A Guide to the Gay Man's Physical Exam

Generally, all patients should be screened annually for heart disease and cancer. Routine annual physicals should always include height and weight assessments, blood pressure readings, and temperature measurements as a way to monitor patients over time, but also to hint at impending disease states. High blood pressure is usually a silent disease and, if left untreated, may lead to issues with heart and kidney disease. Loss of height may indicate osteoporosis, while weight gain can mean fluid retention but can also indicate heart, liver, or kidney disease. On the other hand, weight loss can be a consequence of infection or cancer. Likewise, baseline blood work should include checking cholesterol (high levels are a contributor to coronary artery disease), sugar (an indicator for diabetes), and baseline electrolytes, urine analysis, and complete blood counts to assess heart and kidney health.

For men over age forty, it is recommended that a digital rectal exam be performed to palpate the prostate. This will test not only for prostate cancer but for fecal occult blood (FOB), which is a screening tool for colon cancer. In addition to the digital rectal exam, a prostate specific antigen, or PSA (a blood test that aids in screening for prostate cancer), is also highly recommended. After age fifty, a screening called a colonoscopy is important to assess the entire colon for the possibility of cancer, polyps, or other abnormalities.

The annual physical exam is taught as a universal modality in medical schools. Since there are certain risk factors that pertain specifically to the gay community, this discussion will focus on aspects of the physical exam that are critical for gay men.