Movember has become a global movement that focuses on raising awareness about issues that affect men. Growing a moustache in November is part of it all, hence the name, Movember. Mental health and suicide prevention, prostate cancer and testicular cancer are the charity’s priorities. To mark Movember, the Comfort Keepers editorial team is looking at the impact of prostate cancer in Ireland. Find out what to consider if you’re thinking of getting yourself checked as we look at the facts about this common cancer.
What Is Prostate Cancer?
This kind of cancer happens when the cells of your prostate gland grow in an abnormal way and form a lump or tumour. The prostate is a part of the anatomy in those born physically male. You’ll find it in front of the rectum, just underneath the bladder. With similar dimensions to a walnut, it surrounds the urethra, the tube that gets rid of urine from the bladder. If the prostate gland becomes enlarged, it can cause difficulties passing urine because it pushes on the urethra. As men grow older, the prostate tends to get bigger in size.
Part of the gland’s function is to make a protein called prostate-specific antigen (PSA) that turns semen into liquid. If your PSA level is higher than normal, it can sometimes be a sign of prostate cancer. It can also flag up a less serious condition such as a prostate or urinary infection. Prostate cancer grows slowly in some men. In others, it grows faster and spreads to other parts of the body. In Ireland, this kind of cancer is a relatively common form of the disease. Almost 4,000 men will get a diagnosis every year. The cancer can manifest itself in different ways. These are:
Early (Localised) Prostate Cancer
You’ll only find this inside the gland itself. It won’t have gone any further than the prostate gland. There can sometimes be no symptoms. A medical professional may suspect it’s there after carrying out a specific type of blood test known as a PSA.
Locally Spread Prostate Cancer
This means the cancer has broken through the capsule or covering of the prostate or has moved on from outside the gland to neighbouring tissues. These include your lymph nodes, seminal vesicles, neck of the bladder or the rectum. The seminal vesicles are 2 glands that you’ll find sitting just at the rear of your prostate gland. They are where the seminal fluid gets kept. Some treatments for locally spread prostate cancer set out to cure it. Others aim to control it or stop it from growing.
Metastatic (Advanced) Prostate Cancer
This is when prostate cancer cells have advanced elsewhere. They will be affecting different bits of your body much further away from the prostate gland. The most common place for prostate cancer to spread is to your bones.
Stand Up for Your Prostate 2002
This is the title of one of the Marie Keating Foundation’s latest prevention and awareness campaigns in Ireland. The aim is to get Irish men to have their PSA checked once they reach the age of 50 or 45 if they have a family history of Prostate or Breast Cancer. The test takes 5 minutes and could save your life. If detected early, prostate cancer is very treatable, with a five-year survival rate of 92 per cent. The challenge is getting men to see their GP in order to talk about their health and the PSA test.
The campaign aims to encourage men to see their doctor, to have a conversation about PSA testing and to take further steps to look after their prostate health. There has been a big increase in the number of men diagnosed with prostate issues in the past few years because of an uptake in the PSA blood test. If your father or brother has had prostate cancer, you are twice as likely to get prostate cancer at some point in your life.
What Are the Risks and Causes Associated With Prostate Cancer?
Nobody knows what causes the majority of prostate cancers. There may be a higher risk of getting prostate cancer if:
- You are over 50: prostate cancer is rare in men under this age
- There is a family history of prostate cancer
- You are a man with a faulty BRCA2 gene
- Your diet is rich in fats and low in fibre
- You are from an African-American and African-Caribbean ethnic group
Although early prostate cancer can display no obvious symptoms, you should see a doctor if:
- You find it hard to pass urine and experience pain
- You often need to get to the bathroom to pass urine urgently
- You’re going to the toilet more than you used to
- You are getting up more than twice in the night to pass urine
- It’s taking a while to get the passing of urine going
- Your urine flow is weak and patchy
- You get an unsatisfactory feeling after urinating that the bladder isn’t empty
- There is blood in the urine
Because the prostate tends to get bigger with age, it can cause an obstruction of the bladder outlet. The symptoms are similar to many of those listed above. We refer to this enlargement as benign prostatic hyperplasia or BPH. BPH is more commonplace than prostate cancer, but the 2 conditions can co-exist.
What Action Should You Take?
If you experience any of the symptoms we’ve just listed, you should make an appointment with your GP. They will make a judgement on the severity of your symptoms and carry out an examination of your prostate gland. This might include a digital rectal examination (DRE). Your doctor will use their finger to feel inside the rectum for any abnormalities. The examination is fast and painless. Bear in mind that the earlier prostate cancer gets detected, the more successful the treatment is likely to be.
How Does a Prostate Cancer Diagnosis Get Made?
As well as the digital rectal examination, there will typically be PSA blood tests. There may also be a rectal scan and biopsy too. The PSA test is a blood test that measures the quantity of prostate-specific antigen (PSA) in a person’s blood. PSA is a protein that gets made by normal cells in the prostate and also by prostate cancer cells. It is normal for all men to have a small quantity of PSA in their blood. This amount rises as you grow older. A raised PSA level could be a sign of prostate cancer. But about 75 per cent of men with a raised PSA level will not have the disease. Others with a normal PSA level may in fact have prostate cancer.
To make the decision about whether you need to see a hospital specialist for more tests, your GP will take other factors into account and not just your PSA level. These include:
- The results of a DRE
- Whether you are at higher risk of prostate cancer
- Any other health problems or issues that may have affected the results
- Whether you’ve had a prostate biopsy in the past
Your GP may also do another PSA test, especially if your PSA only appeared slightly raised.
What Is the Treatment for Prostate Cancer?
The type of treatment is going to depend on a variety of factors. These include:
- The kind of cancer cells discovered at the time of the diagnosis
- The age and general health of the person involved.
Options include active surveillance by carrying out regular PSA blood tests and DREs. They also include:
- Surgery, radiotherapy, hormone therapy and chemotherapy
Your doctor will always discuss the potential treatments with you. Some of these treatments may get used alone or together to tackle some prostate cancers. Many people find it helpful to have a friend or relative with them when the treatment gets explained. It can also help to write down a list of questions in advance.
Can I Reduce the Risk of Getting Prostate Cancer?
It may help to lower the chances of getting prostate cancer by looking after your general health. This means sticking to a healthy weight and combining a balanced, low-fat diet with regular physical activity. Taking at least 30 minutes of moderate physical activity 5 times or more a week should be what you’re aiming for, if possible. It’s always worth talking through the advantages and disadvantages of having a PSA test with a health professional such as your GP. Before making your decision, try asking yourself these questions or, better still, talk them through your GP.
- Am I more at risk of prostate cancer?
- If the result of my PSA test was normal, would this reassure me?
- If my PSA level was high, what would I do?
Finally, let’s say the diagnosis was a slow-growing prostate cancer that might not cause you any problems in your lifetime. Would you want to have treatment that may cause side effects that could adversely affect your daily life?
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