First, some hard truths. The average guy pays a lot less attention to his health than the average woman. It’s a fact. Compared to women, men are more likely to drink alcohol and use tobacco; take unnecessary risks and avoid seeing a doctor for regular checkups. The biggest killers of men and women are the same: heart disease, stroke, diabetes, cancer and depression. But men do have conditions that are unique to them, for example prostate cancer and benign prostate enlargement.

I’d like to focus on two other health issues that are unique to men but that aren’t commonly talked about: gynecomastia and testicular cancer.

Gynecomastia is the term for the development of excess breast tissue in a male. It can be painful but even if it isn’t, it can be extremely embarrassing and affect their life dramatically. It’s common, occurring in up to 57 per cent of men. Sometimes it’s a temporary change brought on by hormone imbalances that self-correct (newborns and teenagers). Other causes include a drop in testosterone levels, testicular cancer, hyperthyroidism, kidney and liver disease.

Marijuana, amphetamines and alcohol can trigger it as can some medications. Since it can be associated with breast cancer, any time a lump appears in a male breast, whether or not it is painful, it should be examined by a health care professional. Even if cancer isn’t suspected, it’s important to deal with it sooner rather than later because if gynecomastia is left untreated for more than 12 months it can result in permanent breast changes.

It’s estimated that 1,150 Canadian men will be diagnosed with testicular cancer in 2019. Most are between the ages of 20 and 40 — not an age group that usually thinks of itself as being at risk for cancer. For many men, the first sign that something isn’t right is finding a painless lump or swelling in one testicle. Other possible symptoms can include a feeling of heaviness or a dull ache or actual pain or tenderness in the testicle or the groin; or a change in the way a testicle feels. Your risk is increased if you’ve had an undescended testicle (especially if the surgery to correct it wasn’t done before a year of age); having Down syndrome (trisomy 21); or a family history of this cancer.

If diagnosed early, testicular cancer has a very high cure rate so see a doctor as soon as possible if you notice any changes in your testicles. Testicular cancer usually occurs in only one testicle, and the other testicle is all that is needed for full sexual function and fertility.

Men should do regular self-examination of the testicles, best after a warm shower or bath when the skin of the scrotum is relaxed. Don’t be alarmed if you realize that the testicles aren’t the same size as it’s normal to have different sized testicles and the left testicle often hangs lower than the right. Healthy testicles should feel firm and have a smooth surface.

At the end of the day, most of the major health risks that men face can be prevented with a healthy lifestyle: regular exercise, a healthy diet, not smoking, stress reduction, and limiting or avoiding alcohol. Regular checkups and screening tests can spot disease early, when it is easiest to treat. So don’t be an average guy and ignore your health.

Dr. Mitch Shulman is an Assistant Professor, Dept. of Surgery, McGill Medical School and an Attending Physician, Emergency Department, McGill University Health Centre. He’s also the CJAD AM 800 Medical Consultant.

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