MEDICAL MINUTE: ARE YOU MAN ENOUGH?
September is national prostate cancer awareness month. You may or may not know that the prostate is a gland that is found only in men and is located just below the bladder as it wraps itself around the urethra. The main function of the prostate gland is to play a role during reproduction, however, as men age, a myriad of problems can occur dealing with the prostrate. Virtually all men over 50 will experience an enlarging of the prostate, sometimes called Benign Prostatic Hypertrophy, or BPH. This is usually not serious but can lead to difficulty urinating and gets worse with age. It is often necessary to take medication to control BPH, or in some cases, undergo surgery.
For as bad of an issue as BPH can be, the worst problem associated with the prostate gland is cancer. Prostate cancer is the most common form of cancer in men, save for skin cancers. Risk factors for this disease include age, as the majority of prostate cancer cases occur in men older than 65. Race plays a large role as well. Black males are almost twice as likely to develop prostate cancer than other race. Modifiable risk factors include the usual suspects: poor diet, obesity, and smoking. In rare cases, sexually transmitted diseases and a past vasectomy can cause a predisposition to prostate cancer. If anyone in your family has ever been told they have prostate cancer, your risk factors due to genetics rises greatly.
The truly scary thing is that early prostate cancer has almost no symptoms, at least in the early stages. It is usually much later, often when the disease has spread, that noticeable signs occur. These symptoms include problems urinating, including the urge to urinate more often, blood in the urine, and a generalized pain or weakness in the hips, back, or chest. Prostate cancer, as with most other forms of cancer, is graded by how far it has spread. Local, regional, and distant stage diagnosis rate progression in the body over time. The good news is that local and regional cases (confined to the prostate or nearby structures) are easily treatable and have a 90% survival rate at the five-year mark and about the same amount at ten-years. However, the prognosis is much worse if the disease has spread to the distant stage and found its way to the lymph nodes. The obvious solution is to find the problem before it becomes a major health issue.
The easiest way to treat prostate cancer is through early detection. Often, screenings can locate problems before symptoms become evident. The chemical prostate-specific antigen, or PSA, can be studied in blood work, however, the best exam tool is the digital rectal exam (DRE). During this procedure a physician will insert a lubricated, gloved finger inside the colon to physically feel your prostate gland for any abnormalities. You might have read that last sentence and shook your head thinking there is no way that you would submit to this procedure. As a man, I know that feeling. However, when you weigh the deadly consequences of not getting the exam against adding years to your life, I will choose the exam every time. It is recommended that males above the age of 40 get a DRE every five years. If you are over 50 or have a predisposition to prostate problems, it might be more often.
If you doctor feels something during the DRE or if you have a PSA blood-level above four, you can expect to get another exam by a prostate cancer specialist. From this point, it is highly likely that several tests will occur such as an ultrasound of the prostate and possibly a biopsy of the tissue in question. The feeling of an abnormal prostate during the DRE doesn’t always mean that it is cancer; it just means that further tests are needed to find the root cause.
Discussing the prostate and the screening isn’t fun. No one likes it. It sometimes forces us to discuss things with our physicians that we would rather keep private. However, September is the national month in which all men should remind themselves of the importance of this examination. Consider your age, your lifestyle, and any symptoms that you might currently have of BPH to make your decision. My father taught me that being a man sometimes meant that you had to sacrifice for your family. My question to you is just that. If you are over the age of 40, are you man enough to put your pride on a shelf talk to your doctor about prostate issues? Stay safe out there.
M. Eric Williams, MS, NR-P
Emergency Medical Faculty
Jones County Junior College
Questions/Comments: eric.williams@jcjc.edu
