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illustration by chris mcallister
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Three men in their 50s sit around a fire pit on the back porch of a Gladwyne home. Dinner is over, the kids are out of earshot, and the wives have urged their husbands to be honest.
So, beers in hand, the guys settle into deck chairs, smile politely and brace themselves for my first question. But it quickly becomes clear that they’ve heard them all before—from spouses, doctors, even their moms. And they’re so uncomfortable right now that they don’t want their names used.
What do they see as the two biggest health issues facing men in their 50s? Colon cancer and erectile dysfunction.
They’re wrong.
According to 2015 stats from the American Heart Association, the Centers for Disease Control and Prevention, and the National Institutes of Health, cardiovascular disease is the leading cause of death for men and women, claiming more lives than all forms of cancer combined. In the U.S., one in every three deaths is caused by heart disease, stroke and other cardiovascular diseases.
Given those numbers, one of the three men I’m interviewing will likely die of a heart attack or stroke. All three have heart disease in their family histories, and two of them are on blood-pressure medication.
Have any of them seen a cardiologist? No. Have their primary-care physicians suggested that they do so? Yes.
Women get poked and prodded annually at the OB/GYN. By age 50, most have had several mammograms. And giving birth is much more painful than a colonoscopy. So why do many men delay doctors’ appointments and ignore their health—are they just big babies?
Ask a guy who gives colonoscopies.
“Women I see on their 50th birthdays, right on schedule,” says Dr. Brian Copeland, chief of the department of gastroenterology and liver diseases for Crozer- Keystone Health Network. “The average age that I see men getting a colonoscopy is 54-56, later than what we want.”
Copeland has research showing that one out of three Americans between the ages of 50 and 75 isn’t screened for colon cancer. And if my Gladwyne trio is proof, most men think the procedure is worse than it is.
“I encourage them to read a ‘man’s man’ blog about colonoscopy,” Copeland says. “Mark Cuban, the Shark Tank guy and owner of the Dallas Mavericks, wrote a piece saying that he got a colonoscopy and it wasn’t that bad. He took the edge off of it for a lot of guys.”
Preparing for a colonoscopy is unpleasant, but it lasts for only a day. “I say to my patients, ‘You and the toilet will be good friends,’” says Copeland with a laugh. “And after the procedure, you can go out for a big lunch.”
Copeland says the total time spent at the surgical center is about two hours, and the actual procedure takes 20 minutes. If polyps are found, they’re removed as part of the colonoscopy to stop them from turning into cancer. It’s why the procedure is so important in the first place.
Thanks, in large part, to those insufferable TV ads, erectile dysfunction has entered the public’s lexicon, as has a condition known as low testosterone. But at least one Main Line doctor thinks both are misunderstood. “First of all, ‘low T’ is not associated with ED,” says Dr. Bernie King of Family Medicine in Glen Mills. “You can have ED and have normal testosterone. And men of all ages—not just those in their 50s—experience ED.”
Not only can ED create stress in a relationship, but it also can be a symptom of more serious problems—like circulatory or neurological disorders, and diabetes. “With testing, those things can be ruled out, or they can be discovered, diagnosed and treated,” King says.
As for low T, men in their 50s may think they have it, but they may simply be experiencing the natural aging process.
“The tail is wagging the dog a bit,” King says. “We have commercials for low-T patches and gels, so now people know what they are. But physicians are the ones who determine if a man really needs those products.”
Testing for testosterone is done through blood work—but numbers don’t tell the whole story. King asks patients about hallmark symptoms, which include fatigue, significant loss of muscle mass, and cognitive cloudiness.
Some of that is due to normal aging. “But it’s really the difference between a cold and the flu,” says King.
King admits that, once men actually do come to see him, conversations about ED, low T, colonoscopies and other health issues are easier to have today than they were five years ago. But one topic remains difficult: depression.
“It’s still uncomfortable for most men to admit feelings of concern, fear or the depressing effect of the aging process,” King says. “Women will say, ‘I don’t like this or that about what’s happening as I age. What can I do about it?’ I find men are much more apt to say, ‘Ah, the hell with it. I’m just getting old.’”
King makes every effort to try to get men to talk about how they’re feeling. “Often, that conversation is an entry point to discussing sleep problems, anemia and thyroid issues,” he says. “These are things we can treat, and help men feel better.”
Back at the fire pit, the Gladwyne knuckleheads I’m hanging out with would rather get colonoscopies than talk about their feelings. Still, one does admit that he’s rethinking how far he runs every day because his legs aren’t feeling as strong as they used to. Another says he’s going to the bathroom far too often, and the third confesses that his acid reflux has increased to the point that it’s causing him real discomfort.
So, will they make appointments with their doctors? Sure, they say.
When they get around to it.
SCREEN TIME
A to-do list for men in their 50s.
Source: U.S. National Library of Medicine
every 1-3 years: Vision testing
every 2 years: Blood-pressure screening
every 5 years: Diabetes screening
every 5-10 years: Colon cancer screening with a flexible sigmoidoscopy
every 10 years: Colon cancer screening with a colonoscopy
ask your doctor: Prostate cancer and osteoporosis screenings
