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HOUSE CALL WITH DR. SANJAY GUPTA

Women Visit Doctors More Than Men; Men Often Go To Doctors To Seek Help With Sex Life; KFC Getting Sued; UC Berkeley Has Gone Organic

Aired June 17, 2006 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Good morning. I'm Dr. Sanjay Gupta and you're watching HOUSE CALL.
Today, we're talking about men's health, from who really needs testosterone replacement to high blood pressure, even treatments for sexual dysfunction. If you're a man, or if you care about one, you should be watching this show. After all, women are outliving men.

And as Christy Feig reports, there could be a very simple reason.

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): When he was younger, Charles Dobson never went to the doctor for a check-up, unlike his female friends.

CHARLES DOBSON, GETS REGULAR CHECK-UPS: They will go if they have a hang nail. We stand back in the shadows and hope with our Ouija boards that things will be OK.

FEIG: But now at the age of 70, he goes for routine check-ups. His biggest fear is prostate cancer.

DOBSON: I'd like to see some more birthdays, number one. And number two, I found that this thing is not selective. It can happen to anyone.

FEIG: But for a man, Dobson is an anomaly. Government studies show men tend to go to the doctor only when they feel sick.

DR. ELMER HEURTA, WASHINGTON HOSPITAL CENTER: Men are terribly bad taking care of themselves. It seems that they take care of much more of their cars than their bodies.

FEIG: And that increases the chance of missing some serious diseases early.

HEURTA: The main killers in this country, heart disease, cancer, and diabetes, they don't give you any kind of symptoms when they start.

FEIG: To catch problems early, the CDC recommends men get tested for high blood pressure every two years, cholesterol every five years starting at age 35. As early as 20, if it runs in your family. If you have either of those, get checked for diabetes. And if you're down, ask about depression. Add in tests for colon and prostate cancer after the age of 50. Earlier, if you're at high risk.

Experts say catching these diseases early could add years to your life.

I'm Christy Feig reporting from Washington.

(END VIDEOTAPE)

GUPTA: All right, Christy, thanks.

For many men, not going to a doctor regularly is an understatement. In fact, women are twice as likely to visit their doctor for preventive exams as compared to men. And that could be why even though why more males are born every year, starting at age 36, women outnumber men.

Now the top risks for men are heart disease and cancer. Those are the top two, followed by accidents. And for men younger than 44, accidents are actually the leading cause of death. Stroke and chronic lower respiratory disease round out the top five risks as well.

Helping us decrease all of those risks is Dr. John Bonhomme. He's with the Men's Health Network. He's also founder of the national Black Men's Health Network as well.

First of all, welcome, doctor.

DR. JEAN BONHOMME, MEN'S HEALTH NETWORK: Oh, thank you very much.

GUPTA: Like you know, people talk about this all the time. Why is it that men just simply don't go to see their doctor?

BONHOMME: Part of it is that the information about men's health challenges just hasn't been out there. There's been a lot of public information about breast cancer, and pap smears, and the like, but we haven't been talking about what's been happening to men. So a lot of the public remains ignorant about what the issues are.

In addition to that, the way that males are raised when a boy is eight-years old and he skins his knee, they tell him brave boys don't cry. And by the time he's 50 and having chest pain, he says it's just indigestion. Males have an expectation that if something hurts, don't bother with it. It'll go away by itself. Unfortunately in middle age, that doesn't work any more.

GUPTA: They're told to just tough it out, it seems, from a very young age. We're trying to dispel some of that today.

Let me give you some ideas about some of the viewer e-mails that are coming in. Very specific questions, I think. Let's listen to this one. Ralph in Maryland writes this. "What health screenings should a 40-year old healthy, African- American males begin to monitor besides blood pressure and cholesterol?"

So really specific, 40-years old, African-American. What do they need to be thinking about?

BONHOMME: They also need to be thinking about prostate problems, because the rate of prostate cancer in African-American men is about 50 percent higher than in the general population. African-American males have the highest rate of prostate cancer in the entire world. So that needs to be another consideration.

Blood pressure is very important. Cholesterol is very important, because African-American men also have higher rates of heart disease and earlier deaths from heart disease. So I would also add those.

GUPTA: Now we're going to talk more about prostate cancer. That's an important point. Well, let's keep going with the questions.

This one comes from Alabama. Jerry writes this, "I've had high blood pressure for 2 years, and do not want to start taking medication. What can I do to lower my blood pressure? What are the long term effects on your body?"

Doctor, I mean, how do you know when it's becoming a problem? How do you know when you actually need to start taking the medications?

BONHOMME: Well, that needs to be the decision of a physician that you're working with. Some people have mild cases of high blood pressure. And they can get by, reducing their blood pressure with diet, exercise, weight loss, and lifestyle changes.

If the high blood pressure is of a certain level that it can't be managed that way, then you do need to take some sort of medication. Failure to do so puts you at increased risk of stroke, of heart attack, of heart failure, of kidney failure, and even a blindness. So it's nothing to ignore.

High blood pressure is called a silent killer with very good reason. So work with somebody. If you are afraid of the side effects of taking medication, then work with your doctor to try to find medications that will not give you the type of problems that you're concerned about.

GUPTA: That's good advice. And I think anybody watching the show today who's listening, the first step is actually getting your blood pressure checked. You can do that in pretty simple ways. That might be a good first step.

Let's get another quick question in if we can. This one from Miriam in Michigan write this, "How much do 80-hour work weeks contribute to poor health and relationships for men?"

That's a great question, Miriam. I mean, doctor, how much do social and work pressures contribute to men's health. I mean, I'm sure you work pretty hard. I work pretty hard. You can control that part of it, but what can you do to prevent some of the health consequences?

BONHOMME: Well think back when we were interns how hard we used to work, you know. 100 hours a week and the like. Sure, work pressures do contribute to male health problems. But I do think that we need to make it a priority to make time for ourselves. We need to get our proper exercise, we need to get proper rest, we need to pay attention to our diets. A lot of us who eat on the run are eating not too well, eating fast food and the like. So I think it's a question of we need to prioritize our own bodies. As was stated earlier...

GUPTA: How do we do that, though? You know, it's interesting because people say - you pay more attention researching your car than you do your body. You just heard about that. Why don't we place more of a priority on this? And how do we get there?

BONHOMME: Because we haven't been taught that it is a priority. But I think we can make it so by realizing that the health of men not only affects us, but the people who care about us. When we become disabled, who has to take care of us?

GUPTA: That's...

BONHOMME: When we become disabled, what about the loss of economic productivity to all of society? When we die prematurely, what happens to those left behind? They're in a poorer economic situation. And they have poorer health as well.

So we need to think about it that it's not just us. Our bodies are our priority. By preserving our health, we can be younger longer, we can work better, we can do things that make us feel like better men.

GUPTA: That's good advice. And you know, it's a good message as well on Father's Day to think about our families as they are thinking about us as well.

More of your questions on men's health coming up on HOUSE CALL. Stay with us.

UNIDENTIFIED FEMALE: Men and sex. Find out what to expect as you age, and what men can do tone sure a good sex life.

Plus, the straight facts on testosterone replacement. Who should be taking it?

First, take today's quiz. When does a man's testosterone begin declining? That answer after the break.

(COMMERCIAL BREAK)

UNIDENTIFIED FEMALE: Checking today's quiz, we asked when does a man's testosterone begin declining? The answer, around age 40. One of the biggest reasons men will go see a doctor is because there's a problem in their sex life. The question asked is often what is normal? Well, here's what to expect as you age.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: I love women, like women, like them all.

GUPTA (voice-over): As a culture, it's evident some men are preoccupied with sex.

UNIDENTIFIED MALE: Sex, sex, sex.

GUPTA: You see it in the movies, and magazines, and on the Internet. But what's really going on sexually with men in their 30s?

UNIDENTIFIED MALE: I hope to be active into my 80s and 90s.

GUPTA: Dr. Chad Ritenour says men in their 30s may start to settle down and get married or start a family, but they still remain concerned about the quantity of sex that they're having.

DR. CHAD RITENOUR, EMORY UNIVERSITY UROLOGIST: In the 30s, we start to see men who are concerned that they may not be as sexually active as their counterparts.

GUPTA: For the 30-something-year-old man who wants to remain sexually active in later years, he recommends developing a healthy lifestyle now.

RITENOUR: Exercise, take care of yourself, because what you do at this age may be important as you move into the 40s, the 50s, and beyond.

GUPTA: Dr. Ritenour says men in their 40s may feel their sexual drive or libido change. And that might be related to testosterone levels dropping. As we get older, it becomes more about the quality of sex than the quantity.

RITENOUR: There's a shift in looking at what's important with the sexual experience. It -- there's a change from quantity to quality.

UNIDENTIFIED MALE: I think the best is yet to come.

GUPTA: When men reach their 50s, they often deal with performance issues in the bedroom. And when the frequency of sex goes down, sexual dysfunction is more likely to occur. That's according to Dr. Ritenour.

RITENOUR: Erectile dysfunction starts to set in for most men in their 50s. Something that all men experience a little bit as they get older.

GUPTA: But prescription drugs can help. Dr. Ritenour sees a lot of men in their 50s who are more focused on pleasing their partners. TOM OVERBY, 56 YEARS OLD: Just better. You know more things. And you know, you're more apt to please than just do it.

GUPTA: His best take home prescription for men in their 30s, 40s, 50s is to stay healthy and physically fit. It can help a man's sex life down the road.

(END VIDEOTAPE)

GUPTA: You know, it's remarkable. Approximately 15 to 30 million American men have some sexual performance issues. And for many, it's an embarrassing problem and one that they're reluctant to talk about.

But here's the thing. These problems can be temporary. And there are numerous reasons why sexual dysfunction could be happening.

Various diseases, for example, like heart disease can cause problems, along with some medicines that treat these diseases. Perhaps an operation of any kind or pelvic trauma could damage important nerves. And substance abuse or psychological issues such as stress and depression can contribute to erectile dysfunction. Answering your questions on men's health is Dr. Jean Bonhomme. He's the founder of the National Black Men's Health Network.

Doctor, lots of e-mails coming up on this particular topic. I want to get right to them. Bill in Georgia has this one. He writes this, "I am having a lot of trouble with erectile dysfunction. I this normal for a 63-year old with type 2 diabetes? What can I do since ED medication isn't working for me?"

Dr. Bonhomme, two parts to this question. First of all, is this one of those things every man can expect once they reach a certain age, that they're going to have some problems?

BONHOMME: I think that the decline in erectile ability that occurs is more linked to disease than it is linked to actual age. Because what increases with age is a frequency of diseases that can impair sexual performance, specifically the frequency of diabetes, the frequency of hypertension, the frequency of high cholesterol.

These diseases can disturb the circulation that enables a man to get an erection. And what men need to realize is that if they are losing the ability to perform sexually, it could be an indication of something much more global going on with their bodies. And they need to be checked out.

GUPTA: OK. And that's good advice. You know, sort of along the same question that Bill was asking, though, you know, we hear a lot about the medications out there. There's lots of medications out there. So in this case, it sounds like it's not working for him. Are there other options as well?

BONHOMME: There are other options. He needs to be under the care of a urologist, because sometimes you need to use the medication for a certain period of time before it really becomes effective. It may not be effective the first time you try it, but even if those medications fail, there are other treatments for erectile dysfunction that urologists can prescribe and use with men who are still having difficulty.

But my concern with a man who reports this is, is there an underlying problem? He needs to be checked, his blood sugar, his blood pressure, and his cholesterol at the very minimum.

GUPTA: It may be one of the first signs of something else going on. You should definitely get that checked out. Good advice. Let's keep on theme here. We got another e-mail coming in. This is from Stan in Texas who writes this. "Are there any cancer risks associated with testosterone replacement? What are the alternatives?"

First of all, doctor, how do you know that you even need to take testosterone replacement?

BONHOMME: You know, that is a very important question where there's a lot of disagreement. But if a person is showing signs of perhaps decreased libido and also depression are associated with low testosterone, we've known for years that women go through a menopause where they have a decline in their estrogen. We didn't realize that men more gradually may decline in their testosterone. It's usually not that abrupt as it is with women.

But what you need to do is to get your testosterone levels measured. And if they are below normal, then you need to consider testosterone replacement.

There's some concern about if a person has prostate cancer, then testosterone may cause that to spread more widely. As a matter of fact, one of the treatments for prostate cancer is to block testosterone. So -- but other than that, I think you basically need to be under the care of a urologist to see if you really need testosterone.

GUPTA: OK. So Stan, I hope that helps. Get your testosterone levels checked. Be careful about prostate cancers. Well, we're talking with Dr. Jean Bonhomme. We're taking all of your questions on men's health.

UNIDENTIFIED FEMALE: It's the most common cancer in men. What can you do to prevent prostate cancer. And is a PSA test right for you? Find out when HOUSE CALL returns.

First, this week's medical headlines in "The Pulse."

(BEGIN VIDEOTAPE)

FEIG (voice-over): The colonel is under attack. The consumer group Center for Science in the Public Interest is filing suit against KFC, claiming meals at the fast food chain are high in trans-fats and KFC isn't doing enough about it.

Trans-fats are known to raise bad cholesterol, a risk factor for heart disease. KFC says this is a frivolous lawsuit. They provide nutritional information. And their menu meets all government regulations.

The common antidepressant used to treat anorexia does not decrease the risk of patients relapsing. Prozac is used off label by a substantial number of patients with the eating disorder. Columbia University researchers say new data shows Prozac provides no benefit when it comes to preventing a relapse. Researchers say patient recovery should focus on psychological and behavioral treatment instead.

Christy Feig, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: According to the Men's Health Network, men's life expectancy in the United States is five years less than women. And as we've said, the second leading cause of death in men is cancer.

Lung cancer is the deadliest. Prostate and colorectal cancer can be equally dangerous to men, followed by pancreatic cancer and leukemia.

And although lung cancer kills more men each year, prostate cancer is actually more common. The biggest risk factor is your age, followed by your family history. And then your race. African- American men are twice as likely to die of prostate cancer as well.

Talking with us about prostate cancer is Dr. Jean Bonhomme. He's of the Men's Health Network.

Doctor, this is always a remarkable statistic for people to hear. Why is the risk of prostate cancer so much higher in some minority groups?

BONHOMME: It's believed to be dietary. Animal fat intake is associated with higher prostate cancer risks. As well as in Japan and other societies, the prostate cancer risk is much lower than it is for the United States. Also, African-American men come to be diagnosed mostly in later stages of diseases. They tend to get medical attention later. And that adds to the poor prognosis.

GUPTA: So that's maybe an issue of access to healthcare as well to some extent. Let's keep on topic here. A question on the topic of men's cancer.

Pete in Virginia asked this question. "Are there really any reliable tests for colon and prostate cancer?" And you know, we can't get through this show, Dr. Bonhomme, without talking about the PSA test.

Let's talk about it. Who needs to get it? Do you advocate it?

BONHOMME: I advocate it and I take it myself. I think it's a good basic screen. It doesn't necessarily point to prostate cancer, but something wrong with the prostate. But it also has to be combined with a rectal exam to be maximally effective because either one can miss certain things that the other can't pick up.

Colon cancer definitely they are reliable tests, sigmoidoscopy, colonoscopy, visualizing the colon. They can find it if it's there.

GUPTA: Dr. Jean Bonhomme. It's been a great show. Lots of good advice. Thanks so much for being with us this morning.

BONHOMME: Thank you for having me.

GUPTA: Happy Fathers Day to you.

BONHOMME: Thank you.

GUPTA: When we come back, going organic. How students work together for a healthy campus.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: I used to weigh 250 pounds when I was 18.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: Not the average college eating story. Discover why these veggies are packing a powerful punch.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. Well, we've been talking about men's health issues today. And experts believe obesity and diet can be risk factors for heart disease and some male cancers as well.

For that and many other health reasons, we've been on a quest to help build a more fit nation. A part of that quest is searching out people and places, trying to create healthier futures.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): When you think of a college student's diet, you probably envision pizza, beer, and fast food. However, one college is offering a fresher, healthier option. UC Berkeley has gone organic.

CHUCK DAVIES, EXEC. CHEF, UC BERKELEY: We're 100 percent certified organic. What that means is at least 95 percent of the products that we have on our salad bar on any given -- at any given time are organic.

GUPTA: Berkeley says it's making history, but it's now the first college in the nation to have a certified organic salad bar. Now being organic meant meeting strict food guidelines.

DAVIES: And then the processing has to happen in a separate space so that there's no intermarrying between conventional products and organic.

GUPTA: Berkeley Student Dining Committee insisted the organic salad bar accommodate special dietary needs, such as vegan, vegetarian and allergies to gluten, soy, and milk. The students also felt passionate about helping the environment and the community.

DAVIES: Berkeley is, you know, the birth of the free speech movement. And it's very politically progressive. And there's -- I think there's a lot of awareness about organic and the advent of supporting local farmers.

GUPTA: One Berkeley student credits the organic salad bar with transforming his life.

GARY CHAMPAGNE, BERKELEY STUDENT: I used to weigh 250 pounds when I was 18. So the way I did it was basically when I come in here, before I could eat what I wanted to eat, I would have to eat a full serving of vegetables or a salad first with a glass of water just to kind of fill myself up.

(END VIDEOTAPE)

GUPTA: And boy, he looks remarkable as well. Great idea, Gary. And congratulations on losing all that weight. And according to the Centers for Health Statistics, folks like Gary who get healthy don't have to see the doctor as much. And they have better health than those who remain obese.

That is just one reason we are committed to helping you stay healthy and get healthy. For ideas on how to do that, tune in to our Fit Nation special. That's coming up this weekend.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Childhood obesity rates are exploding. Diabetes, heart disease, even death now coming at a young age. Where will we find the answer to this contemporary health crisis? From government, from doctors, from big business?

BILL CLINTON, FORMER PRESIDENT OF THE UNITED STATES: It costs a lot more to let this obesity epidemic develop and then pay for the consequences of it.

GUPTA: Is there something you can do?

UNIDENTIFIED FEMALE: We are looking for this magic bullet. There is no magic bullet. There is commonsense.

GUPTA: How did we get here? And what can we do to create a fit nation?

(END VIDEOTAPE)

GUPTA: And find the answers to those questions and more when my Fit Nation special airs. It's this Sunday night at 7:00 p.m. Eastern. You can watch HOUSE CALL every weekend for the latest news and ideas about turning back this nation's obesity epidemic. We are committed to this.

In fact, next week on the show, we're going to go behind the headlines to investigate the brain-heart connection. How big of an impact do they have on one another? It's fascinating. The answers are going to surprise you.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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