Cancers
All cancers are caused by the runaway growth of cells in various parts of the body. With time, uncontrolled cell growth results in masses of tissue called tumors that can often be felt as lumps under the skin or seen on the skin. Screening for different cancers occurs at different times during the life cycle, whether a man is gay or not.

However, gay men are at greater risk than straight men for many cancers. Prostate, testicular, colon and lung cancers are significantly more common among gay men. Only a few types of cancer are discussed here, but that does not mean gay men are only at risk for these types of cancer. Every gay man should educate himself about cancer in general and pay especially close attention to any unusual changes in the skin or other parts of the body that may be the first signs of the onset of cancer. A family history of any type of cancer is also an indication of increased risk for all kinds of cancer so even closer attention should be paid if a number of relatives have had cancer.

For more information on cancer go to the American Cancer Society’s website at www.cancer.org.

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  Colon Cancer (Colorectal Cancers)
Colon cancers involve malignant tumors in the rectum or colon. Colorectal cancer is the second leading cancer killer in the United States and is a cancer that disproportionately affects men. Of those affected, 58% are men who are predominantly over 50 but it can strike much younger men as well. Most colorectal cancers develop during a ten-year “silent window period” from benign polyps (excess tissue growths in the colon), which can be seen and removed using anal scopes while still in the benign stage

Symptoms may include:

1. Change in bowel habits, that is, frequency, stool consistency, etc.
2. Blood in the stools
3. Bowel obstruction near the tumor (rare)
4. Anemia with tiredness, malaise or pallor
5. Unexplained weight loss
6. Enlargement of the liver due to a spreading tumor causing pain and/or jaundice mimicing some symptoms of hepatitis
7. No symtoms at all

Risk Factors:
Direct causes of colon cancer have not been identified but a number of factors that can put you at higher risk of developing this type of cancer include:

1. Age--most cases appear in the 60s while cases under age 50 are uncommon unless a family history of early colon cancer is present
2. Polyps in the colon
3. Personal history of other cancers
4. Family history of colorectal cancer
5. Long-standing ulcerative colitis
6. Smoking--male smokers have a 30% increased risk of dying from colon cancer
7. Diets high in fats and red meats and low in fresh fruit, vegetables, poultry and fish.
8. Physical inactivity and obesity
9. Exposure to some viruses—especially the human papilloma virus (which also can cause anal warts)
10. Heavy alcohol use

Diagnosis and Screening:
There is a wide range of diagnostic tests and screenings available now for your doctor to use in determining if you have colon cancer or polyps that may become cancerous. The most frequently used procedures and tests include the following:

1. Fecal occult blood test to search for blood in the stool that may not be visible to the naked eye
2. Digital rectal examination to feel for abnormal areas in the rectum
3. Endoscopic examinations including Sigmoidoscopy for the lower colon and Colonoscopy for the entire colon
4. Barium enema with X-ray or Virtual Colonoscopy (using a special computed tomography scan instead of X-ray)
5. Blood tests for elevated levels of certain proteins given off by tumors

Treatment for Colorectal Cancers:
Treatment for colorectal cancers largely depends on the stage the tumor is in which can only be determined in consultation with oncologists and colo-rectal surgeons. When colon cancers are caught in the early stages (with little or no spread to other organs), it can be cured with surgical removal of infected parts of the colon. Subsequent chemotherapy and/or radiation therapy may be recommended depending on the stage and spread of the cancer and other medical considerations.

Prevention:
Because colon cancers can be well advanced before they are detected, the most effective ways to prevent colon cancer is to try and reduce any risk factors you may have and get screened. Beginning at age 50, or before age 50 if you have a family history of colon cancer, get screend by asking your doctor if an occult blood test is necessary or by getting an endoscopic examination every 3 to 5 years. Early detection and removal of precancerous polyps are the best way to prevent colon cancer.

For more complete information on colorectal cancers, click on the following site: www.medicinenet.com/colon_cancer.

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  Lung Cancer
Lung cancer is the number one cause of deaths in both men and women in the United States and around the world. Smoking as the number one cause of lung cancer everywhere. Some studies have shown gay men smoking at the rate of 50% which is twice as high as the 23% of adults in the U.S. who smoke. While smoking continues to decline among the straight population, smoking appears to be increasing among gays and so lung cancers deaths are on the rise along with other tobacco-related health problems such as heart disease, high blood pressure and stroke. Lung cancers tend to spread very early in its course and so is very life-threatening. It is also one of the most difficult cancers to treat. Lung cancers can spread to any part of the body, particularly the adrenal glans, liver, brain and bone.

Causes:
Exposure to cancer-causing substances are thought to cause changes to the tissue of the lungs that build up over time. More and more tissue gets damaged until tumors develop. The major causes of lung cancer include:

1. Carcinogins in cigarette smoke, asbestos, some air pollutants, etc
2. Radiation exposure such as to radon gas or excessive X-rays
3. Genetic or family suseptibility
4. Viral infections may also influence course of the disease

Symptoms and Signs:

1. Shortness of breath
2. Coughing up blood
3. Chronic cough or change in coughing habits
4. Wheezing
5. Pain in the chest or abdomen
6. Weight loss, fatigue and loss of appetite
7. Hoarse voice
8. Difficulty swallowing
9. Clubbing of the fingernails(uncommon)

Prevention:
Tobacco smoking is still widespread and so cessation of smoking is the best way to prevent lung cancer including second hand or passive smoking. In up to 25% of people with lung cancer there will be no symptoms until a lesion or tumor is first discovered on a routine chest x-ray or CT scan. Because treatment and sucessful outcome depends heavily on early diagnosis of lung cancer, new screening tests using advanced CT scanning are now being developed but the process is expensive and not covered by most health care plans. Because there are few signs and symptoms of lung cancer that appear before the disease is very advanced, smoking cessation is the only effective means of preventing lung cancer at the present time.

Treatment for Lung Cancer:
Treatment of lung cancer usually involves a combination of surgery, chemotherapy and radiation therapies. Some newer experimental methods are also being used all of which have to be worked out with board certified oncologists and/or surgeons.

For more complete information on lung cancer, go to the following site: www.medicinenet.com/lung_cancer.

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  Male Breast Cancer
While cancer of the breast in men is rare and accounts for only 1% of all breast cancers, there is evidence that a disproportionate number of those affect gay, bi-sexual and transgendered men. All men possess a small amount of nonfunctioning breast tissue that is concentrated directly behind the nipple even though it never produces milk. Any condition that increases the amount of breast tissue, such as estrogen treatments, obesity or even heavy use of pot, can also increase a man’s risk of breast cancer. Most male breast cancer occurs in men over age 60 but younger men also get breast cancer so every man should pay attention to unusual lumps in the breasts.

Causes:
As with many other cancers, the cause of male breast cancer has not been fully discovered but certain environmental and genetic influences are known to play a role and therefore are risk factors for male breast cancer including the following:

1. Radiation exposure, especially radiation therapy in the chest area
2. Unusually high levels of estrogen, a female hormone
3. Abnormally enlarged male breasts or gynecomastia
4. Family history—several female relatives with breast cancer
5. Cirrhosis (damage) of the liver, usually associated with alcohol abuse
6. Medications including antipsychotics and those used in the treatment of prostate cancer that lead to gynecomastia. Some also include excessive marijuana use.

Signs and Symptoms:

1. Non-painful lump just under the nipple
2. Ulceration or changes of the skin in the area of the nipple
3. Bloody or opaque discharge from the nipple
4. If spread to other body parts, same symptoms as other cancers including weakness, malaise and unexplained weight loss

Diagnoses and Treatment:
Since men have little breast tissue most lumps can be felt, most mendo not require a mammogram. Male breast cancers are most often diagnosed by taking a biopsy of the lump and examiniation under a microscope. Often the lump is just ta ken out and then examined for cancerous tissue. If a nipple discharge is present, microscopic examination of a smear can often diagnose breast cancer.

If the lump is a cancerous tumor, further tests such as x-rays, CAT scans or MRIs are sometimes prescribed in order to determine if the cancer has spread. If the cancer has not spread, male breast cancer is virtually 100% curable. However, if the tumor is not discovered early and has spread to other parts of the body, more aggressive surgery, chemotherapy and radiation may be recommended by your doctors.

For more complete information on male breast cancer and gynecomastia go the following sites: www.medicinenet.com,
en.wikipedia.org/wiki/Gynecomastia.

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  Prostate Cancer
Prostate cancer is a malignant tumor of the prostate gland which can be confused with a benign enlargement of the prostate that usually comes with age. Prostate cancer mostly affects older men but is the second leading cause of deaths from cancer among American men of all ages. Prostate cancer usually grows very slowly, at least more slowly than most other cancers. Because of slow growth these cancers may take years or even decades to spread to other parts of the body like the bladder, lungs, liver or bones which is what actually kills people. However, with early onset in men under age 40, the cancer can be much more aggressive and can spread quickly to other parts of the body so doctors may recommend more aggressive treatments like surgery if you are under 40. The causes of prostate cancer are unknown but a few risk factors have been identified, especially aging and a family history of prostate cancer.

Symptoms of Prostate Cancer:

1. Early stages have no symptoms
2. Hard nodule or lump in the prostate
3. Difficult, frequent urination
4. Burning with urination
5. Blood or clots in the urine

Prevention and Treatment:
No measures are known to prevent prostate cancer but changes in diet may prevent or slow the progression. Low fat diets, avoiding red meats, use of soybean products, eating tomato products or other foods high in lycopenes, the mineral selenium and vitamin E are all thought to slow the growth of prostate tumors. Some herbal supplements like Saw Palmetto Oil are also thought to be beneficial.

Proven preventative measures include regular screenings for prostate cancer. Digital rectal examinations beginning by age 40 can detect unusual lumps or nodules in the prostate. A simple blood test that measures the Prostate Specific Antigen (PSA) released by the prostate into the body can also detect high levels of this antigen which sometimes indicates possible prostate cancer. PSA readings up to 4 are considered “normal”, from 5 to 10 are “borderline” and may be caused by prostate infections or other factors unrelated to cancer. Very high readings of 30 or more are almost always indications of advanced prostate cancer. Regular PSA tests are recommended for men age 50 or older.

Treatments for prostate cancer range from surgery to remove the prostate, external radiation treatments, radiation seed implant therapy and alternative treatments, listed here in order of the degree of invasiveness of the treatments. All three standard modes of treatment are very successful if the cancer is detected early before it spreads, however, surgery is the most traumatic and may result in impotence or incontinence or both. Alternative medical treatments including use of herbal or dietary supplements and acupuncture have also shown efficacy in dealing with this condition. One new and promising treatment is an herbal medicine called PC Spes. In some trials for men who have failed standard medical treatments for advanced prostate cancer, use of this herbal drug appeared to be useful.

For more complete information on prostate cancer, click on the following sites: www.medicinenet.com/prostate_cancer or www.www.healthpolitics.org

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