HEALTH

Published with the permission of the Men’s Health Network (MHN) and Cassie Whyte. This article first appeared on the MHN Blog. https://tamh.menshealthnetwork.org

PROSTATE CANCER IS THE MOST COMMON CANCER IN MEN

The Case for Prostate Cancer Diagnostics & Treatments

Written By: Cassie Whyte

A few days ago, I had the pleasure of speaking with prominent Urologist, prostate cancer expert, and men’s health advocate, Dr. E David Crawford. Throughout his decades of experience, Dr. Crawford has dedicated himself to improving prostate cancer diagnostics and treatment, as well as educating students and the public alike about men’s health and its intersection with urology. As the third leading cause of death in men, prostate cancer remains relatively understudied and disregarded by health advocates. But Dr. Crawford maintains a positive attitude:

We’ve got to get away from the way we’ve been burying our heads in the sand with prostate cancer. It’s not that hard, really. Prostate cancer is the most common cancer in men, second leading cause of death. If we find it early, we can treat it, cure it, or control it…it’s pretty simple.

Having been devoted to the field of urology for the vast majority of his professional life, Dr. Crawford has been present for every stage of development, evolution, and regression, in terms of treating and containing advanced prostate cancer. He explains how prostate health awareness had a proclivity to lag behind other anticancer campaigns:

“It goes back many decades, dealing with so many patients who walked into my clinic with advanced, incurable prostate cancer. A couple of friends too.”

The nonprofit and advocacy realm regarding breast cancer, for instance, had been thoroughly solidified as a benevolent, preventative force by the 1970s. Dr. Crawford continues,

“There was a lot of interest among women and discussions about breast cancer, and we were way behind that. We didn’t see that. And that was very successful, the whole movement about early detection of breast cancer. We were really dragging.”

Luckily, a small group of illustrious healthcare professionals, such as Dr. Crawford, helped prostate cancer awareness catch some steam in popular discourse by collaborating with and incorporating public figures in the discussion. Dr. Crawford retells,

“There are a couple of well known men who got prostate cancer a couple of decades ago. I had the chance to work with a couple of them, General Norman Swartzcoff, General Powell…Bob Dole…and that generated a lot of interest too.”

Encouraging politicians, athletes, and celebrities to act as frontier educators is always a great way to animate the public; it also has an overwhelming effect on normalization and destigmatization, particularly regarding health issues that are otherwise perceived as embarrassing or marginalized. Prostate cancer, especially previous to the ubiquity and triumph of the Prostate-Specific Antigen test (PSA), is very much so one of those issues. The intrusiveness of the classic prostate exam proved a difficult obstacle for both professionals and patients to overcome:

“The way to diagnose prostate cancer back then…we didn’t have any mammograms. The only thing you’d do was a rectal exam. The acceptance of that was not terrific, as you can imagine.”

The introduction of the PSA was a transformative endeavor. Dr. Crawford remembers when the PSA was first approved, declaring that,

“The rectal exam, even when you felt something, it was usually more advanced…but then a sort of miraculous thing occurred: this blood test, PSA, came out. That was the game changer.”

Not only is the PSA less intrusive and thus less intimidating, but it is consistently more effective and advantageous. PSA is a protein produced by tissue in the prostate which can be either cancerous or noncancerous. The test measures the amount of this protein and detects abnormally high levels, subsequently indicating that a man may potentially have prostate cancer. An enlarged prostate and other related conditions can also increase PSA levels, but the test is a uniquely efficient means of eliminating those who are at very low risk. Dr. Crawford refers to this process as…

“Throwing out a large net, and catching the big fish.”

But the success of the increasing prevalence of PSA did not come without its own detriment. Due to the rapid and widespread implementation of PSA usage, coupled with an eagerness to learn more about prostate cancer,

“A lot of over-diagnosis and over-treatment occurred,”

says Dr. Crawford. He proclaims that this…

“Led to a number of organizations, and rightfully so, saying ‘Hey, we gotta put the brakes on this, we gotta stop the screening, because we’re doing more harm than good.’”

While PSA was revolutionary in detecting prostate cancer, it required a complementary tool that would distinguish which cancers necessitated treatment. Prostate cancer is unique in that it is somewhat inevitable in aging men:

“If you ripped prostates out of a hundred 90 year old men off the street, you’ll find 80% of them have prostate cancer.” And even more shocking is the fact that, “They don’t know about it, and they never will.” Because of this peculiar disposition, primary care physicians and urologists alike must be equipped with not only PSAs, but molecular markers, which help to isolate life-threatening cases of prostate cancer from less risky manifestations, or, as Dr. Crawford calls them, “toothless lions.”

           After a steady pattern of over-diagnosis and over-treatment of prostate cancer, and the resulting pressure from organizations and stakeholders to minimize usage of the PSA screening. As Dr. Crawford articulates,

“We were over-treating people, and they were having side effects, and they didn’t need the treatment…we got together and said, we’re harming most people, let’s not do it. Then that blew up in everybody’s face, because prostate cancer, the advanced disease, it has started creeping back in and becoming very common again.”

Prevention and treatment of prostate cancer is, ultimately, a balancing act. Medical professionals and researchers must walk a very delicate line and avoid over-correction on either side. Luckily, Dr. Crawford maintains that there is a pathway to do so: PSA screening, molecular markers.

“It’s not that difficult, but we make it difficult,” he says.

Dr. Crawford also emphasizes the fundamental importance of taking personal preventative measures, such as prioritizing nutrition, fitness, and moderation. Moreover, men specifically have a detrimental tendency to disregard recommended health practices; they regularly skip annual checkups and fail to follow up with their primary care physicians, even when issues present.

Dr. Crawford recalls a comical, but incisive anecdote:

“I’ll tell you a story of a guy who came to see me a couple years ago. I said to him ‘Yes sir, why are you here?’ and he says ‘I don’t know.’ I say ‘What’s the problem’ and he says ‘Nothing.’ …I said ‘Who told you to come here?’ He says, ‘My wife!’ I said ‘Oh yeah, why did your wife send you here?’ He says, ‘She sent me to see you cause I get up to urinate 6 times a night. It doesn’t bother me, it bothers her!’ There’s something to be said about that.”

Men are socialized to pull themselves up by their bootstraps. Even concerning subjects as potentially fatal as their own well-being, seeking health care is sometimes framed or perceived as weakness. “Men tend to be somewhat stoic and  say, ‘Oh nothings gonna harm me,’” says Dr. Crawford. But that conception is terribly misguided. And that very faulty reasoning is, perhaps, upstream of men’s falling behind in critical health metrics, such as the astonishingly disparate lifespan gender gap.

Throughout my conversation with Dr. Crawford, he was insistent on highlighting one question in particular: “How do you motivate people?” In other words, how do we, as medical professionals and advocates alike, consistently and persistently encourage people to proactively pursue their own health?

“Most people know you shouldn’t smoke, you shouldn’t drink too much, you should exercise…it’s hard to find anybody that argues with most of that, any of that. Except, we don’t do it,” he says.

Approaching one’s own health, as a comprehensive constellation of environmental factors and biological predisposition, can be extraordinarily intimidating. But knowing the facts regarding one’s family history, genetic risk factors, and psychological disposition provides a great infrastructure. As for health professionals and advocates, it can sometimes feel like a frustrating and impossible project; it all comes down to that aforementioned question: how do you motivate people?

Dr. Crawford provides a working answer:

“Well, everybody’s buttons are different. That’s where the art of medicine comes in, what turns some people on and what doesn’t. That’s where we need a team approach. For some people it’s their apple watch. For some people it’s, ‘Hey, if you don’t change your lifestyle, you’re not gonna live 10 years.’ It’s variable.”

This may seem like a pessimistic takeaway on the surface, but really, it is not. Health is less of a singular metric as it is a perpetual process of self-improvement, personal initiative, and medicinal intervention when necessary or beneficial. The good news is: we are all, at least to some extent, masters of our own well-being.

As for his closing advice, Dr. Crawford offers…

“You gotta stay on top of it. Weight, diet, exercise, things like that–that’s better than any medication we can give you most of the time.”

HOW TO VOLUNTEER FOR ALZHEIMER'S CURE RESEARCH

No volunteers for clinical research, no cure for Alzheimer's and other dementias. It is that simple. The Alzheimer's Association thusly emphasizes the importance of volunteers: 

Without clinical trials, there can be no better treatments, no prevention and no cure for Alzheimer's disease. Scientists work constantly to find enhanced ways to treat diseases, but improved treatments can never become a reality without testing in clinical trials with human volunteers.

You can easily volunteer for the Alzheimer's Association's TrialMatch program, or for the AHEAD Study funded by the National Institutes of Health (NIH).

 The AHEAD Study is an investigational trial of lecanermab, an FDA-approved medication. The study will determine whether the early treatment of a person who is symptom free, but at risk of developing Alzheimer's in later life, will substantially lower his probability of developing Alzheimer's by reducing the amyloid plaque in the brain.

This study requires volunteers who:

• Are healthy adults ages      55-80.
• Have not been diagnosed with      Alzheimer’s disease or another dementia.
• Have a study partner, either      a close relative or friend, who will participate in one study visit      per year.
• Have elevated or      intermediate levels of amyloid in their brain found by imaging as part of      the study.

The AHEAD Study is a four-year clinical trial evaluating a potential treatment to slow the earliest brain changes and may help prevent symptoms associated with Alzheimer’s disease. The study requires a number of medical procedures that will be performed at no cost to participants, including:

· Physical examinations

· Memory and thinking tests

· Positron Emission Tomography (PET) scans (pictures of your brain taken by a device similar to an x-ray, after injecting a small dose of a detectable dye in your arm to look for the amyloid plaques and tau tangles associated with Alzheimer’s disease).

· Magnetic Resonance Imaging (MRI) scans (pictures of your brain taken by a device similar to an x-ray to assess changes in your brain structure)

· Blood and urine tests

· Once or twice-a-month intravenous (IV) infusions of an investigational treatment (or placebo) that aims to help remove amyloid plaques from the brain.

For additional information about the Study or to learn whether you are a qualified applicant contact AHEAD at 800-243-2370 or https:/www.AHEADstudy.com.

The Alzheimer's Association TrialMatch needs volunteers for trials for these seven diseases:

· Alzheimer’s Disease (692 trials available)

· Dementia (692 trials available)

· Lewy Body Dementia (57 trials available)

· Mild Cognitive Impairment (328 trials available)

· Vascular Dementia (33 trials available)

· Frontotemporal Dementia (43 trials available)

• Parkinson's      with Dementia (5 trials available)

TrialMatch makes it easy to identify studies you may qualify for in a location near you. Our continually updated database contains hundreds of studies being conducted at sites across the country and online. Find potential studies in these three easy steps:

1. Start      TrialMatch. Get      started by calling 800.272.3900 or emailing TrialMatch@alz.org.
2. Answer a few      simple questions. This information will refine      the list of recommended studies to those that best apply to you or the      person you are helping sign up. All information is kept completely      confidential unless you choose to share it with a study team.
3. Review your      study matches. You’re      under no obligation to participate. You can reach out to researchers      directly to sign up, or let researchers know that you are open to being      contacted with more information about their study.

Get started.

If you have questions about TrialMatch or your clinical study matches, please call the Alzheimer's Association at 800.272.3900 or email TrialMatch@alz.org.

VISION PROBLEMS MAY DISGUISE ALZHEIMER’S

If your eye doctor can't diagnose your vision problems, you may want a referral to a first-class neurologist to determine if you have a rare variant of Alzheimer's 

called posterior cortical atrophy (PCA) also called the Benson syndrome.It affects areas in the back of the brain responsible for spatial perception, complex visual processing, spelling, and calculation.

A Washington Post article published this week summarized the results of the first extensive study involving 1092 PCA patients in 16 countries published in most recent The Lancet Neurology journal. According to the WP article, researchers determined that PCA may be responsible for as many as 700,000 or 10% of the Alzheimer cases in America. Researchers at the University of California San Francisco lead an international team that found, among other facts, that PCA began at about age 59, about five or six years earlier than most other Alzheimer’s variants, and that 60% of the victims were women.

Most commonly, the early symptoms of Alzheimer’s include memory issues followed by a gradual deterioration of cognitive abilities and the memory of CPA victims often remains normal, while they demonstrate the eyesight symptoms of PCA. According to the study, because of these two factors, PCA was not properly diagnosed for an average of four years after the onset of symptoms. The study also found that some patients experienced memory decline within one or two years after the visual symptoms appeared.

According to The Memory and Aging Center at the University of California’s Weill Institute for Neuroscience, “In people with PCA, the visual problems are not due to problems with their eyes. Rather, the shrinking brain can no longer interpret and process the information received from the person’s healthy eyes.”

Symptoms of PCA may include:

· blurred vision, 

· difficulties reading (particularly following the lines of text while reading) and writing with non-visual aspects of language preserved, 

· problems with depth perception, 

· increased sensitivity to bright light or shiny surfaces,

· double vision and difficulty seeing clearly in low light conditions, 

· trouble accurately reaching out to pick up an object. 

As the disorder progresses, other symptoms evolve such as getting lost while driving or walking in familiar places, misrecognition of familiar faces and objects, and rarely visual hallucinations. Calculation skills and the ability to make coordinated movements maybe affected in some cases.

Regarding the cure and care for PAC patients, the Center states:

Although no cure for posterior cortical atrophy exists, several medications, as well as many non-pharmaceutical approaches, can potentially improve daily functioning and quality of life. Patients with posterior cortical atrophy can often benefit from physical and occupational therapy.

Cholinesterase inhibitors approved for Alzheimer’s disease, like donepezil (Aricept®), rivastigmine (Exelon®) and galantamine (Razadyne®), can help the symptoms of PCA by boosting the function of brain cells to compensate for damage caused by Alzheimer’s disease.

Patients experiencing depression, irritability, frustration and a loss of self-confidence may benefit from antidepressant medication.

Hopefully, this study will lead to earlier diagnoses of PCA and increased research toward better treatments and, ultimately, a cure.

Sources:

Memory and Aging Center. UCSF Weill Institute for Neuroscience

“For some Alzheimer’s patients, vision problems may be an early warning” by Mark Johnson, Washington Post, January 23, 2024

“Posterior Cortical Atrophy: new insights into treatments and biomarkers for Alzheimer’s disease” Bejanin and Villain, The Lancet Neurology, February 2024, Vol 23 No 2, p 123-218

THE NEED AND SUPPORT FOR A FEDERAL OFFICE OF MEN'S HEALTH

Men need help. In the last decade, suicides have rocketed up, and life expectancy has plummeted like a cannonball dropped in the ocean.

To reverse these tragedies,the federal government must provide the same broad mental and physical health care programs as well as research programs to determine why so many men, young and old, are killing themselves and why they are dying earlier.

Representative Donald M. Payne Jr., founder and co-chair of the congressional Men's Health Caucus, reintroduced the Men's Health Awareness and Improvement Act that would establish an Office of Men's Health within the US Department of Health and Social Services (HSS) to support and promote programs and activities to improve the state of men's physical and mental healthcare nationwide. 

This proposed bill has the support of two well-respected men's health care advocates:  Ron Henry, president of the Men's Health Network, and Richard V. Reeves, president of the American Institute of Boys and Men at the Brookings Institute and author of the recently published Of Boys and Men support this legislation. This article includes my interview with Mr. Henry and the article I wrote about Mr. Reeves’ recent article supporting this legislation. 

Men’s advocates want the federal government to fund health care programs as needed iregardless of gender and age. Some women express concern that new men’s health programs will come at the expense of care for women. Men’s advocates seek equal care, not special care. and unanimously respond that they do not support the reduction of care for women to provide care to men. Common sense should tell woman women that healthy men make better fathers, spouses, brothers, lovers, and friends.

INTERVIEW WITH RON HENRY

I recently interviewed Ron Henry, President of the Men’s Health Network (http://www.menshealthnetwork.org), a well-established advocate for improved health care for men and boys.

Dan Bell

Thanks for taking the time to talk with me. I’ll begin by asking you what you consider to be the Men’s Health Network’s most important goal currently?

Ron Henry 

We're trying to do our bit to reduce the lifespan gender gap.

Dan Bell 

Very good. And how do you go about doing that? What does Men's Health Network do?

Ron Henry 

I advocate primarily for education and advocacy. There are other groups that do local community services, health clinics and so on. But what's been missing in the discussion about mental health is somebody to look at it from a broader perspective and try to create real change so that more people are paying attention to the underserved men. That brings us back to the lifespan gender gap. There's nothing inevitable or inexorable about the current situation where men on average die younger than women. That gap has grown and shrunk over the decades. In the last few years, it's been growing unfortunately. For example, men suffered 60% of the COVID deaths. They're also disproportionately affected by the suicide epidemic and the fentanyl epidemic. So, men have born and continue to bear the larger portion of some real tragedies. And Men’s Health Network’smission is to bring more attention to the need to take care of the fathers and brothers with every bit as much fervor as we do for the mothers and daughters. The men who have been struggling deserve to enjoy their lives as well.

Dan Bell 

And what kind of success have you had? How do you measure your success? 

Ron Henry 

Well, when the lifespan gender gap is shrinking, we jokingly claim 100% exclusive credit for making that happen. But it is a marker. That's very important. If you look back 100 years ago, the lifespan gender gap between men and women was as small as one year. And there's historical evidence indicating that up until the Industrial Revolution and the great growth of medical science, men on average lived longer than women. But starting around 1920 the gender gap grew and grew through the 20th century and peaked at about 7.9 years in 1980. This enormous lifespan gender gap occurred because. medical science made progress for both sexes during those 100 years but made progress more rapidly for women than for men Then around 1980, it started to shrink again and got down to as low as 4.4 years. The radical shift from 7.9 down to 4.4 shows that it can be closed if we pay attention to it. Publicizing issues which can cause premature death, such as smoking, helped reduce the gender gap. But as I mentioned a minute ago, the problem that we're facing right now is that having shrunk to 4.4 years and trending downward. It's already gone up again partially because of COVID, suicide, drug overdose deaths, and a lot of accidental deaths and a lot of unintended deaths. It's a great tragedy and loss for our society including the women who may lose a husband or partner.

Dan Bell 

Do you see any connection between the loneliness in older men that was mentioned in the recent Surgeon General's report and premature death?

Ron Henry 

Absolutely. There's a real challenge that we're facing right now as a society. We live in a time when it's difficult to get empathy for older men. The Washington Post did a very nice article. Several of us were quoted in it. And one of the key elements of that article was recognizing that as a society, we are really not paying attention to men, to their humanity and their wellbeing, in the same way that we're paying attention to women. Now, it's great that medical science and society has made progress for women and girls. Our mission at Men's Health Network is to say, hey, we're the other half of the population. Can we please catch up a little bit?

Dan Bell 

And is there any evidence that the policy makers are listening to you and proposing changes that would allow men to catch up?

Ron Henry 

So, obviously, we're working on it. There's a bill pending in Congress right now to create an office of men's health. There are other activities to create commissions on men's health at the state level or even at the city or county level. But truth be told, it's an area that is grossly underdeveloped. If you look around the country, at the state level, the county level, the city level you'll find an astonishing number a Women's Commissions, women's health groups, women's legal position issues, and many, many commissions and organizations agencies that are created to help women and girls. At the federal level. for example, there are separate offices of women's health and there are zero offices for men’s health. . So, it again, it's great that women's health is getting attention, and it has made a difference. For example, women's lifespans have increased faster than that of men. And again, we're really pleased to see the medical science advances for women. We support the attention given to women and we do not want that reduced. However, our idea is that it would be great if we could give the same attention to men’s health and help them catch up.

Dan Bell 

I noticed on your website that you have prominent partners who are working with you on this. Is there any type of movement among the partners such as forming their own committee and moving forward? 

Ron Henry 

We belong to several coalition's, some of which we would be the founding member or the organizing member, and each one of these coalitions brings attention to one aspect of mental or physical health. Clearly, there are coalition's centered around prostate cancer, testicular cancer, different organs, different cancers that are unique to men and different diseases that are unique. But also, it's important that these coalition's pay attention to those conditions that, are even if they're not exclusively men, they tend to effect predominantly or mostly males. So, whether you're looking at colorectal cancer, diabetes, heart disease, or lung disease, there are many places where men are most of the patients, most of the sufferers, but we still have not paid enough attention to the men in those respective communities. And that's one of the things we're trying to do. We want to level the playing field so that we value all lives equally.

Dan Bell 

I read recently that the suicide rate for older men is close to four times that of women. Are you familiar with that?

Ron Henry 

Yes. That is one of the great tragedies. If you look at every age range from elementary school kids up to older folks who are in their 70s and 80s, there are more completed male suicides than female suicides. And a lot of it comes from the under diagnosis of depression in males. Typically, a doctor screens for depression by looking at symptoms like is the person sad, does the person cry a lot? These are the kinds of symptoms that women would typically exhibit if they're depressed, but typically are not the kinds of symptoms the man would express if he's depressed. Male depression more often exhibited as withdrawal from social contact, anger, sometimes violence. The male depression indicators are different. Overall, there's obviously overlap of symptoms between men and women. But if you consider the indicators of depression and men, a lot of screening tools simply don't properly detect when a man is suffering from depression and as a result, we see the completed suicide because of failing to diagnose and treat depression.

In addition, there's a strong social stigma that the man is supposed to be the strong, silent supporter-protector-provider and is not supposed to have any problems or if he does have problems, he's supposed to solve them on his own. And that's a very heavy burden that unfortunately a significant number of people are unable to sustain. And we see the consequences of that. Whether it's the suicide rate, people dropping into trying to self-medicate with drugs or alcohol, or the many different consequences that come from untreated emotional, mental, and psychological stress.

Dan Bell 

And have you come across any way to encourage men to get set aside this sense that it's not manly to do so and to seek professional help?

Ron Henry 

First, we must make it safe for the men to do so. I don't find men who are unwilling to seek help. What I find is men who are afraid to seek help because of the potential consequences of it. The guy who's afraid of losing his job, the guy who's afraid of having his family fall apart, the guy who's afraid of social stigma from the community around them. We must make it safe for men to participate in the healthcare system before we can expect them to come forward.

Dan Bell 

Have you been able to find a way to make it safe?

Ron Henry 

Well, this is where it comes back to empathy and concern. And again, the Washington Post article was very strong on this, recognizing that the lack of or shortage of empathy for the humanity and the vulnerability of the male half of our population is a real problem. And it is something we must work on societally. We can't just tell the man you need to do X by adding your one more thing to the list of things he needs to do. We must help make it possible for him to do those things. We must make it safe to use those things. And we must make it practical for him to do those things. So, for example, men are less likely to have health insurance than women. That's a surprise to many. But the way our social programs are structured, it's easier for women to get coverage than it is for men to get coverage. Take a program like WIC which is for women, infants, children. What's missing from that? Obviously, the men are simply missing from that program. And we have many programs like that where either the men are excluded entirely or it's harder for men to get into the program than women.

Dan Bell 

And you mentioned the bill that's pending in Congress. Is there an active opposition to it? Or is it just a matter of not being high up enough on the priority list?

Ron Henry 

Well, first, the bill is pending right now. We only recently been introduced, and people are still signing up as co-sponsors of it. It'll be a while before it gets the committee hearing. Second, in terms of the risks or the difficulties in passing the legislation, the real challenge is there are some people who, unfortunately, have a kind of a zero-sum mentality, that somehow anything we're doing to help men must necessarily disadvantage women. But of course, that's not true. If you look at the impact on the family, the wives, the daughters, mothers, the sisters, you’ll find that the people who love and depend upon men really want their brothers, fathers, husbands to stay alive. All those women are adversely impacted by premature death and disability. In addition, government is impacted by premature death and disability among men. The government loses productive taxpayers, loses productive workers, and loses intellectual and physical capacity. The government pays out benefits to survivors and pays for disabled people who could have been kept in better health for a longer period. So, the government suffers a tremendous loss from premature death and disability among men. Same thing with employers that lose productive workers. They must try to find a replacement for a skilled worker. They must train somebody in a tight labor market. Same thing with communities. Communities lose all the contributions that those men could continue to make if they had lived longer. So, it's not a zero-sum game. You know, we're very excited about and grateful for the progress that has been made for women. And we're simply saying, that's great. It proves it can be done. Now, let's do that for the men as well.

Dan Bell 

And one last question, Ron. Women have been favored over men in terms of health care. Is there any sense that younger men and middle-aged men have been favored over older men and that older men have been left out of the discussion in improving care? 

Ron Henry 

That one's got more challenge because it requires a breakdown of the different kinds of services. So, in fact, in one respect, older men are taken care of better than younger men because Medicare's available to older men, whereas younger men are less likely to be eligible for the various programs. We mentioned WIC earlier. There's also Medicaid other programs that are disproportionately available for women. The biggest problem that we have is that many men are simply not connected to the health care system. If you look at little kids, they start out with their parents taking them to the pediatrician. As they get into the teenage years, the boy stops going to the pediatrician. He doesn't go to a doctor at all unless he needs a sports physical maybe. The girl starts going to the gynecologist on a regular basis and maintains communication with the healthcare system. That just doesn't exist in the same way for the boy. So, when they start their job, or move away to college, or you step out of the family home and away from that original pediatrician experience, you find that the girls are connected to the health care system and the boys aren't. So that continues through the 20s when the boys think they're invincible and that there's no reason to go to the doctor. It continues into the 30s where the young men are now busy building their careers and building their families and simply don't have time to think about the doctor. It continues into their 40s where they're getting a little bit nervous, but maybe don't want to know and continues into their 50s where for some of them, it's becoming too late to get the proper treatment for a disease. So, you have a life cycle that compounds men's separation from the healthcare system, all of which needs to be attended to.

Dan Bell 

Okay. Thank you very much. You're very articulate. And very informed. Again, I appreciate taking your time. 

Ron Henry

I think we've covered quite a bit. Thank you for setting this up. I'm glad to have the outreach from your organization. 

RICHARD REEVES ARTICLE

Richard  Reeves illustrates the necessity of nationwide improved mental health care for men and physical health care for men with these two facts: One, the projected life expectancy in the US in 1921 was 73.5 years for women for men and 79.3 years for women that is  5.8 years was one year wider than the 4.8 gender gap reported in 2010, and, male suicide rates are four times higher among boys and men than girls and women and rising. No concrete explanation exists for either of these startling and frightening sets of statistics. According to Reeves, “… the lack of awareness of men's health problems creates a lack of political will to address them which in turn undermine support for male-focused healthcare.”

He is right. The misnamed “Healthy People 2030” program, run by HSS, shamefully illustrates the lack of attention given to men's physical and mental health problems. The program’s vision sees “…(A) society in which all people can achieve their full potential for health and well-being across their lifespan.” To achieve this, the program’s mission will  “… promote, strengthen, and evaluate the nation's efforts to improve the health and well-being of all people.” Note that both vision and mission included “all people”. 

Reeves notes that this program specifies 29 Health targets for women,18 Health targets for LG BTQ people, and, for men and boys, four health targets, that's right 4, which three of which relate to sexual health and the fourth to reducing the death rate from prostate cancer.

”This is a glaring disparity in official health goals for the nation, especially in light of the wide and growing life expectancy gap between men and women, and the high and rising risk of death from suicide for boys and young men.” Reeves said. “ I don't think this is because the officials at HHS don't care about boys and men. I think it is because there are no official agencies in government with this with a specific focus on the health of boys and men, advocating on their behalf.”

For Reeves, a federal Office of Men’s Health is ‘…an idea whose time has come.”

Reeves and Henry are right. An Office of Men's Health would become the organizational structure that would provide programs to treat men’s and boys’ mental and physical health and research answers to the complicated questions about the causes of the growing life expectancy disparity gap and the rising suicide rate.

Contact Ron Henry at http://www.menshealthnetwork.org

Contact Richard Reeves at ofboysandmen@substack.com

VISION PROBLEMS MAY DISGUISE ALZHEIMER’S

If your eye doctor can't diagnose your vision problems, you may