How often do you consider your risk of being diagnosed with prostate cancer? For most men, the answer to this question varies from “not often” to “never”. But, because about one in eight men will be diagnosed with prostate cancer at some point in their lifetime, it’s time to change the way we see and speak about this disease.
Understanding prostate health
Awareness is key when it comes to early detection of prostate cancer. One of the most important facts for men to know right off the bat is that the risk for prostate cancer increases sharply after the age of 55 and peaks between the ages of 70 to 74. It’s also worth noting that black African men tend to get prostate cancer at a younger age.
The Prostate Cancer Foundation recommends that Black men (who are at a 60% higher lifetime risk of being diagnosed with prostate cancer than white males) and men with a history of prostate and/or breast cancer in a first-degree relative, start screening from the age of 40. Men who have been diagnosed with lower urinary tract problems should also start screening from the age of 40. All other men should consider prostate cancer screening with a healthcare professional from the age of 45.
Screening tests include the Prostate Specific Antigen (PSA) blood test and the Digital Rectal Exam (DRE). These are the initial steps that healthcare professionals will take, and if they reveal abnormal results, the next step is further investigation by a urologist to determine whether prostate cancer is present.
But before we delve into the details of tests and what happens after diagnosis, it’s important to get familiar with the prostate gland to understand how prostate cancer develops, and how to prevent it from progressing.
What is the prostate gland?
The prostate forms part of the male reproductive system and is responsible for producing some of the fluid (seminal fluid) which carries the sperm during ejaculation. It is about the size of a walnut and is located deep within the pelvis, under the bladder and in front of the rectum.
The prostate can become larger as men get older and, while this may cause some discomfort (particularly during urination), this does not mean that the prostate is cancerous. However, normal cells can become abnormal and reproduce uncontrollably, causing prostate cancer to develop.
According to The Prostate Cancer Foundation, if prostate cancer is diagnosed and treated in the early stages, the cancer can be cured. It’s also worth noting that there are no symptoms in the early stages of prostate cancer, which is why regular screening tests are vital for men in their 40s and older.
It all starts with a blood test
Prostate-Specific Antigen (PSA) is a protein produced by both normal and malignant cells in the prostate, and the PSA blood test measures the amount of – you guessed it – PSA in the blood. Generally, your GP will be looking out for an elevated PSA score, which can mean that there’s a problem with the prostate.
However, a higher-than-normal PSA score is not necessarily a prostate cancer diagnosis – several factors can cause the score to rise, including infections and inflammation. Certain activities, such as ejaculation, cycling, and trauma to the prostate area, can also result in a false score if they occur within 48 hours before going for a PSA test.
Give prostate cancer ‘the finger’
The Digital Rectal Examination (DRE) is a simple test that takes less than 30 seconds for a doctor to perform. The examining doctor inserts a gloved and lubricated finger into the rectum so that they can feel the prostate for any abnormal lumps, hardening, or other signs of prostate cancer. Seeing as the prostate is divided into several anatomic ‘zones’, and most prostate cancer starts in the peripheral zone (the back of the prostate) near the rectum, a DRE is a common and useful screening test for prostate cancer.
Based on the results of your PSA score and/or digital rectal examination, your doctor may recommend a prostate biopsy or an MRI scan if he/she suspects prostate cancer. A biopsy is a procedure which is normally done under general anaesthetic where some needles are inserted into the prostate to obtain a sample of cells. The cells are sent to a laboratory where they are analysed to see if they are cancerous or not. If there are cancerous cells, they are examined and graded according to how aggressive the cancer is. This results in what is called a Gleason score.
The DRE tends to be considered daunting for many men and maybe the reason why many men avoid going to the doctor to get screened in the first place. This, unfortunately, causes many late-stage prostate cancer diagnoses. Surely it’s worth suffering 30 seconds of slight discomfort if you can prevent the growth of this terrible disease?
Where to go to get tested
The majority of women are aware of the need to visit a gynaecologist regularly, but where do men go when they need to get their ‘bits and bobs’ checked?
When something is untoward, the answer is a urologist – a medical specialist who deals with problems of the male reproductive system and the urinary system of both men and women. Urologists are most qualified to deal with problems affecting a man’s sexual organs, including the prostate. However, you should start by asking your GP to be your ‘guy-nae’ and start the discussion about your reproductive health. If you’re not sure where to find someone, you can go to guynae.org to locate a healthcare professional near you who can help.
Support the cause to create awareness of male cancers in South Africa by joining the Hollard Daredevil Run 2019, where men of all ages, shapes and sizes will paint the streets of Johannesburg purple on Friday 15 March 2019 to run cancer outta town. Kicking off at 15h00, the 5km fun run challenges the city’s bravest males to strip down to Purple Speedos and run through the streets for a good cause. For more information and to enter, please visit www.daredevilrun.com.
Runners are welcome to bring their loved ones and fans to cheer them on from the side-lines on the day, as participation in the run is restricted to men and boys. Donations in support of the cause can be made at www.daredevilrun.com/donate.
Marketing Communications Manager, Hollard
Account Manager, Tribeca Public Relations (on behalf of Hollard Daredevil Run)