Kaiser Permanente to guys: "Let's talk."

Urologist Gregory Marshall, MD, has simple advice for men dealing with health problems: Speak up.

All too often men ignore issues or are too embarrassed to talk about them, said the Kaiser Permanente Walnut Creek physician.

Dr. Marshall plans to take on the topic of men’s health in the next Health Talks Online webinar, “Men’s Health: Cutting through the Hype.” Health Talks Online is a free, monthly program featuring Kaiser Permanente physicians and other experts who discuss current health topics with members and nonmembers. Dr. Marshall’s hour-long webinar is scheduled for 12:30 p.m. on Wednesday, June 12, and registration is open at kp.org/healthtalks.

Dr. Marshall recently discussed a few of the most pressing issues in men’s health, the latest recommendations on prostate cancer screening, and why men should turn to their physicians more.

What are a few of the top concerns in men’s health?

Prostate cancer gets the top billing; it is common. While it is present in microscopic amounts in over half of men over the age of 50, it is only destined to become a problem in a small percentage of them.  It’s also been in the news recently, especially as some prominent people have come out saying they have prostate cancer. For instance, junk bond king Michael Milken created the Prostate Cancer Foundation and has done huge outreach. He’s essentially the poster child of someone doing well with prostate cancer. There are other things, too: urinary issues and sexual problems. Urinary problems affect 50 percent of men in their 50s, and up to 90 percent of men in their 80s suffer from urinary issues.  Erectile dysfunction and other sexual problems are present in 15 to 30 million American men, though not all men are equally bothered.

Tell us about the latest recommendations for prostate cancer screening

It’s an interesting disease. It has the word cancer in it, but it doesn’t always act the same as other cancers. The majority of the prostate cancers are not aggressive; most men will die with it and not from it. When prostate cancer became more prominent in the media over 20 years ago, there was a large push for more aggressive treatments with surgery and radiation.  More recently, some national organizations have come out with recommendations to be less stringent with screening and treatment. At Kaiser Permanente, we recommend that high-risk groups, those with a family history and African Americans, get screened from age 40.  For everyone else, they should discuss the pros and cons with their doctor.  Screening is done with a blood test called a PSA.  While that can detect most significant prostate cancers, there can also be false positives, which can lead to unnecessary biopsies and risks of infection, bleeding, and worry.

What is the most difficult topic in men’s health to discuss?

Men in general have a hard time talking about any health problem. Because they don't typically share these issues with their friends, they don't realize that they have a common problem that can be treated.  With sexual problems, if they don’t talk to their physicians, they may turn to supplements, and the marketers for those supplements prey on men’s reluctance to seek medical attention. But there are things we can do for most common men's health problems, and they don’t always involve medications. Men should be confident that we can take care of them and address these issues.

Register  for Dr. Marshall’s upcoming webinar “Men’s Health: Cutting through the Hype.”