PORT ST. LUCIE — Men often delay or avoid preventive medical care, a habit that can make it harder to detect serious health conditions early, according to a Treasure Coast urologist marking Men’s Health Month.
Dr. Michael Tradewell, a urologist with Florida Coast Medical Center in Port St. Lucie, said routine screenings and timely evaluations can play a critical role in identifying health issues before they become more serious.
“As a urologist, when it comes to early detection of urologic issues, that can make all the difference,” he said.
Among the conditions he watches for most closely is prostate cancer, one of the most common cancers affecting men. Tradewell said recommendations vary depending on whether a patient is experiencing symptoms or is seeking routine preventive care.
“There's actually a difference between routine screening in the asymptomatic male and then when men are having symptoms. So if men have slow stream or trouble with urination, it's actually not screening anymore, and they should get checked out,” he said.
For men without symptoms, screening decisions are based on age and individual risk factors.
“But in truly asymptomatic men, screening really comes to shared decision making about whether or not to be tested and then risk,” he said. “The earliest that we start screening men is at 40 years old, and these are men with elevated risk. And so those risk factors are men with African-American race, if you have known genetic mutations or a strong family history of prostate cancer, and those men can start at 40. Men at average risk, the earliest we would check is actually 45.”
Tradewell said prostate cancer screening is most common for men between ages 50 and 69.
“That's called an early baseline. That's sort of the bulk of prostate cancer screening happens between the ages of 50 and 69 years old,” he said.
While prostate cancer is a leading concern for older men, younger men face different risks. Tradewell said testicular cancer, though uncommon, can have serious consequences if not detected early.
“Testicular cancer is rare, but can be devastating for young men,” he said. “This is best done in the shower, and basically if testis cancer feels like a hard lump within a regular border, that's actually inside the testicle.”
Tradewell also said misconceptions about testosterone treatment can prevent some men from getting appropriate care. He said younger men often assume they need testosterone therapy when lifestyle changes may be sufficient, while older men are more likely to benefit from supplementation.
“One of the largest misconceptions I see for people is that they think testosterone is a young man's game,” he said. “But often I find that these young men don't always need it, and sometimes lifestyle changes can be enough to really improve how they're feeling. But men in their 60s and 70s are often the ones who need testosterone supplementation and can benefit the most.”
He cautioned against purchasing supplements online without medical supervision and said patients should discuss treatment options with a physician because testosterone therapy requires ongoing monitoring.
“The two primary things we watch out for are heart attack and stroke risk, as well as prostate cancer,” he said. “We know testosterone doesn't cause prostate cancer, but it can make it act more aggressively should you develop it, and so it's important to be following the PSAs while men are on testosterone supplementation.”
He added that blood testing remains an important part of managing cardiovascular risks associated with treatment.
“And then with heart attack and strokes, there was a big study in 2023 that came out and said testosterone is safe for your heart, but if you look at that data closely, anyone at higher risk because of elevated hematocrit, they're actually taken off the trial,” he said. “So it's important to have routine blood monitoring to mitigate these risks.”
Since arriving on the Treasure Coast, Tradewell said one diagnosis has appeared more frequently than he expected.
“I've been surprised by how much bladder cancer I've diagnosed,” he said.
He said blood in the urine should never be ignored and warrants prompt medical attention.
“The first sign of bladder cancer that can be useful in terms of screening is anytime you see blood in the urine,” he said. “So if you ever see blood in the urine, it warrants prompt evaluation by a urologist.”
Despite the range of health concerns men may face, Tradewell said the foundation of prevention remains straightforward.
“When it comes to these men's health issues, essentially there's three things, and there's no surprises here; it's diet and exercise and then sleep,” he said.
He also encouraged men not to let anxiety or embarrassment keep them from seeking care.
“When you visit the urology office, you can expect to leave a urine sample, you can expect to be examined, and I think you can expect to leave thinking that that visit wasn't as bad as you thought it was going to be,” he said.
Tradewell added that Florida Coast Medical Center has specialized equipment available to address a wide range of urological conditions.