Overview

This overview focuses on how an Integrative Health approach can be useful for prevention and treatment of issues specific to men. As with all aspects of our health, men’s health issues do not exist in isolation; focusing on prostate health, erectile function, testosterone, and other concerns must be done with the full picture in mind. Integrative Health emphasizes mindful awareness and general self-care along with conventional and integrative approaches to health and well-being. The Circle of Health highlights eight areas of self-care: Surroundings; Personal Development; Nutrition; Recharge; Family, Friends, and Co-workers; Spirit and Soul; Mind and Emotions; and Physical Activity. The patient narrative below provides an example of what might be covered in a men’s health-focused encounter. Some studies have also showed success with certain complementary approaches, particularly supplements, when prostate cancer, erectile dysfunction, benign prostatic hypertrophy, testosterone deficiency, and other problems arise.

Meet the Patient

Keith is an 88-year-old retired teacher who is seeing you for an Integrative Health visit. His wife of 60 years died unexpectedly five years ago from a stroke. He has a history of prostate cancer (Gleason score of 8, 4+4) and is status post-prostatectomy in 2010. Before that, he had benign prostatic hypertrophy (BPH) with severe lower urinary tract symptoms with an average International Prostate Symptom Score (IPSS) of 24 and had a prostate-specific antigen (PSA) level of 27 before his prostatectomy. He now suffers from urinary incontinence and erectile dysfunction (ED) with an International Index of Erectile Function (IIEF) score of 6, but he is not interested in treatment for ED.

Keith’s stated reason for coming in today is to improve his chances of living until 90, so that he can see his granddaughter, Jessica, get married. He is very close to her because she lived with him and his late wife after his daughter passed away from a drug overdose. Jessica is currently attending college locally.

Keith’s son, Jeremy, 52 years old, is struggling with depression and substance abuse. Jeremy is recently divorced and moved back in with Keith. Keith is concerned that Jeremy’s depression is worsening as his alcohol use increases.

Keith’s other past medical history includes the following:

• He has coronary artery disease and had a four-vessel bypass in 2000. 
• He has recently had bilateral cataract surgery. 
• His PSA was undetectable until last year when it was 0.05 ng/dL. Just last week it increased to 0.75 ng/dL, and he is aware that this means his prostate cancer is coming back.