Movember Puts The Spotlight On 'Staches And Men's Health
October 29, 2013 1:13 p.m.
Greg Koch, CEO, Stone Brewing Company
Dr. Luis Castellanos, Cardiologist, UC San Diego
Dr. Christopher Kane, Chief Urologist, UC San Diego
Related Story: Movember Puts The Spotlight On 'Staches And Men's Health
MAUREEN CAVANAUGH: Mo-vember is a mustache growing event fundraiser for men's health issues. Today we'll talk about some of the issues dominating men's health. I would like to welcome Gerg Koch, founder of Stone brewing. Every guy starts from scratch in growing their mustache in November. Clean-shaven for everyone on November 1?
GREG KOCH: That is a particular challenge for me. I have bushy beard at the moment.
MAUREEN CAVANAUGH: It will entail some sacrifice.
GREG KOCH: Yes, physical and emotional sacrifice. For a good cause.
MAUREEN CAVANAUGH: Tell us how this fundraiser works.
GREG KOCH: Essentially on November 1 they have to shave. All participants start from clean-shaven, and then during the month of November, growing a mustache and only a mustache. Someone like me with a big bushy beard you have to shave everything. It will be emotionally challenging, but I'm doing it for the better of other people.
MAUREEN CAVANAUGH: Where does the money come in?
GREG KOCH: That is a good question. It's participants that take pledges to grow mustache, and get other people to join in, tickled by the idea of watching these people. It qualifies as silly and funny, play some hip 70s music as I'm walking around. You earn money by telling people you will go clean shaven and grow a mustache throughout November if they raise enough funds.
MAUREEN CAVANAUGH: So women can get involved in fundraising for this court if they get pledges for the men?
GREG KOCH: Yes it's very participatory. Social media is a technique to build this up. I've been focusing on this as well. I set a minimum of $15,000. I would not shave unless I got that much. It looks like I'm just over $25,000 now. I was hoping in the back of my mind that I would not have to, that I would keep the beard. No such luck.
MAUREEN CAVANAUGH: Thank you and good luck on November 1. If you like to know more about the event, go to US.Movember.gov. Now I will introduce Luis Castellanos. What you think about this effort? Do you think it gets men talking and thinking about health issues?
LUIS CASTELLANOS: I think so. I see what the breast cancer community has done for breast health. You have to be blind to not notice the great effort that breast cancer advocacy groups have done. We have missed that on the men's side. We're not competing, we want to help the fundraising for everyone, but anything that gets people's attention is a great thing. It's also fun that there is a fun element to it.
CHRISTOPHER KANE: We get family members to support you and encourage you to actually implement changes in your life. It's a physical change, but eventually it can chance they do something meaningful such as changing your habits.
MAUREEN CAVANAUGH: That's interesting. I want to focus on some health concerns that affect men, including prostate cancer. The issue of testing for prostate cancer is in the news again. What is the standard for when screening should begin?
CHRISTOPHER KANE: The challenge is experts in the field are disagreeing about what we should do for screening. The American Urological Association recommends screening at fifty-five years of age. For the average American man. For men with a positive family history, African American men should be considering getting screened earlier. US cancer prevention has rigorously criticized PSA screening. That is what generates controversy. Criticisms are valid, there have been previously been quite a few men who have prostate cancer diagnosed and treated that were not very threatened by the cancer. It's a slow-growing cancer, so there's this concept of overtreatment. We realize that we should be screening and treating smarter. Instead of throwing the baby out of the bath water, and stopping screening, we have to be smarter with screening.
MAUREEN CAVANAUGH: I'm wondering, are there a lot of false positives that come back?
CHRISTOPHER KANE: Yes. PSA stands for prostate specific antigen. Many men with the elevated PSA have elevated PSA from other problems. Enlarged prostate, and inflammation in the prostate, it's a very sensitive test for prostate cancer. Most men with prostate cancer do have elevated PSA. What we end up doing is screening determining whether someone has abnormal PSA, then going through secondary tests. Diagnostic tests usually involving prostate biopsy. That can be painful and have some risks associated with it, in my view it is a small price to play. Yes, that is one of the criticisms. Abnormal PSA testing leads to many secondary tests.
MAUREEN CAVANAUGH: At what point do you decide you are not going to aggressively treat the prostate cancer?
CHRISTOPHER KANE: There are two parts to that question. How far along is the cancer, and how well is the patient doing? Prostate seems to be slow-growing. Someone is older who tends to have a lot of health concerns, and someone has a very slow-growing prostate cancer, he may not want to go through the extra treatments. We are now much better at judging how bad the cancer is. That is an important measure of progress. We measured tumor grade, PSA velocity, how much cancer is on the prostate biopsy, and now we have molecular tests that we can add to that to get a great sense of how aggressive the cancer is. Now, somewhere between fifteen and 25% growth, we recommend no aggressive treatment. We do not want to ignore it, we want to carefully follow it with a strict regimen, but we are understanding who needs treatment more here.
MAUREEN CAVANAUGH: Now November's Mo-vember interest is to raise awareness about all men with health issues. Is heart disease still is the leading cause of death?
LUIS CASTELLANOS: Yes, heart disease is still killing millions each year.
MAUREEN CAVANAUGH: Is this an effort to get fewer men smoking, and lowering their cholesterol?
LUIS CASTELLANOS: We've made tremendous work towards reducing mortality for cardiovascular diseases and reducing cholesterol levels.
MAUREEN CAVANAUGH: For men who suffer from heart disease?
LUIS CASTELLANOS: You are referring to cardiovascular risk factors. Yes in individuals who have high cholesterol or diabetes or smoke have a higher chance of developing cardiovascular disease. We need to make more efforts in reducing this risk factors.
MAUREEN CAVANAUGH: Are there always signs of heart disease?
LUIS CASTELLANOS: Most of the time, yes. There is a certain percentage of the population who end up having some heart attacks. Individuals who are diabetics can have a heart attack without actually experiencing it. It's not until they go into late stages and developcongestive heart failure that they knew they had coronary artery disease.
MAUREEN CAVANAUGH: For most, then, what are the signs?
LUIS CASTELLANOS: Most individuals experienced chest discomfort and pressure, sometimes radiates down the left arm or jaw. For each individual it is different.
MAUREEN CAVANAUGH: Is it true that symptoms are often different between men and women?
LUIS CASTELLANOS: Sometimes it can be similar, but women can present with atypical symptoms. Symptoms that are not necessarily what you would read in a textbook. Some females can actually present with symptoms that are a little bit different, pain on the right side of the chest rather than the left. Their symptoms can manifest as just anxiety.
MAUREEN CAVANAUGH: You think men generally are more resistant to see a doctor?
CHRISTOPHER KANE: Definitely. I think it's hard to get men to have regular medical visits. I've seen it in my practice. I'm embarrassed to say it took me an extra year to see my physician. We're all guilty of that.
MAUREEN CAVANAUGH: Why is this?
CHRISTOPHER KANE: It is a combination of things. Denial, feeling we're invincible, part of it is busyness. Many of us feel busier than ever with life. When we reach out to women, it's a great opportunity to get wives and girlfriends to engage with men to get them into be seen. For listeners, it's a great way to get people in for blood pressure and cholesterol screening and to think about prostate screening as well.
MAUREEN CAVANAUGH: Luis, do you find the same thing, that men are not overly eager to come in?
LUIS CASTELLANOS: Exactly, they tend to allocate symptoms to other discomfort. They basically end up missing the boat on early treatment. I agree that it's important to have men actually go see primary care physicians early so they can be screened for disease early. Sometimes children can be very helpful and encourage parents to ask to go see a provider. We take our kids in for the doctor, why not adults do the same thing?
MAUREEN CAVANAUGH: As he said, this is not men against women. We want everyone to have good health, but the National Cancer Institute says that nearly the same amount of patients with breast cancer and prostate cancer come in each year. But why did they spend more money ñ almost 3 times as much money ñ on breast cancer?
CHRISTOPHER KANE: There is been criticism of health spending. There is a concept that if we save a man with prostate cancer we're saving someone later life. We see a man with testicular cancer we save someone younger, with more years of life to save. There is a bit of a bias against prostate cancer, in that way. It tends to be a disease of older men. I cannot tell you how many men it I've cared for in their 40s and 50s. Now with better management of cardiovascular disease, average life span of men is going up. We project a greater nummber of prostate cancer patients, but advocacy for research in prostate cancer is something that we need to be actively engaged in. We have great groups like the Prostate Cancer Foundation and others who are trying to fill that gap. In November, funds are being raised for prostate cancer in different research avenues to drive money to active researchers.
MAUREEN CAVANAUGH: Thank you both so much.