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Prostate cancer: the silent killer
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Many men don't like to talk about it but prostate cancer is a silent killer and its main victims are men over 40; a generation that doctors say tend to talk less openly about personal health issues. In the UK alone, it claims the lives of 10,000 men every year. It's actually Britain's most common cancer amongst men and the second highest killer, after lung cancer.
In the UK alone, it claims the lives of 10,000 men every year. It's actually Britain's most common cancer amongst men and the second highest killer, after lung cancer.
There are two types of prostate cancer - aggressive and non-aggressive. Two-thirds of sufferers get the non-aggressive variety, which has a high survival rate and patients can often lead a healthy life. The rest develop the more aggressive form, which is harder to treat and has much higher fatality rates. In fact, most sufferers die within 18 months of diagnosis.
The western world may have more advanced technology and easier access to better health care, but we also have more incidences of prostate cancer when compared to Asia, Africa and South America. The reasons for this are still unclear, however it's believed that lifestyle differences including diet may also be important.
To understand the range of problems that can occur we need to know exactly what the prostate gland is. About the size of a walnut, the prostate gland in men surrounds the urethra (the passage that allows urine to flow from the bladder and out through the penis). Its main function is to make some of the fluid of semen.
But it's not just cancer that men need to be aware of when it comes to the health of their prostate gland. Prostate UK is a charity which funds free training seminars for GPs and nurses each year on the topic as well as producing much-needed brochures on prostate cancer and prostate related diseases. Gareth Ellis-Thomas of Prostate UK spoke to Confidential about why it's important to raise awareness of other prostatic diseases, as well as cancer, in men of all ages.
He said: 'As men get older, they naturally become more prone to developing an enlarged prostate. This can cause a variety of urinary problems and many of the symptoms of prostatic diseases, cancerous and benign, overlap. Other benign but prostate diseases that have a major impact on quality of life, Prostatitis and Benign Prostatic Hyperplasia (BPH), affect more men and at a much earlier age. One in two men will suffer from one of the three at some point in their lives.'
Common prostatic diseases
Prostatitis
An inflammation of the prostate gland, this can affect men at any age. Acute prostatitis is often caused by bacterial infection usually associated with spread from the bladder or urethra. Chronic prostatitis is rare and usually associated with infection elsewhere in the urinary tract or from a surgical instrument.
Benign Prostatic Hyperplasia (BPH)
This is the most common prostate disease and is more likely to affect men over the age of 50. It can lead to acute urinary retention, which is very painful and can prevent a man being able to urinate. It is important to deal with this before it gets too bad, or it can become impossible to treat effectively.
Screening can detect prostatic diseases and prostate cancer at an early stage. It's recommended that men at the age of 50 go for a screening, although you should consult your GP if you have any of the following symptoms at any age:
-Poor flow of urine.
-Frequency of urination, particularly at night.
-Dribble after passing urine.
-Pain or discomfort when passing urine.
-Blood in the urine.
-Back pain.
-Painful ejaculation.
It's important to note that prostate enlargement and prostate cancer don't necessarily go together and therefore it is possible to have cancer without any symptoms whatsoever. This is why a simple blood test called Prostatic Specific Antigen (PSA) is so important.
But does this mean every man should rush to the doctor and have a PSA test? According to Dr Charles Levinson, chief executive of Doctorcall Medical Service Group, prostate problems tend to affect elderly men but are much more worrying in younger men in their forties and fifties.
He said: 'Once men get into their eighties, it is almost inevitable that if you looked you would find a very low grade cancer. However, fortunately, this old-age prostate cancer is generally so slow-growing that it doesn't cause problems. The type we are most worried about is in younger men, where, although rarer, it tends to be more aggressive. It is almost unknown before the age of 50. A well-known example that is often wheeled out to illustrate how aggressive it can be in younger men is that of Frank Zappa who contracted it at the age of 50 and was dead by 52.' Gareth Ellis-Thomas said that all middle aged men need to be aware of their prostrate health, but adds that there are other important factors to consider when judging the likelihood of prostate cancer occurring:
'Those that have a family history of prostate disease (father, grandfather, brother, uncle etc) are more likely to be diagnosed. Men from an Afro-Caribbean background are also in a higher risk group. Men who fall into either of these groups should consult their GP about getting a PSA test that can help determine prostate health when they reach 45. Men who don't fall into either category should get tested at 50.'
There's a wealth of public information campaigns for cancers that are considered preventable. Unfortunately, prostate cancer has never fitted into this category despite recent progression in research and treatment. On top of this there has also been an issue about the cost of prostate screening and doubt about its success rate, which has led to an even lower profile for the disease.
However, Dr Levinson said: 'The latest generation of PSA tests are really pretty accurate and well worth having if you are over 50 years of age. You can ask your NHS GP for testing too, but it isn't as widespread in the NHS as cervical cancer screening.' So unlike cervical screening in women, don't expect a letter from your doctor to remind you to get tested when you hit 50. You have to use your own initiative when you reach that age bracket and/or if you're experiencing even the slightest discomfort, at any age.
Diet has long been associated with prostate health; western diets, which tend to be high in saturated fat, are thought to be the big evil. Low-fat diets along with plenty of water and exercise are favoured by the medical establishment as decreasing chances of various cancers as well as diseases such as heart disease and diabetes. Studies have also shown that fish oils can reduce inflammation in the prostate gland. Prostate massage is also often used by urologists to look for nodules of prostate cancer and is widely believed to be beneficial for maintaining prostate health, if performed correctly.
Whilst there is no prevention, prostate diseases and cancer can be treated if caught early. Dr Levinson said: 'Specialists will advise on the appropriate treatment for any case. In some situations, there are a choice of treatments that could be adopted with different risk-benefit profiles to be weighed up depending upon the preferences of the patient. It is essential to get the best advice, and to ensure that sufficient time is dedicated to explaining these options properly. The options include surgery, hormone therapy and radiation.'
Recent reports suggest scientists believe a drug - abiraterone - could be capable of treating the lethal form of prostate cancer, where it has spread to another part of the body, and where hormone therapy is no longer working. They believe it is capable of shrinking tumours in up to three-quarters of cases but it's still being looked at in clinical trials. Results from trials won't be available for at least a couple of years and the results will affect whether the drug becomes more widely available in the future, but for now at least it gets prostate awareness back in the news and hopefully on the top of every man's health agenda. Doctorcall Medical Services Group provides a range of medical services for individuals and corporate clients alike. For more information please visit www.doctorcall.co.uk or telephone 0844 257 0346.
Doctorcall
St Ann's Square
Manchester
M2 7HA
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Additional information:
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Medicine & Science in Sports & Exercise - Fulltext: Volume 40(10
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