Men Die Five Years Earlier than Women, On Average

Deborah
This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here's Deborah Howell Welcome. I'm Deborah Howell, and when it comes to preventative cancer care, there's a lot of factors and variables to consider. To find out about the comprehensive care at the MemorialCare Todd Cancer Institute at Long Beach Medical Center today, we'll turn to one of its leading advocates. Our guest is Dr. Nilesh Vora, medical director at the MemorialCare Todd Cancer Institute at Long Beach Medical Center. Welcome, Doctor Vora.

Dr. Nilesh Vora
Thank you.

Deborah
So, so happy to have you on today. Now, research tells us that on average, men die five years earlier than women. What are some of the contributing factors to that?

Dr. Nilesh Vora
Yeah, I think that this is an interesting question. I think there's a lot of variables and factors that contribute to this fact that research has shown us. In my experience, in looking at some of the factors, it's quite apparent that in general, men take bigger risks in life. So they have more of that adventure type of lifestyle that causes sometimes risks for things like death. Men often choose jobs that are a little more dangerous, being on the front lines of the police force or firefighters, things like that. I think that's kind of a lifestyle choice, but I think there's also a component of health care choice. So I think that research has shown that men are less likely to see their physicians on a regular basis. They're less likely to go to a doctor and look for asymptomatic problems that aren't causing them to feel poorly, like high blood pressure or high blood sugars. And as a result, these issues get undiagnosed. And by going undiagnosed, they can present problems later in life. I think in general, the theory is that men tend to avoid doctors more often than women do.

Deborah
I think so, and I also think they don't like to ask for directions either. Why do you think men are more reluctant to go to a doctor than, say, many women?

Dr. Nilesh Vora
Part of this is kind of the culture that we've all grown up in. I can think of when I used to play sports and if I was hurting, we weren't going to stop playing. We were going to play through pain. And so that seems to be how we're trained as young boys growing up. And then when we become men, if we're not feeling poorly, then we're not going to go to doctors. It's just kind of this generalization. I think health complaints have been looked at as signs of weakness in some cases. And so, men skip their doctor visits, men skip their screening tests, which is a big problem. And so as a result, there is this reluctance to go to doctors, but rather men will say, I'd rather do things myself. I'd rather fix things on my own.

Deborah
Yeah. You know, I think it's probably changing, though. I mean, every woman I know play sports and blows it off if they have a sore leg or a sore thigh or something like that. So maybe it's changing a bit over time, as women become way more active and way more involved in those dangerous jobs.

00;03;21;29 - 00;03;36;08
Dr. Nilesh Vora
I think so too. I think there's definitely going to be a shift going forward. It's sort of a historical thought that some of these things were happening with men compared to women. Having said that, it's the issues that we see that men just seem more reluctant to go to doctors.

Deborah
Okay. Got it. Now, why do men have a higher rate of getting and dying from cancer specifically than women?

Dr. Nilesh Vora
Again, I think missing screening tests is a big problem because men tend not to feel sick. And when men don't feel sick, they are reluctant to have that colonoscopy, that PSA test looking for prostate cancer, etc. I think as a result of that, we see cancers diagnosed at later stages. When it comes to men compared to female. I have some data that we've collected here at Long Beach Memorial Medical Center, where between the years 2009 to 2017, males were more likely to be diagnosed with stage four cancer than females, and the results are almost twice as frequent in terms of diagnosing at a later stage. And that's not an accident. That's not specific to biology. That has me convinced that it's just avoiding these screening tests that are so important, and males just have a harder time with that.

Deborah
It's a couple things, maybe a matter of pride and to people just say, oh, I'm just too busy. I'm feeling great. Why do I need a colonoscopy? I mean, truly, I begged my husband to go get one. And then of course, it was a little late, but he's fine now. But it was stage three and totally preventable.

Dr. Nilesh Vora
You're absolutely right. And we see that stage distribution across both genders. So women just tend to find their colon cancer stage one or stage two. And men are later stage three or stage four. And that has impact on survival. I think there's another point, too, that I didn't make earlier, which is that just historically, men were heavier smokers and drinkers than women. And we all know that smoking and drinking alcohol are both risk factors for cancer development. And so, I think that also contributes to some of the cancers we see in gender specific situations.

Deborah
Absolutely. What are some of the most common types of cancer diagnosed in men?

Dr. Nilesh Vora
The most common is prostate cancer by far. Actually, most males will be diagnosed with prostate cancer at some time in their life if they live long enough. The following other cancers are colon cancer, lung cancer, and skin cancer, which also make up the majority of the cancers we see in males.

Deborah
We touched on this earlier. Can you tell us more about the importance of cancer screenings, and which screenings should men get regularly?

Dr. Nilesh Vora
The importance of cancer screening can't be overstated. Cancer screening is based on data that suggests that we perform a test to look for cancer before cancer becomes symptomatic. By doing so, data has shown that we can diagnose cancers at earlier stages and then make an impact on survival. And so that is the importance of cancer screening. Finding it at earlier stages before people have symptoms specifically for men. Colonoscopies are vital in terms of diagnosing colon cancer at earlier stages. PSA for prostate cancers are used to fine prostate cancer earlier stage, and I think it's important to have a conversation with your primary doctor about the importance and value of doing PSA screening in specific patients. I think that becomes very, very important. And then we are also advocating for lung cancer screening, especially among smokers, people who've had a history of smoking. So getting an annual CT scan, looking for lung cancer has been shown to prevent death from lung cancer as well.

Deborah
That leads to my next question. If you have a history of smoking, does that make a difference in that type of frequency of screenings someone may need?

Dr. Nilesh Vora
Absolutely. So, the national lung cancer screening trial included patients who had a smoking history that was significant and were between the ages of 55 and 70. Those patients who got a annual CT scan of their lungs were shown to have a 20% decrease in death from lung cancer compared to patients with similar criteria who had a chest x ray. And so if you think about that, we're talking about saving 1 in 5 people who have a smoking history just by doing a low dose CT scan once a year. That's really significant.

Deborah
That's huge. Let's put this myth to rest that x rays are more harmful to you and can cause cancer.

00;08;00;25 - 00;08;23;19
Dr. Nilesh Vora
Absolutely. So, the amount of radiation that you get from an X-ray or a CT scan is minuscule, and then you compare that with the benefits of diagnosing and detecting lung cancer. Early stages. And I always tell patients that it doesn't really make sense to be afraid of a CT scan when the benefits are so high.

Deborah
Exactly. Thank you for that. What are some of the healthy habits that men should practice to decrease their risk for cancer and other common illnesses like heart disease and stroke?

Dr. Nilesh Vora
So, I'll take cancer in terms of ways to decrease the risk. And really, I can't again emphasize enough the importance of cancer screening. So seeing your primary doctor making that checklist of tests that need to be done to screen for cancer at earlier stages, a colonoscopy every ten years, for example, a yearly PSA blood test looking for prostate cancer, perhaps a CT scan screening for lung cancer if indicated. These things are extremely important and should be done even in the absence of any symptoms. And the other points are exercise. We're seeing a lot of information about active lifestyles, healthy diets, and the impact they have not only on cancer reduction, but also on stimulating and improving the immune system, which we're on the cusp of figuring out plays such a vital role in suppressing cancer or preventing cancer. I think skin cancer should also be mentioned, and I think being careful out in the sun with the harmful UV rays is another important way to avoid skin cancer, and it should be mentioned. As we talk about avoiding all types of cancer, I think I'd go on next to heart disease and heart disease, which is a major problem for patients in our society. And again, the importance of regular checkups. You may not feel high blood pressure. You may not have any symptoms from having high blood pressure. But every day, every week, every month that your blood pressure is high. Our risk factors for promoting cardiovascular disease and leading to things like heart attacks and heart failure. And so seeing your doctor, getting regular checkups, eating healthy, exercising are all ways that we can decrease the risk for these common illnesses.

Deborah
And red meat, in your opinion, is cancer causing.

Dr. Nilesh Vora
I get that question all the time, and there is no hard and fast data about red meat and the link to cancer. I think I tell patients that moderation should be used in things that seem like they may not be healthy, so some red meat here and there I think would be okay. But a diet exclusively based on red meat probably leads to heart disease and other illnesses.

Deborah
Got it. Thanks for that. I always ask anyone in the expert line of medicine that question because it is such a different answer every time. But I think you're right. Moderation and a wide variety of foods is always a good idea. Dr. Vora, where can people go to learn more about the preventive cancer screenings and the care available at MemorialCare Todd Cancer Institute.

Dr. Nilesh Vora
So, they can look at our website at the MemorialCare.og website under the link for patients. All this information is nicely located giving patients information about cancer screening, about cancer treatments, and about all the services that are offered here at our Institute.

Deborah
Beautiful. MemorialCare.org/TCI. Thank you so much, Dr. Vora for your time and expertise today. We really enjoyed having you on with us.

Dr. Nilesh Vora
Thank you Deborah, I really appreciate your time.

Deborah
Our pleasure. For more information or to listen to a podcast of this show, please visit MemorialCare. podcasts. That's MemorialCare.org/podcast. That's all or this time. I'm Deborah Howell. Have yourself a terrific day.