I’ve just turned 50; the great half-century of a man’s life. A time of wisdom, reflection and probing; not of the meaning of life or the mysteries of the universe. The other sort – the one sort of probing we blokes don’t like to discuss. I’m not a paragon of virtue when it comes to health and fitness, but this is an easy one to manage although not too pleasant.
Prostate cancer is a big threat to New Zealand men. All the resources available say that it kills around 600 New Zealand men a year and that is from a pool of 2,500 men diagnosed with the disease. On these figures alone that’s a 24% mortality rate for men diagnosed with prostate cancer. Most of the diagnosed cases of prostate cancer are found in men above the age of 60. Interestingly enough, the prevalence of prostate cancer in Maoris is lower than non-Maoris; however the mortality rate is higher.
What is a prostate and why should I care?
The prostate is an almond shape gland that surrounds the entrance to the bladder. Its main role in the body is to produce seminal fluid – the fluid that protects and transports sperm through and out the body. Think of it as the jelly that surrounds passionfruit seeds or to put it more crudely, the “wet spot”. In some older men usually after 50, the prostate seems to grow on its own accord, especially the part that is around the urethra. This can make it more difficult for the man to pee. It’s just one of those mysteries of the aging body, like ear hair – a cruel joke.
Cancer in the prostrate occurs when the cells that make up the prostate mutate or become damaged. As the mutation/damage spreads, the cells form a tumour. This tumour may be localised with the prostate or it may spread to tissue around the bladder, or even further. The best time to detect prostate cancer is in the early stages when the cancer can be treated locally.
Images from: https://www.southerncross.co.nz/
So what are the symptoms or the “wee warning signs”?
Unfortunately, early signs of prostate cancer are far and few between. In fact it is possible to be in the early stages of the disease and not have any symptoms. Furthermore, the symptoms are fairly generic so they could be the signs of other illnesses. Common symptoms are trouble stopping and starting peeing, like a “stutter of your putter”, urinating frequently, night time peeing and/or it’s painful to pee. Other less common symptoms may be blood in the urine; ejaculation may be painful and achieving or maintaining an erection.
The problem with these symptoms is that they might also indicate diabetes, urinary infection or another malady; best to have it checked by a doctor. Any of these diagnoses are pretty easy to treat or managed if caught early enough. Leaving it makes it a lot more difficult to manage.
So how do they test for prostate cancer?
It starts with a little prick (sorry- obvious pun) and ends with a poke, but it’s not as bad as you might think. You will probably undergo a blood test to see if you are at risk of getting the disease. Prostate specific antigen (PSA) is a marker in your genes that will indicate if you are at greater risk of contracting prostate cancer. A blood test will help identify the presence of this marker in your genetic profile. The blood test will only tell you if you have PSA. But it does not detect the actual disease.
For that you will need to have a digital rectum examination. “Cool” I hear you say! Anything digital is cool right? Wrong. So, so very wrong. In this case digital
refers to finger, rectum refers to your anus and examination means, in this case, putting the finger on the problem. The doctor will use gloves and get hands in, I mean, hands on. This enables the doctor to feel the gland for irregularities in shape and consistency that might indicate the presence of cancer. It can initially feel awkward and uncomfortable but is worth it – let’s face it, a moments discomfort is worth the knowledge gained. Let me put it bluntly – some prostate cancers are slow growing and will never cause problems; others grow quickly and cause serious symptoms or death. If caught early, prostate cancer can be managed well and can usually be cured. What’s more uncomfortable? A finger in a “foreign land” for a minute or two, or the alternative?
What happens if prostate cancer is suspected?
If the doctor finds something suspicious the next form of detection is called Transrectul Ultrasound Biopsy. This time technology takes a little trip, and that means going up the rectum where an image of the prostate is created. If anything looks unusual or suspect, tissue samples are taken for further testing. If the results require, they may run a more direct test involving a needle and your perineum (the space between the rectum and the testicles).
If cancer is detected in the prostate then more x-rays, ultrasounds and other scans will be conducted to check to see if the cancer has spread. So is there any good news? Yes, not all lumps are cancerous. The prostate gland sometimes just becomes too big; the condition is called Benign Prostatic Hyperplasia (BPH). BPH is not cancer, but must be treated.
How can you prevent prostate cancer?
Have a chat with your dad and brothers. A man has a much higher risk of developing cancer if his identical twin has it but the guy whose brother/s or father has/had prostate cancer runs twice the risk of developing it, compared to other men. If this is the case you should have an annual check once you turn 40. Otherwise an annual check from your 50th birthday is advisable.
Research shows that having a healthy active lifestyle helps reduce the risk of prostate cancer. So aim to improve your diet, your exercise and your stress levels. Obviously the side effects of chillin’ out, focusing on low meat and high vegetable and fruit meals and regular exercise reduce chances of cancers (pretty much all of them), and increase life expectancy (extra time to chase the grandchildren) and improve vitality (extra strength to chase the wife!).
On the topic of wives, the published statistics on prostate cancer show that single men are diagnosed much less frequently than married men. On the other hand, married men diagnosed with prostate cancer live longer than single men with the disease. My conclusion that I can draw from this is that men should stay single, but should get married if diagnosed with prostate cancer. Just don’t tell my wife. She’d say something sensible like, “the wife would advise (translation: nag) the hubby to the doctors whereas the single feller would ignore the problem till it’s too late”.
You can also donate and encourage other people to donate time and money to support research into prostate cancer. In New Zealand the peak information body for this illness is the Prostate Cancer Foundation of New Zealand (http://prostate.org.nz/) . Their focus is on helping people who have been diagnosed with Prostate Cancer, as well as increasing the awareness of the disease. Their site was very useful in building this article.
You can also participate in Movember, a regular event dedicated to raising money for prostate and testicular cancer research and education. (http://nz.movember.com/?home)
Finally keep an eye on the government’s health education website so that you are familiar with the treatments available for prostate cancer and their associated risks.
If you want more information about prostate cancer here are some useful sites…
The Rugby World Cup is held every four years (it was in New Zealand in 2011) and New Zealand is one of the best teams in the world. Tickets to the Tests, as the games are called, are scarce as hens’ teeth. Kiwi Ken, living in Australia managed to get tickets for the final Test series, but he wasn’t feeling too good – bladder problems mainly – so he went along to his doctor.
The doctor gave him a thorough examination and told him that he had long existing and advanced prostate cancer and the only cure was testicular removal. “No way, doc!” said Ken, “I’m getting a second opinion!” The second Aussie doctor gave him the same diagnosis and also advised him that removing his testicles was the only cure. Not surprisingly, he refused the treatment again, but was devastated and wondered if he’d get to the Tests or if he should make out his will and leave his tickets to his brother.
Then someone told him about an expatriate New Zealand doctor and he decided to get one last opinion from someone he could trust. The Kiwi doctor examined him and said, “Bro, you have definitely got prostate cancer.” “What’s the cure then, doc?” asked Ken, hoping for a different answer this time. “Well,” said the Kiwi doctor, “For starters, we’re going to have to cut off your balls.”
“Phew, thank god for that!” said Ken, “Those Aussie bastards wanted to take my Test Tickets off me!” .