your antioxidant intake. Just enjoy in moderation, as every cup of coconut water has more than six grams of sugar.

SPARKLING WATER OR INFUSED WATER

Yes, technically this is still water. But by adding a hint of flavor or bubbles, you can turn it into something more exciting to drink — and a great alternative to sugary or artificially sweetened sodas. Simply putting fresh-sliced fruits and veggies — think lemons, cucumbers, berries or citrus — along with herbs like rosemary or mint, can make water a lot more palatable.

Real Simple magazine provides smart, realistic solutions to everyday challenges. Online at www.realsimple.com.

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IT’S NEVER TOO LATE TO PREVENT SKIN CANCER

Howard LeWine, M.D., Harvard Health Publishing, The Medicine Cabinet

Q:I recently had a basal cell skin cancer removed. Is it too late to take precautions against future skin cancers?

A:Many people feel that there is no point in using sun protection after skin cancer because the damage that could lead to other cancers was done a long time ago. While it is true that past damage is often responsible for recurrences, new damage can also lead to new cancers.

Whether you’ve never had skin cancer or you’re vigilant after a previous diagnosis, understanding and practicing thorough safety measures can significantly reduce your risk of new or recurring cancers.

The first step in sun protection is to find a good sunscreen — and apply it properly. A broad-spectrum sunscreen protects you against two types of solar radiation: ultraviolet A (UVA) and ultraviolet B (UVB). UVA exposure is linked most closely with skin cancer. However, UVB causes sunburns, and experts generally believe that the more often you’ve been sunburned, the more likely you are to develop melanoma.

There are two basic types of sunscreen: chemical or mineral. Chemical sunscreens absorb the sun’s rays, and mineral sunscreens physically block UV radiation.

When it comes to choosing the sun protection factor (SPF), the numbers can range from 8 to more than 100. The American Academy of Dermatology (AAD) recommends 30 or higher. SPF 30 filters out about 97% of harmful rays, and SPF 50 filters out 98%.

Once you’ve purchased your sunscreen, the key is to apply it properly. To fully cover your body, the AAD recommends using an ounce of sunscreen, enough to fill a shot glass. Apply it 15 minutes before going outside and then every two hours you’re still outdoors. You should also reapply it after swimming or sweating.

According to the AAD, no sunscreen can protect against 100% of UV rays. Plus, sunscreens wear off, and few people reapply them properly. That’s why additional strategies are also needed.

• HATS. A hat can go a long way toward protecting your face and neck when you’re out in the sun. Choose a hat with a wide brim that extends two to three inches to shade your neck, nose and ears. A baseball cap isn’t sufficient.

• SHIRTS AND PANTS. Any clothes with a tight weave and long sleeves or legs can provide some level of protection. But there are also lines of clothing that are specially designed for sun protection.

Even the most scrupulous use of sunscreens and protective clothing is not as effective as minimizing exposure to dangerous UV light in the first place. The sun’s rays are most intense between 10 a.m. and 2 p.m., so if you’re going to be spending time outside, try to do so early in the morning or later in the afternoon.

TRY THIS: WARM-UP FOR WALKING AND RUNNING

Solan, Harvard Men’s Health Watch, Premium Health News Service

Follow this three-step routine before your walk or run to prepare your muscles and joints for movement, address any stiffness and prevent soreness. It focuses on the key lower-body areas: hips, buttocks, calves and feet. For each move, begin by standing with your feet together, hands on your hips, or if needed, hold on to a steady surface for balance.

1.Leg swings. Shift your weight to your left foot. Slowly swing your right leg forward and back, increasing your range of motion by lifting your leg a little higher each time, up to about a foot or so off the ground. Tighten your buttock muscles on the backswing. Complete 10 to 20 swings, switch legs, and repeat.

2.Hip circles. Raise your right knee in front of you. Slowly move the knee clockwise in a circle, rotating from your hip. Do eight to 10 circles and lower your leg. Repeat, rotating the knee counterclockwise eight to 10 times. Repeat the sequence of circles with the left knee.

3.Foot rolls. Lift both heels, rolling onto your toes, and hold for a moment. Lower your heels to the ground, then immediately roll back onto your heels, pulling your toes up, and hold for a second. Repeat this continuous rolling motion until you’ve completed 10 to 20 rolls.

Matthew Solan is executive editor of Harvard Men’s Health Watch.

Matthew

UNDERSTANDING COLORECTAL CANCER

DEAR MAYO CLINIC:

I recently read that more and more young people are getting diagnosed with colorectal cancer. I’m in my 30s, am I at risk? What does colorectal mean?

ANSWER:

The term colorectal cancer combines colon and rectal cancer, two parts of the intestine. The first part of the large intestine is called the colon, and the last part refers to the rectum. These two divisions of colorectal cancer are important because they’re often treated differently. Cancers of the colon, for example, may initially be treated through surgery. With cancers of the rectum, we may do treatment long before someone goes to surgery.

Symptoms of both cancers are similar and can include unintentional weight loss, overall changes in bowel characteristics such as more frequent diarrhea, blood from the rectum or in the stool and ongoing abdominal pain, cramps or gas. These symptoms can

Derek Ebner, M.D., Mayo Foundation for Medical Education and Research, Premium Health News Service

be embarrassing for some people to talk about, and that is normal. However, it is extremely important if you have any of those symptoms to share it with your healthcare team. Early diagnosis of colorectal cancer increases your chance of survival.

People of all ages are at risk for colorectal cancer. It is true that there have been increased rates of colon and rectal cancer in younger patients, which has led to a shift in screening recommendations. We used to start screening average-risk individuals at age 50, but because of this new trend, we’re now encouraging average-risk individuals to start screening at age 45. Through screening, we can prevent the development of cancer and capture polyps — precancerous growths — even before symptoms start.

It is unknown what has caused this increase among young people. Findings show that it may be an environmental factor. Over the last 50 years, we’ve seen major changes in diet. Ultraprocessed foods and higher quantities of red meats have potentially led to some negative changes to the bacteria that are normally in our gut, making it not as protective as it once was. A decrease in exercise and an increase in obesity also could be contributing factors. Living a healthy lifestyle is critical — exercise and a wellrounded diet can help protect you.

We typically divide people into two groups: those who are at average risk and those who are at high risk for colorectal cancer. Average-risk individuals are people who don’t have any associated symptoms that would be linked to colorectal cancer or have any of the factors that would place them at high risk.

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For those who are at high risk, there tends to be at least one of three variables:

1. A medical condition that places them at higher risk.

2. A genetic condition that increases their risk.

3. A family history that places them at higher risk. For example, a first-degree family member such as parents or siblings who have a diagnosis of colorectal cancer or advanced polyps.

Any of those three components would place you at higher risk, and therefore, you should start screening sooner and possibly more often than average-risk individuals.

When it comes to cancer care, we try to make our efforts personalized, particularly with rectal cancer. The treatment team consists of a gastroenterologist, an oncologist, a surgeon and a radiation oncologist who help direct what the next best step would be for you, whether that’s chemotherapy, immunotherapies, surgery or radiation.

Any delay in sharing information translates to a delay in diagnosis, which can lead to later-stage cancer. It is the later-stage cancers that can be a bit more challenging to treat. Don’t delay in making an appointment. — Derek Ebner, M.D., Gastroenterology, Mayo Clinic, Rochester, Minnesota

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