PROSTATE CANCER: OVER 50? MALE? PLEASE READ THIS.
By Dr. Pega Ren

- Originally published on DrKoop.com

Prostate cancer is not a subject we want to talk about....or think about, for that matter. Still, as with many diseases, early detection is the key to survival, and awareness of our risk factors promotes testing before
the appearance of symptoms. All men past the age of fifty should get tested annually. For those of African-American heritage, the age of first testing drops to forty. This is true also for those who have a close relative with the disease, for that factor increases risk two to five times.

The test itself is called a PSA, for Prostate Specific Antigen. Although it detects only about half of all cancer cases, it is still the best screen available. With an uncertain or elevated PSA result, most doctors will recommend a biopsy and/or ultrasound. The biopsy involves a probe equipped with a needle being inserted into the rectum (more embarrassing than painful) and a series of six to twelve samples being removed from the enlarged prostate gland. This is uncomfortable and awkward, but no more so than the annual
mammograms women endure. And of course, it is just as life-saving. Other diagnostic alternatives are MRIs, a painless procedure requiring 45 to 60 minutes, and CAT scans, which use contrast dye to map the growth of the gland.

If cancer is found, the treatment options include radiation, hormone therapy, and surgery. During radiation, much like receiving an x-ray, you will be immobilized and subjected to noisy equipment. Still, it is painless,
fast, and has minimal side effects. A bone scan, a twenty minute procedure, may be suggested to determine if the cancer has spread. You may also hear the term brachytherapy or seed therapy, a one-hour, out-patient treatment. Hormone treatment is particularly effective in treating prostate cancer. It reduces the size of tumors in 90% of men and is the only effective systemic treatment yet known. The side effects are lowered libido or sex drive, increased weight, hot flashes, diarrhea, and nausea. Exciting research is being done in the area of chemotherapy, and scientists hope that in another five to ten years this will be the treatment of choice.

Prostate surgery refers to prostatectomy, or removal of the prostate gland. This 2 ½ to 4 hour operation causes temporary loss of bladder control. You will need to wear a catheter (a tube inserted through your penis and into your bladder) for a couple of weeks following surgery, and you will need to relearn bladder control during the convalescent period. This is usually successful, as only 25% of men remain mildly incontinent and only 2% never regain urinary control. Maintenance of sexual functioning, the ability to attain and maintain erections, is dependent on whether nerves can be preserved during surgery. You will not know this outcome until your healing process is complete.

What will you need following treatment or surgery? It goes without saying that you locate a physician in whom you have confidence, and with whom you can discuss your situation openly, including your sexual concerns. Support groups are available for you, and men report that they are invaluable in helping to navigate the turbulent waters of such a distressing diagnosis. Do research on prostate cancer, its treatments, and its effects. Talk with other men and with the women in your life - you do not need to go through this stoic and alone. The rates of prostatic and breast cancer are comparable, making this an area where men and women can support and educate each other. Both breast and prostate cancer have the same mortality rate as well, and the key to survival is the same: early detection and prompt intervention if trouble is found. Do not wait. Book your appointment for a PSA and a physical examination today. You’ll be glad you did.

© 2001. Pega Ren, Ed.D. All Rights Reserved.