Prostate cancer remains the leading cause of cancer deaths in men – accounting for around 13% – and it needs to be taken seriously.
The good news is that prostate cancer is not as aggressive as other cancers. The bad news is that while it occurs mostly in men over the age of 65, we are starting to see a higher incidence of prostate cancer in younger men.
The fact that most prostate cancers develop without showing any symptoms in the early stages means that regular screening is very important.
So gents, if you really want to support the fight against prostate cancer this Movember, go further than just growing a moustache. If you are over the age of 45 you should have a prostate check at least every three years. If you show any symptoms, particularly urinary symptoms, such as difficulty urinating, dribbling of urine or blood in the urine, see your doctor immediately.
Liberty’s medical officer Dr Thabani Nkwanyana answers your questions on prostate cancer:
What is prostate cancer?
The prostate is a gland found only in men, which is situated between the bladder and the penis, just in front of the rectum. It produces seminal fluid (semen) that nourishes and transports the male sperm produced in the testicles. Cancer occurs when certain genes that either control the growth or death of the cell are affected, which results in abnormal cell growth and/or death, resulting in a malignant tumour.
If left untreated, prostate cancer may eventually spread to other parts of the body, such as the lymph nodes and the bones. By this stage, the cancer is more difficult to treat and chances of survival decrease.
Is a positive diagnosis a death sentence?
Not at all. The prognosis varies widely and depends on many factors, including the age and health of the patient, the stage of the tumour when it was diagnosed, the aggressiveness of the cancer, and the cancer's responsiveness to treatment.
Studies have shown that men with non-aggressive prostate cancer are unlikely to die from it and treatment should be constant surveillance rather than a prostectomy (removal of the prostate). If a cancer is discovered early and is cured, your life expectancy is what it would have been had you never been diagnosed with it.
Survival also depends on your lifestyle choices. Studies suggest that if you continue to eat a Western diet with its high levels of sugar, fat and carbohydrates after diagnosis instead of more vegetables, fruit, fish, grains and legumes, you increase your risk of dying from prostate cancer. One study found that intensive lifestyle changes, including a healthier diet and frequent exercise, may slow the cancer’s growth.
Which factors increase the chances of developing prostate cancer?
The exact causes of prostate cancer are not known. However, your lifestyle, age, ethnicity and gene make-up play a significant role in increasing your risk factors.
A sedentary lifestyle and bad eating habits will increase the risk of most cancers, and if you have a family history of prostate cancer or have the BRCA 1 and 2 genes, your risk factor is significantly higher. Genes are inherited and so gene mutations that increase the risk of developing cancer may be passed down.
Older males are at greater risk and black men are more likely to develop prostate cancer than white men.
What are the symptoms?
Often there are no symptoms at all, which is why screening is important. But if you have any of the following problems you need to consult a doctor immediately:
- A frequent or excessive need to urinate during the day and/or at night
- Difficulty in starting, maintaining or stopping the urine stream
- A weak or interrupted urine stream
- Straining to urinate
- Inability to urinate (urinary retention)
- Loss of control of urination that may be associated with coughing or laughing, or sudden urges to urinate
- Difficulty urinating when standing, requiring you to sit on the toilet
- Pain with urination or ejaculation
- Blood in the urine or semen
What does a prostate cancer test involve?
Screening for prostate cancer may involve a blood test to determine the prostate specific antigen (PSA) level and/or a digital examination. PSA is a protein produced by the prostate and rising levels indicate a problem with the gland, but this is not specific to cancer. Researchers are working on different tumour markers to identify cancer more specifically.
Unfortunately, not all men with prostate cancer will have raised PSA levels as other factors, such as obesity, could affect the test results. Obese men have a lower level of PSA. Therefore the PSA blood test together with a digital rectal exam is best for early detection. However, both tests may result in false positives and negatives.
If a lump is felt in the prostate but the PSA test is normal, a biopsy is not required. A repeat PSA test in six months’ time is advisable.
If the result of one of the tests is abnormal, you will need a prostate biopsy where samples are taken from the prostate and sent to the laboratory for examination under a microscope.
When a prostate biopsy is done the cancer cells can be missed. Scientists are working on finding ways to enhance the cancer cells so that the doctor can easily identify them at the time of biopsy.
Financial protection against cancer
Depending on the aggressiveness of the cancer, you may incur additional expenses or be required to take time off work. Liberty’s Lifestyle Protection and Loss of Income Protection would provide financial security so that you can focus on recovery.
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