Healthwise Maui

Q: Should all men be screened for prostate cancer, and is PSA screening enough?

Dr. Derrick Beech, surgical oncologist, Maui Health System: Men’s health is something that we’ve struggled with nationally, as many men avoid seeing the doctor unless there is a traumatic or life-threatening issue. We need to encourage men to approach their health and wellness as they do their vehicles. Maintenance checks can prevent catastrophic issues from developing. Prostate cancer screening involves a rectal exam and PSA (prostate-specific antigen) test. Although controversial, serum PSA checks can detect prostate cancer at a treatable stage and are still recommended.

Q: I have diabetes. Why does my doctor want to check the blood pressure in my legs?

Dr. Robert Connaughton, vascular surgeon, Maui Health System: Anyone with diabetes should have a screening called an ankle brachial index and have their toe pressure checked as well. The ankle brachial index is a simple and painless screening tool that compares the blood pressure in your ankles with the blood pressure in your arm. In a healthy person, those two numbers should be the same. But if the blood pressure in your ankles is lower, it could be a sign that plaque in your arteries is restricting blood flow to your legs. This can cause serious health problems that lead to limb loss. With screening, your doctor can let you know if medical intervention is necessary.

Q: I read that smoking increases the risk of heart disease. What about marijuana?

Dr. Robert Connaughton, vascular surgeon, Maui Health System: I’ve treated patients in their 20s and 30s for conditions like emphysema and blocked blood vessels due to smoking marijuana. By now, many people are aware that smoking cigarettes can cause problems like a hardening of the arteries and the buildup of plaque in your blood vessels, as well as diseases like emphysema and COPD (chronic obstructive pulmonary disease). But they may not realize that the health risks associated with smoking also apply to marijuana.

While smoking can lead to health problems in anyone, people who have diabetes or a family history of heart disease should be especially cautious about smoking in all forms, including marijuana.

Q: What causes liver cancer and bile duct cancer, and why are they more prevalent in Hawaii?

Dr. Derrick Beech, surgical oncologist, Maui Health System: Hawaii has a unique demographic profile compared to the Mainland USA and Asian countries. In several Asian countries, liver and bile duct cancers are more prevalent than on the Mainland U.S. Much of this increased risk is related to diet. However, we currently don’t have enough information to address early detection and prevention.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem.org/contact.