In this article: Heart disease Hypertension Back Pain Prostate Cancer Erectile Dysfunction Testicular cancer Diabetes Also this week: Benson Campbell's triumph over testicular cancer 5 things you can do right now Resources: More information Ask Dr. Tedd Mitchell a health question

HEALTH REPORT

Manage stress. Manage illness.

Men: We're talking heart disease. Hypertension. Back pain. Prostate cancer. Erectile dysfunction. Testicular cancer. Diabetes. With "Men's Health" magazine, we bring you solutions to maximize your well-being.

Cancer is the original terrorist. Its sleeper cells wait until an appropriately random moment and then begin to mutate and multiply. Other illnesses, such as hypertension, can be equally capricious, plotting their attack for decades, until one day -- boom! -- it feels as if a bomb has been detonated in your brain.

Time to worry? Yes. And no. As with al-Qaeda, the fear of a terrorist attack can be as damaging as the attack itself. For example, the psychological stress of worrying about, say, prostate cancer has the physiological effect of increasing cortisol levels. A key stress hormone, cortisol plays a critical role in the body's fight-or-flight response to danger. But like always being at orange alert, too much cortisol released too often can wreak its own havoc -- especially in men.

When Arizona State University researchers exposed middle-aged and older men and women to the same type and level of stress, they discovered that the men pumped out significantly more cortisol. But here's the disturbing part: Elevated cortisol levels have been linked to increased risk of heart disease, hypertension, diabetes and, coming full circle, prostate cancer. Bottom line: These diseases don't even have to attack to win.

So if worrying is dangerous, and not worrying at all is dangerous, too, what's the answer? Take action. Not only will you feel more in control, which will dramatically lower your stress levels, but you'll also be taking the fight to the terrorists, rather than waiting for them to attack, resulting in a frantic 911 call.

To that end, we've plotted out the following plan for preventing, detecting and treating some of the worst threats to your health and well-being. Think of it as your body's Department of Homeland Defense, minus the government bureaucracy.

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HEART DISEASE

We were all born with immaculate arteries. Then we learned how to feed ourselves, and from that moment our hearts have gradually gone from clean to clogged. The result: Heart disease affects more than 13.2 million Americans and is the No. 1 killer of men. Scary statistics, but not immutable ones.

The easiest place to start protecting yourself is your snack habit. Instead of mindlessly munching on chips, grab a handful of unsalted almonds. Researchers at Loma Linda University in California found that adding that many almonds to your daily diet can reduce low-density lipoprotein (LDL) cholesterol -- the "bad," plaque-forming kind -- by 7%. It isn't magic that performs this trick. It's monounsaturated fat, as well as vitamin E and fiber.

Although the chips have to go, the beer can stay. Researchers from the Netherlands discovered that men who drank 2 pints of beer daily raised their levels of high-density lipoprotein (HDL) cholesterol by 7% after 10 days, and 12% after three weeks. (Note: More beer is not better.) Think of HDL cholesterol as your circulatory system's garbage truck -- it's responsible for picking up all the trash (LDL cholesterol) gunking up your blood vessels, then hauling it to your body's recycling center (the liver).

As important as LDL and HDL are to your heart health, another acronym is just as critical: CRP. That stands for "C-reactive protein," an inflammation marker in the bloodstream that, at elevated levels, can signal heart disease in men whose cholesterol levels and blood pressure are only slightly elevated. In fact, new research indicates CRP may even contribute to ticker trouble.

"Over the last 10 years, we've learned a lot about the molecular biology of atherosclerosis," says Sidney Smith, M.D., director of the Center for Cardiovascular Science and Medicine at the University of North Carolina at Chapel Hill. "From this research, we are now beginning to investigate additional markers beyond the standard epidemiological risk factors that might help us."

Another such marker is Lp-PLA2, which is mercifully short for "lipoprotein-associated phospholipase A2," an enzyme that's been shown to increase heart attack risk by 67%. The Food and Drug Administration recently approved a blood test for Lp-PLA2 called PLAC.

And what if you are diagnosed with heart disease? Cholesterol-lowering drugs called statins have improved the prognosis for millions of men, as has the continued refinement of angioplasty, a procedure in which a balloon is inserted into the affected artery and slowly inflated until the blockage is cleared. The most notable improvement in angioplasties has been seen with the stent, a sort of scaffold used to keep a cleared artery open.

"With traditional stents, we'd open the arteries with a balloon and put in a stent, but in certain patients, return of narrowing can occur," Smith says. "It's been shown that coating the stents with a drug will prevent the arteries from narrowing and growing in around the stent. That's a major step forward."

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HYPERTENSION

When the National Heart, Lung and Blood Institute revised its blood pressure guidelines in 2003, almost 23 million men who thought they were in the clear suddenly found themselves in a new danger zone called "pre-hypertensive." You're in there with them if your systolic pressure (the top number) is between 120 and 139 or your diastolic pressure is between 80 and 89. Consider it a wake-up call that may help you sidestep a stroke down the road.

Any effort to open your body's pressure-relief valve has to include cutting back on sodium. And it isn't only the stuff in the shaker that you have to watch. For example, 2 cups of cornflakes contains 400 milligrams of sodium, nearly one-third of the daily amount recently recommended by the Institute of Medicine. Cold cuts are another culprit: One slice of ham hides about 240 milligrams.

There's also evidence that building a buff body can result in an equally buff blood-pressure score. In an eight-week study, researchers at Michigan Technological University found that when subjects lifted weights for 45 minutes, three days a week, their blood pressure dropped by an average of nine points systolic and eight points diastolic. It may be that the temporary rise in blood pressure caused by lifting actually helps keep it lower in the long run. "That continued and constant high blood pressure while you're lifting may create some sort of vascular adaptation," says Jason R. Carter, Ph.D., the study's lead author.

If you're already struggling with hypertension, you may want to take a second look at the dental floss gathering dust in your medicine cabinet. Researchers at Harvard have found that men with healthy teeth and gums are less likely to have a stroke. Why? The bacteria that causes periodontal disease can slip into your bloodstream and damage vessel walls.

Just as important, consider buying a home blood pressure monitor. According to a study published in the "Journal of the American Medical Association," 25% of people who monitored their blood pressure daily at home were able to go off their medication after a year. Cuffing yourself also may provide a more accurate snapshot of the inside of your arteries, because the stress many men feel in a clinical setting can cause blood pressure numbers to rise.

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BACK PAIN

Back pain isn't just physically uncomfortable -- it causes wallets to suffer as well. Researchers at Duke University found that Americans with back pain spend about $1,300 more per year than those without the ache, shelling out almost twice as much on doctor's visits and prescription drugs. But new research in the field offers men hope for pain relief without expensive drugs or doctor's appointments.

The first do-it-yourself directive: Try to tune out the ache. One Austrian study shows that listening to relaxing music (although not necessarily "Edelweiss") for a half-hour a day for three weeks can reduce back pain by 40%. The researchers believe the music distracts a person from pain while also reducing stress hormones and muscle tension that can exacerbate it.

Or your path to a pain-free back could be as simple as adding a new supplement to your diet. Chondroitin sulfate may help bad backs just as it's advertised to help bad knees. In a Russian study, 73% of those who took a daily chondroitin sulfate supplement -- about 2,500 milligrams* -- had less pain and more mobility. Apparently, chondroitin helps rebuild the cartilage tissue worn away from the vertebrae, a leading cause of back pain.

At the end of the day, the best remedy for an aching back may be a medium-firm mattress. Researchers in Spain found that those who slept on a medium-firm mattress had half the pain of those who sacked out on a rock-hard bed, the usual choice of people suffering from back attacks. Medium-firm mattresses offer a comfortable middle ground between back support and cushioning for the curves of the spine.

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PROSTATE CANCER

Last month, the Food and Drug Administration approved the claim that walnuts may help prevent heart disease. The bad news: There was no mention that walnuts would do anything for the prostate, the gland they most resemble. Boy, could we have used the help. Prostate cancer killed 29,000 men last year, and 221,000 were newly diagnosed with the disease.

Still, although walnuts may have let us down, there's another "W" food that hasn't: whey. It contains an amino acid called cysteine, which helps to increase our body's production of the prostate-cancer-fighting antioxidant glutathione. Just a small amount of whey -- 500 micrograms -- has been shown by Ohio State University researchers to increase glutathione levels in prostate cells by 64%.

Ricotta cheese is loaded with whey, so why not start eating more Italian? Just hold the high-fat mozzarella, go heavy on the garlic and pour yourself a glass of red wine. In a study published in the "Journal of the National Cancer Institute," men who ate about three cloves of garlic (or 2 tablespoons of scallions) daily had a 50% lower risk of prostate cancer. As for the vino, the red variety contains resveratrol, another antioxidant with cancer-fighting properties.

Starting a food fight with prostate cancer is only one way to beat the disease. From age 50 on, you should have your prostate-specific antigen (PSA) levels checked annually (unless the disease runs in your family or you're an African American, in which case, start at age 45). In the past, only a score of 4.1 or higher was considered dangerous, but that approach may miss 82% of cancer diagnoses in men under 60. Instead, Harvard researchers suggest that readings between 2.6 and 4.0 should be followed by a biopsy. The payoff: You may double your chances of detecting prostate cancer.

Even the worst-case scenario -- a biopsy that comes back positive for cancer -- isn't the nightmare it once was, thanks to advances in treatment. One promising (and completely non-invasive) strategy is to take Zyflamend, a pill that contains extracts from ginger, oregano, rosemary and green tea. It inhibited prostate cancer cell growth by 78% in laboratory experiments.

Or if it looks like removal of the diseased prostate is the best option, ask your physician about the da Vinci system. This procedure allows doctors to perform a radical prostatectomy using 3-D imaging to guide robotic hands through the surgery. It's so precise it reduced the rates of incontinence in postoperative men by 90% and cut the incidence of impotence in half.

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ERECTILE DYSFUNCTION

It's safe to say 2003 was an emotionally (and physically) uplifting year for men suffering from erectile dysfunction. It saw the release of two drugs touted as promising alternatives to Viagra: Cialis from Eli Lilly and Levitra from Bayer. "There's no Holy Grail, but these drugs are as close as it gets," says Neil Baum, M.D., an associate clinical professor of urology at Tulane University.

Levitra may last a few hours longer than the little blue pill, although Viagra can start working more quickly. The downside: Like Viagra, Levitra is off limits to any man taking nitrate medication for a heart condition. That combination has the potential to cause a deadly drop in blood pressure -- which would kill more than the mood.

Cialis uses the same blood-vessel-dilating mechanism as the other two drugs, so it shouldn't be mixed with nitrates either. But one area in which Cialis does differ from Levitra and Viagra is the 36-hour opportunity for amour it provides. "Partners of men on this drug often comment that the sex is natural, the way it once was," Baum says.

Even still, Cialis, Levitra and Viagra should not necessarily be the first line of treatment for a downward-trending love life. Sometimes addressing an underlying medical condition, such as heart disease or hypertension, can help eliminate erectile dysfunction. For example, scientists reported in the "International Journal of Impotence Research" that hypertensive men with erectile dysfunction who took the anti-hypertensive drug monoxidine reported improved erectile function.

For those who don't like the idea of a chemically engendered erection, there are alternative therapies. Austrian researchers recently found that men whose erectile dysfunction was caused by psychological problems responded remarkably well to acupuncture: 70% reported satisfactory results after 20 treatments. Go to nccaom .org/find.htm to find an acupuncturist certified by the National Certification Commission for Acupuncture and Oriental Medicine.

What if your equipment is operating flawlessly and all you want is to buy some insurance to keep it that way? Simple: Do the basics for your heart -- exercise for at least 30 minutes three days a week, and avoid saturated and trans fats -- and, barring any psychological sabotage on your part, you should be able to dodge erectile dysfunction.

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TESTICULAR CANCER

A story of inspiration Benson Campbell, 29, used his own triumph over cancer as a steppingstone to raising money so others could afford the same quality of medical care that saved his life. Story

We hope Lance Armstrong continues to rack up the Tour de France wins, if for no other reason than to keep testicular cancer in the national spotlight. His own cancer was diagnosed at age 25, when he was squarely in the at-risk group -- men between 15 and 40. Fortunately, the disease is rare, affecting less than 1% of the male population, and now entirely treatable. "Today, 95% of those diagnosed with testicular cancer should be cured," says Patrick Loehrer, M.D., director of the hematology and oncology program at the Indiana University Cancer Center.

The key, of course, is early detection. Perform a monthly testicular self-exam during a hot shower, when the skin is softer and more relaxed. Gently roll each testicle between your fingers, feeling for lumps or other masses. If you notice anything suspicious, even something the size of a pea, see your physician, who can then schedule follow-up tests to pinpoint the problem.

One of the most high-tech of these tests is being used by doctors at New York's Weill Cornell medical school. Employing needles guided by ultrasound and an operating microscope, they're able to open up the testicle without injuring it, says Marc Goldstein, M.D., the urologist who pioneered the technique. "Then I can follow my needle right to the tumor and remove it. If it turns out to be benign, I can sew the testicle up and save it." And if it's malignant? "Most men only require removal of the cancerous testicle and low-dose radiation to prevent recurrence," Goldstein says.

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DIABETES

As our waistlines balloon, so does the rate of diabetes -- about 8.7 million American men have either Type 1 or Type 2 diabetes, and hundreds of thousands more will be diagnosed with some form of the disease this year. What's worse, the damage caused by runaway blood sugar also can include a cardiovascular train wreck: Diabetics are up to four times more likely to die from heart disease and stroke than non-diabetics.

Despite the numbers, there is reason to be optimistic, because at least now we're making better use of one of our most powerful weapons: education.

"It's everywhere. You hear about diabetes on the nightly news, in the schools, in the Department of Health and Human Services," says Robert Rizza, M.D., vice president of the American Diabetes Association. This shift in attitude can be seen everywhere from McDonald's, which has said it will eliminate its "supersize" option, to schools in cities such as Los Angeles and Philadelphia, which have banned the sale of sodas and other sugary drinks, to the government, which recently announced plans to develop a national strategy for targeting obesity.

You can make a few far-reaching policy changes of your own, beginning with breakfast. In one Harvard study, researchers determined that eating a healthful morning meal reduces the risk of diabetes by 35% to 50%. Note that "healthful" means eating fruit and whole-grain cereals at home, not popping energy bars and Red Bull in your car. Whole grains help control your appetite and regulate your metabolism, while also providing magnesium, a mineral that may help reduce the risk of diabetes as much as 30%. Top your cereal with cinnamon and you'll cut the risk even further; studies have shown 1 teaspoon of cinnamon daily can improve blood sugar levels.

Try to work more dairy into your diet, too. Harvard researchers (busy, aren't they?), in collaboration with other scientists, determined that people who ate three servings of dairy daily were 60% less likely to be overweight than those who consumed less. Calcium is the key component. In its dairy form, calcium requires your body to burn more calories during digestion than other nutrients do. Aim for about 1,200 milligrams daily, and make sure most of your moo is the low-fat kind. A diagnosis of diabetes calls for a slight shift in strategy. In addition to the obvious must-do of managing your blood sugar, take a daily multivitamin. A study published in the "Annals of Internal Medicine" revealed that diabetes sufferers who adopted this one health habit helped reduce their risk of certain illnesses, such as the flu and upper respiratory infections, by 75%.

Whatever you do, don't let diabetes dampen your sense of humor: Japanese scientists found laughing helps lower blood sugar.