Silent killers - How yearly check-ups can save lives

Dr. Suresh Rajpaul, Specialist Physician at Melomed Gatesville

More than half of all premature deaths among men are preventable. Getting an annual physical exam or check-up and scheduling the necessary health screenings can detect and treat preventable health problems like heart disease, prostate cancer, hypertension and diabetes early. These silent killers, with no visible signs or obvious symptoms, prefer men as their targets, and can progress to an advanced stage before they are discovered. Additionally, HIV and depression are less well taken care of by men as compared to women. Unfortunately, these medical conditions are often overlooked until it is too late to intervene. But most men are unlikely to seek medical care unless they are experiencing symptoms, they cannot ignore any more, or are confronted with a serious health issue. In fact, men are 25% less likely than women to go to the doctor for annual exams and preventive care.

Being aware of the deadliest silent killers can help you or a man you care about, be proactive in preventing and treating these health issues.

1. Heart Disease

Heart disease and stroke are South Africa’s biggest killers after tuberculosis and HIV/AIDS. The World Health Organization (WHO) estimates that up to 80% of premature cardiovascular disease (CVD) and strokes can be prevented through lifestyle change and proper management of blood pressure, cholesterol and blood sugar (WHO Global NCD report). CVD encompasses a wide range of conditions that affect the heart and blood vessels, which includes heart failure, angina, coronary artery disease and arrhythmias.

Heart disease (CVD) is so deadly because it causes few to no symptoms in its early stages. Several of the most common risk factors for heart disease like high blood pressure, high cholesterol, and a family history of heart disease do not necessarily have symptoms a person can feel. If left unchecked, these risk factors can add up over time. It is important to see your doctor on a regular basis to make sure all of your cardiovascular risk factors are well-controlled.

Did you know?
Erectile dysfunction can be the first sign of current or future heart disease. Somebody who doesn’t have any other problems, but notices erection difficulties in either getting or maintaining an erection should view this as a first sign that he needs a cardiovascular check-up.


2. Prostate Cancer Prostate cancer is the most commonly diagnosed cancer in South African men. An estimated 1 in 15 South African men will develop prostate cancer in their lifetime (CANSA). This form of cancer is life threatening if left untreated. Unfortunately, prostate cancer typically produces no symptoms until it has metastasized, or spread throughout the body. It is thus important for men to go for regular check-ups as many men do not notice the symptoms during the early stages. For this reason, regular prostate-specific antigen (PSA) screening is of the utmost importance for detecting prostate cancer while it is localized to the prostate.

CANSA recommends talking to your doctor about screening by age 45, or sooner if you have a family history. The most common risk factors are being of African ancestry, older than 50 years and a family history of prostate cancer on either the mother or father’s side. Black men are more likely to get prostate cancer at a younger age and a more aggressive type of prostate cancer. If detected early there is a 98% chance of survival beyond 5 years. If detected late, the % chance of survival beyond 5 years is only 26%.

Did you know?
The main function of the prostate is to produce prostatic fluid to carry the sperm. Three quarters (75%) of men over 50 do not know what the prostate’s function is.


3. Hypertension
Hypertension or high blood pressure, which, if left untreated, can lead to a fatal heart attack. Although 1 in 4 men have hypertension, most people do not know they have it. Blood pressure may gently increase over time due to a lot of different factors: chronic stress, poor diet, and family and genetic influences. Uncontrolled hypertension causes premature death. It increases the risk of heart attack, stroke, kidney failure, blindness and other complications.

Did you know?
Sustained blood pressure higher than 135/85 mm Hg may often be accompanied by prediabetes, diabetes , weight issues and elevations in cholesterol


4. Diabetes
589 million people have diabetes in the world and 25 million people in the Africa Region; by 2050 it will be around 60 million. Out of the 49 countries and territories in the International Diabetes Federation’s (IDF) Africa Region, SA has the fourth highest number of adults (20 – 79 years) – 2.32 million, living with diabetes (IDF, 2025).

Diabetes can increase the risk of heart disease, strokes ,blindness , amputations and chronic kidney failure leading to dialysis. It’s easy for diabetes symptoms to go undetected, but frequent urination, fatigue, weight loss and blurred vision are all symptoms of the condition.

A blood glucose screening test, starting at age 45 and repeated annually is recommended. Screenings may begin earlier or be done more frequently if you are at risk for diabetes (for example, being overweight or having high blood pressure and/or high cholesterol or a positive family history of diabetes).

Did you know?
Worldwide half the people with diabetes are undiagnosed, and in SA the figures are not much better. An estimated 2 million South Africans do not know they have diabetes.

Adopting a healthy lifestyle and scheduling routine check-ups can help prevent or catch these silent killers before it’s too late. The best screening test is the one that gets done. Missing out on potentially live saving screenings may put your health at risk. Early detection is key. See your doctor or health practitioner – routine check-ups can spot a number of conditions that can impact a man’s health.


Sources and references consulted
www.cansa.co.za
www.diabetessa.org.za
www.heartfoundation.co.za