The ageing male
A CGH doctor has come out with a new book to touch on male ageing topics in hopes of getting men to look at their health more seriously and take preventive steps.
BY: Eleanor Yap
There are many differences to men and women in terms of how each view healthcare. For women, they believe in preventive medicine and often go for their regular health checks. However, in the man’s case, if there is a problem, he tends to put it off until he can’t any longer. This is not advantageous if men want to have longer and healthier lives.
In a new 156-page book titled “Managing Male Ageing” that was released in July to major bookstores, Changi General Hospital’s urologist Dr Ng Kok Kit touches on a number of male conditions and hopes through this education, men will be more aware. We talk to him over e-mail while he is overseas:
Why a book on male ageing? Why not a book on ageing in general or one on female ageing? What made you embark on such a book?
This is because men’s health in general has been neglected for a long time, both by healthcare providers and by the men themselves. This is in contrast to female ageing. Women tend to take their healthcare more seriously. This may be because of their roles as mothers when they are exposed to healthcare services early on. They also bring their children to see the family doctor and basically, they take care of their family’s affairs. In this context, they are in constant contact with healthcare providers, and they have much more opportunities to receive healthcare information. Also, more preventive care services have been developed around them like cervical cancer and breast cancer screenings.
Men, on the other hand, tend to neglect their bodies and generally do not embark early enough on preventive healthcare. It may be because they have not been in contact with medical providers, or at least as often as the women. Traditionally, men have been cast into the mould of being strong and stoic. They do not want to see the doctor for ‘minor ailments’, and would see their medical providers only when the disease almost incapacitates them. They prefer to fix their body when they have a problem rather than preventing the problem in the first place. They may also have many problems affecting their quality of life, but not wanting to appear weak, they would bottle them up rather than to seek a remedy. In fact most of the time, they can be helped with modern medicine and technology if they know where to look for it, and more importantly, to seek a solution in the first place.
I have been a practising physician, and later urologist for 14 years, and I have seen many examples of men, who have ignored their health for too long to their own peril. There are men who have prostate cancer who waited until the disease spread to their bones and compressed their nerves, thereby paralysing them, when currently, there are ways to detect prostate cancer early, which is very much potentially curable. There are men whose urinary streams grew weaker each day and each month, and yet they sought medical care only when they developed complications such as kidney failure. Many conditions, when detected early, can be cured. Many quality of life issues, when presented early, can be resolved satisfactorily. I hope that my book will help men embark on the first steps towards looking after their health.
Would you say the book is a first of its kind in Singapore? What conditions do you touch on? Of all of them, which ones are most worrisome and why?
There are books out there talking about diseases that may affect the ageing men. What I am more concerned about is the health of the ageing men, and the quality of life issues affecting the ageing men. I want to reach out to the men out there on the street. There is a lack of books in Singapore talking about male ageing in this respect.
In my book, I talk about health issues that affect men, like benign prostatic hypertrophy and prostate cancer. In a study by Cancer Research UK, it was found that men are 40 percent more likely to die from any cancer as compared to women. I’ve also talked about conditions that affect the quality of life in the ageing men, like erectile dysfunction and andropause. I’ve touched on matters that concern men as they age like memory, vision, hearing, hair and bone problems. Most importantly, I explained how to age healthily and preventive healthcare that will allow men to live long and fruitful lives.
What are some misconceptions about men’s health?
The main misconception is that diseases will declare themselves in the form of pain or disability. In fact, when diseases progress to that stage, it is almost impossible to cure the disease. Yet many men wait till then to see their doctors, when it’s too late.
It is when men are young and seeming healthy that they should reflect on their lifestyles and how to prevent diseases from occurring.
An urologist talking about eye problems – how did you pull that one off?
I’m an urologist first and foremost, a surgeon specialising in the urinary system (organs which include the kidneys, ureters, bladder, prostate, testes and penis). Many of us, who have been in specialties, so often speak of ourselves as ‘knowing more and more about less and less’. As I am running the Andropause and Men’s Health Clinic at CGH, many men are concerned about their general wellness, rather than specific problems. For example, they may have decreased libido suggesting andropause, but they are also concerned about their bulging waistlines.
Initially, I had envisioned a book encompassing what I know very well within my specialty as an urologist like prostate problems and erectile dysfunction. However, in the course of treating ageing males, I realised that I needed to treat men holistically rather than as a bag containing different disparate diseases. Certainly, I have seen many men with vision and hearing complaints, which are part of the spectrum of the ageing process. I have diagnosed and treated some simple conditions. I did hesitate to write beyond the confines of my specialty but with the encouragement of my publisher and medical writer, I decided to give it a go. As medical student, I learnt all aspects of medicine, and in becoming a specialist, I have slowly forgotten many of the other aspects. I am now beginning to re-learn what I have known in the past, and appreciate that there are more to a man than his collection of problems. I realise that the medical field is rapidly advancing and changing, and to make sure that I am on the right track, I also sent my draft of the book to the appropriate specialists to look through. They were a great help and they taught me quite a few things.
Why do men take a while to see a doctor compared to women? Do you think men’s mindset about health will change anytime soon or maybe the revelation that men might live longer than women instead of the other way around?
Men treat their bodies like pieces of machinery. For example, they treat their bodies like their cars or computers. If they are not broken, they do not want them to be fixed. Men have also been taught to be stoic since young, and they should bear their sufferings in silence and take it whatever comes to them. Seeking help, more often than not, is a sign of ‘weakness’.
However, I believe that with appropriate education, which I hope my book can contribute to, men can appreciate that they need to listen to their bodies and take care of them. Treating their cars like machinery may not be a bad thing, as they should know that cars require regular maintenance like oil change. Checking the brake pads is like preventive healthcare, as both prevent further problems ‘down the road’.
Men tend to be more active and want to be in control of things. I believe in harnessing the male drive towards his own healthcare. Once he realises that caring for his body and taking part in preventive healthcare can avert further problems in the future, he can take positive steps towards his well-being. He just needs to know what’s important and be educated about what can be done.
I do not seek that men live longer than women. For one thing, I think men might be pretty lost if their women were not around! Women have traditionally brought their parents, husbands and sons to see the doctor. What are men to do when women are not around? I speak this only half in jest. The main problem is not which sex will live longer, but rather the chasm in knowledge about their bodies between the two sexes. I hope my book can help bridge this gap.
What advice would you give to men (those younger as well as older)? If older men have led sedentary lives for a long time, how should they go about changing their lifestyles?
Men, whether young or old, should listen to their bodies and seek knowledge about how to lead healthy lives. They should realise that what happens in the advancing years depend upon the foundation that they built when they were young. In my book, I talk about the importance of an active lifestyle and how to go about achieving it.
Certainly, we all have many work and other commitments that prevent us from exercising. Some men would say that they have not been active at all throughout their lives, and now it’s too late to start exercising, quitting smoking and so on. It is never too late to start. Of course, if you have certain medical conditions like heart problems, consult your physician before embarking on any programme. Start slow and make a habit of being constant in your approach to your health. If you make it a habit, you will find it easy to follow your regime. In fact, many men, after they start exercising, find it uneasy that they do not exercise for more than a few days. If you’re young and you start a healthy lifestyle early, this habit will carry on for the rest of your very long and fruitful life.
Would you like to add anything?
I can’t emphasise this more – with improving healthcare and increasing lifespan, men will need knowledge about how to best harness their increasing term on earth. Learning early what’s about to happen, and preparing for what’s to come, will make the journey on earth that much more enjoyable.
** The book is available at all major bookstores. Price is $18.50 before GST. This writer assisted in the book.