Prostate cancer is on the rise in South Africa, with the number of reported cases increasing from 3,958 in 2000 to 6,143 in 2011 (stats courtesy of the SA National Cancer Registry).
You’ve Earned It spoke to the Prostate Cancer Foundation of South Africa to find out why you should be scheduling your annual prostate examination now.
One of the contributing factors is that most men are unaware of the symptoms and the risks of prostate cancer and are only present for treatment in the later phases of the disease.
What are the risk factors for Prostate Cancer?
The exact causes of prostate cancer are not known. However, research has shown that:
• The risk of prostate cancer increases with age
• The risk of prostate cancer increases if you have a brother or father with prostate cancer
• Black African men are more likely to develop prostate cancer at an earlier age
What are the symptoms?
There are generally no symptoms in the early stages. This is why age appropriate screening is so important. If you have any of the symptoms below you may have a prostate problem and you should see a medical doctor.
• Difficulty urinating
• Difficulty with stopping/starting the flow of urine or it starts/stops by itself
• Weak flow of urine, pain or burning sensation during urination
• Needing to urinate often, especially at night
• Difficulty getting or maintaining an erection
• Blood in the urine or semen
• Painful ejaculation
• Pain in the lower back, hips or upper thighs
When should you be screened or tested for Prostate Cancer?
The Prostate Cancer Foundation recommends screening at age 40 for black African men and for all men who have a father or brother who have had prostate cancer. At 45, all other men should be tested.
What screening tests should be done?
• The Prostate Specific Antigen Test (PSA). The PSA test is a blood test that gives an indication of whether something is wrong with your prostate. If your PSA result comes back high, it could be cancer or it could just be an infection of the prostate. The PSA test does not always pick up prostate cancer which is why the test below also needs to be done.
• A Digital Rectal Examination (DRE). This involves your doctor inserting a gloved and lubricated finger into the rectum so that they can feel the prostate for any abnormal lumps or hardness.
What will happen if screening shows that there is a problem?
If screening shows that there may be a problem, your doctor will refer you to a urologist. This is a doctor that specialises in male reproductive problems and problems with the urinary system. The urologist will do a biopsy to check for cancer cells. A biopsy involves inserting an ultrasound probe up the rectum. These are used to help guide the urologist who then inserts a special needle into various parts of the prostate to take tissue samples. These cells are then sent to a laboratory to check for cancer.
What happens when I get the biopsy results?
The Results of the biopsy will show whether you have prostate cancer or not, and at what stage the prostate cancer is at.
Treatment for prostate cancer
Treatment will depend on what stage of prostate cancer you have and how aggressive the cancer is.
Patients need to be fully informed of the advantages and disadvantages of the different treatment options and decide together with their doctor on the treatment that is best for them.
Treatments may include:
• Surgery to remove the prostate (prostatectomy) and the surrounding glands and lymph nodes, if these have been affected
• Radiation therapy through external beam radiation or brachytherapy
• Androgen Deprivation Therapy to remove testosterone from the body through removal of the testes or by using drugs that block the body from producing testosterone (prostate cancer requires testosterone to grow)
• Watchful waiting or active surveillance – where no treatment is given but the cancer is monitored
To back up the advice above, read Lyn’s story to gain a real-life insight into the dangers of not being tested regularly:
“At the age of 62, my husband couldn’t hold his urine for long periods at a time. If he was in the car and he travelled for more than 20 minutes, he had to find a place to urinate. I asked him several times to go for a check up, because I thought he had a bladder infection. He finally went – two years later – and had a thorough examination – PSA test, prostate test through the rectum, and an ultra sound. He was sent home with antibiotics. The next day, the doctor called to say he must come in urgently as they had all his results back. His PSA count was 297. What a shock, he was diagnosed with Prostate Cancer. From the time he was diagnosed until he died was three years and seven months. The cancer spread rapidly and we went on a nightmare journey of radiation, hormone therapy, anti-depressants, and constant tests. Being a chef, for health reasons, he was boarded from his job due to the catheter leaking sometimes. You must understand a chef has to be scrupulously clean. If only he had had his yearly check ups from the age of 50, he might still be alive today. His father died of Prostate Cancer at the age of 60, a couple of his uncles as well, and a nephew. He was told that if it’s in the family, he should be having check ups from the age of 35. My two sons, aged 32 and 34, have already had their first examination and they will continue to have them every year. We are all mortified that he had not gone for an annual examination sooner. During his illness, he testified to many men that they must go for PSA tests.”
Lyn’s story says it all – don’t think about it, just do it. Schedule that prostate examination now.
There is some evidence that choosing a healthy lifestyle can contribute to a lower risk of prostate cancer. What does this involve:
• Choosing a healthy diet
• Choose a low-fat diet. Though the evidence is not conclusive, there are findings that reducing your fat intake has general health benefits such as controlling your weight
• Eat more fat from plants than from animals. Studies have found that animal fats are most likely to be associated with an increased risk of prostate cancer
• Increase the amount of fruits and vegetables you eat each day. The nutrients and vitamins in fruits and vegetables are thought to reduce the risk, though the evidence has not proven that any particular nutrient is guaranteed to reduce the risk
• Eat fish, especially fatty fish rich in omega-3 fatty acids
• Reduce your intake of dairy products
• Maintaining a healthy weight
• Exercising for 30 minutes most days of the week
• Talking to your doctor about your risk
For more information about prostate cancer, please contact the Prostate Cancer Foundation of South Africa by visiting their website, www.prostate-ca.co.za, or calling them on 0842833982.
Do you have a prostate cancer story which you would like to share with us?
Let us know in the comments section below this article.