I know each year during my annual physical, my doctor and I have to joke about how each of us looks forward to the highlight of the session which is me rolling over on my side so he and his finger can take a short journey into my ‘dark inside’ to see that all is well with this little organ we know as the prostate gland.
The fact is that we wouldn’t give the prostate a second thought if it wasn’t that we’ve heard that it is a source of big troubles for us as we age. The infamous rectal exam is funny in small talk over a couple of beers, but all laughter stops when prostate and cancer are used in the same sentence.
What Is the Prostate?
The prostate is a gland, which is located at the base of the penis, in front of the rectum, surrounds the urethra (tube connecting bladder to genitals), and produces seminal fluid. It assists in transporting sperm and urine out of the body through the penis. So, it’s a kind of important thingie to keep working properly.
Let’s briefly survey some things in order to get a better idea what the likelihood of prostate cancer (PC) and our options should we get it.
Who Gets It?
Doctors have yet to pinpoint the cause of PC but certain lifestyles and good old genetics are known to increase our chances of developing prostate cancer. Look over this short list of factors.
A) Age: Higher the number larger the prostate, literally, oftentimes, and higher the probability of being diagnosed with it. The median age for PC is 70.5 years of age. Typically not a young-man’s cancer.
B) Race: Some research suggests that African American men are 1.6 times more likely than Caucasian men to develop PC, whereas Asian Americans have a very small chance of ever developing PC.
C) Genetics: Your risk of developing PC can be up two or three times greater due to hereditary factors. Unfortunately, unless a family member actually has a serious bout with this cancer or dies from it, we don’t hear all that much about it. People simply don’t talk about it as much as other illnesses.
D) STDs: A recent study suggested that those who have contracted sexually transmitted diseases have a greater chance of developing PC.
E) Diet: Consumption of fatty foods and obesity are suspected contributors to the growth of the prostate and later problems associated with it.
How Do You Know You Have It?
Uh, you won’t! That is, there are no obvious symptoms for early stage PC and this fact highlights the importance of getting one of those rectal-probing doctors to do his or her thing. Takes only a moment anyhow, and it’s not painful, so just DOOOO it!
When the disease has progressed any number of warning signs can emerge. Some common symptoms include difficulty urinating, increased urge or frequency of urination, weak pressure while urinating, blood in the urine, pain in urination, constant feeling of a full bladder and/or pain while urinating. This is not the full list. These are normally symptoms of a more advanced condition, so getting checked is the best way to detect early development.
Part of the problem is that an enlarged prostate is not synonymous with cancer. Hence, the importance of testing and a proper diagnosis.
How Is Testing Done?
Aside from the infamous ‘finger-up-your-rear’ option (properly called a ‘digital rectal exam’), a blood test is common as well. The blood is tested for a prostate specific antigen (PSA), ingeniously referred to as a PSA test. It is THE test used and seems about as controversial as it is common. The debate centers on its accuracy in detecting prostate cancer. Some argue it mis-diagnoses as often as it gets it right. As a result, a lot of unnecessary additional testing is done based on a ‘false’ positive. This was my case.
Doctors admit the controversy (and the unreliability of the test), but usually argue that we have nothing better at this point. If the PSA score shoots above a certain reading, then the doctor may recommend that a biopsy be done.
Now you have to prepare for further hassle and humiliation – you bare your butt and ‘private parts’ to more and more strangers in the name of... something, I forgot what exactly... oh yeah, our wellness! Yes, so at this stage they’ll use real pieces of hardware to shove up your rectum in the name of getting a better look.
Then, in layman’s lingo here, the surgeon, with the aid of the ultrasound technology inserted into your rectum from which to ‘see’ what he’s doing, shoots needle-like probes through the rectal wall into different parts of the prostate gland. I say shoots, as in my experience that is what it sort of sounded like in my half-groggy state during my ‘shoot’ a year or so ago.
While there was some discomfort in this procedure, it certainly wasn’t as disturbing as the later ‘everything was red’ experiences. I had blood in everything – urine, seminal fluids and feces. Oh goodie!
While the bleeding should stop within a day or two or less, the remnants of this event will stay in the seminal fluid for multiple ejaculations – I say again, multiple ejaculations. The material I read for this article stated that only rarely will there be blood in these areas. Well, for me, there was a lot.
Some experts argue for less invasive testing methods such as sonograms, even CAT scans or an MRI. Ask your doctor about your options.
What Are Some Treatment Options?
The progression of the cancer is determined based on the size, location and extent of spread of the cancer. Stage I & II can normally be determined by the initial tests and normally means that it has not moved beyond the prostate gland - which is good news. Where as Stages III & IV mean the cancer has spread beyond the prostate gland to other tissues or has spread to the lymph nodes.
Once the stage of the tumor is determined the treatment options are laid out on the table. All treatments will have some potential side effects associated with them that will be about as easy to swallow as the whole ‘red pill - blue pill’ scenario - so take the time to get a second opinion.
Treatment options will depend on the progression of the cancer. They can range from hormonal injections to manage the cancer, to different types of radiation treatments, and all the way to surgical removal of the prostate.
The negative side-effects from the treatment will vary as well, ranging from hair loss and minor sickness all the way to severe sickness, impotence, and loss of bladder control.
The good news is that successful treatment is very possible, of course, depending on how soon the cancer is detected and the specific type of cancer being dealt with. The most common form of prostate cancer is not aggressive and fast moving.
Early detection is the key! Our vigilance is key to our victory, so let’s take care of business. It is not convenient to get an exam, and can be a bit expensive. Many insurance programs pay for annual physical exams and a prostate exam is standard procedure in this for men our age.
Below is a link to the National Cancer Institute which provides good information and informative diagrams related to many of the things we’ve touched on in this article.
[Here’s my caveat, and I must say it again. These discussions are not intended as professional or medical advice. You should consult with your doctor when making decisions regarding this or any other medical condition you may have or wish to discuss.]