the prostate – no longer secret men’s business
With November seeing the appearance of not-always-attractive facial hair thanks to “Movember”, focus is being turned to men’s health issues. Movember aims to improve awareness and education of some of the most serious health issues affecting men. Prostate cancer is one of the key focus areas.
Prostate cancer is the most commonly diagnosed cancer in men in Australia. In fact, 1 in 7 men will be diagnosed with it before they turn 75. It is expected that more than 18,000 new cases will be diagnosed in 2016.
The risk for prostate cancer increases with age and genes. By the age of 85, the rate of diagnosis increases to 1 in 5 men. A man is twice as likely to develop prostate cancer if they have a father or brother who also had it.
Despite having one of the highest survival rates after diagnosis, more men will die of prostate cancer than women will die of breast cancer. More than 3,000 men die of prostate cancer in Australia every year.
Prostate – what is it ?
Only men have a prostate.
Part of the male reproductive system, the prostate is a small gland situated between the bladder and the rectum. It surrounds the beginning of the urethra (the small “tube” through which urine and semen pass), and produces an enzyme-rich fluid which helps to activate sperm.
The prostate is often described as being the size of a walnut in young men, however testosterone causes it to continue to grow larger. It doubles in size between ages 21 and 50, and almost doubles again in size from age 50 to 80 years.
With the urethra passing through the prostate from the bladder, the prostate can sometimes cause problems, such as difficulty urinating.
Common prostate problems
Benign prostatic hyperplasia or hypertrophy (BPH) is the most common disease.
BPH is a non-cancerous enlargement or growth of the prostate gland. Because the prostate surrounds the top part of the urethra, an enlargement makes the urethra more narrow, impacting the passing of urine. Some may experience a delay or strain when start to urinate, or urgent or frequent urination during both day and night.
BPH usually starts after the age of 40 years and is more common in older men. If symptoms are mild, no treatment may be the best option. Medication may help moderate symptoms, while surgery may be an option for severe cases.
Prostatitis is the inflammation of the prostate gland. It can be caused by a bacterial infection or non-bacterial inflammation, resulting in the prostate feeling sore and irritated.
Prostatitis can affect men at any age – it is estimated that one in every six men experience this at some stage during their life. Prostatitis can be very painful, causing frequent and painful urination, and an urgency of urination. It can also result in lower back and/or perineal pain, and painful ejaculation. It can have a major effect on quality of life.
Treatment depends on the cause but it cannot always be cured. Antibiotics are useful for acute bacterial prostatitis, while non-bacterial prostatitis treatment aims to help painful symptoms.
Prostate cancer occurs when cells in the prostate develop abnormally, and begin to multiply in an uncontrolled way, resulting in a tumour. If left untreated, the cancer cells may spread outside the prostate, to distant parts of the body.
Cancer of this type is generally slow growing. Men with low-grade prostate cancer can live for years without it spreading or becoming life threatening. However, high-grade cancer can spread quickly.
Many men can have early stage prostate cancer with no symptoms – a worrying thought ! Symptoms are not dissimilar to symptoms of BPH or prostatitis:
- frequent or sudden need to urinate
- difficulty urinating, including discomfort, or weak/interrupted flow
- blood in urine or semen
- pain or stiffness in the lower back, hips, or upper thighs
If any of these symptoms are felt, it’s important to go see your doctor for a few checks – catching prostate cancer in it’s early stages is key.
Testing for cancer is likely to involve a digital rectal exam (DRE) (to feel part of the surface of the prostate) and also a PSA blood test (looking for presence of a specific protein in the blood). Depending on these results, a biopsy may be taken to specifically determine if cancer cells are present.
For confirmed prostate cancer, there are a number of different stages:
- Localised (the cancer has not spread beyond the prostate)
- Locally advanced (the cancer has moved beyond the prostate gland, but is still in the region)
- Advanced (the cancer has spread to other nearby organs, eg bladder, rectum)
- Metastatic (cancer has spread to distant parts of the body)
Treatment options are very individual. Advice from medical professionals is key, with further information also available through sources such as Prostate Foundation of Australia and Andrology Australia.
For some men, treatment may not be appropriate with “watchful waiting” the recommended course of action. This may be the case for older men with major health issues, where their health would continue to be monitored and symptoms treated.
For men with low-risk cancer, active surveillance may be recommended. Regular monitoring via PSA, DRE and/or biopsies is done, with results determining what further action is required. With some treatments having side effects that affect quality of life, it may sometimes be thought to be better to delay treatment as long as possible.
Those requiring active treatment would require treatment or procedures aimed at completely eradicating the cancer.
Unfortunately, there are no clearly known causes of prostate issues, making prevention difficult.
A healthy lifestyle with nutritious diet and regular exercise can improve overall health and thus reduce the risk.
Risk factors linked with developing prostate cancer include family history – a father or brother with current or past prostate cancer means increased risk of more family members developing it. Older age, people with a diet high in animal fat/protein, or men with a history of sub-fertility are seen as having increased risk. Those with known high risk should be seeing their doctor on an agreed frequency for PSA and/or DRE checks.
For those struggling with BPH, reducing intake of substances that irritate the bladder may help (eg. caffeine and alcohol). Diet to avoid constipation (to maintain strong pelvic floor muscles for bowel/bladder control), as well as body weight, diabetes and blood pressure may also help.
Bowen Therapy can help
Bowen Therapy is another treatment option that is known to help men’s prostates. For those having issues, Bowen Therapy helps to reduce swelling and/or inflammation of the prostate, and supports bladder control and urine flow. A couple of treatments will often give noticeable results, before moving to a less frequent regime for maintenance. For men with a family history of issues, Bowen treatment on some frequency is a useful addition to help maintain good prostate health, to prevent more serious problems in the future.
In the case of active treatment of cancer, Bowen Therapy is one technique recommended by the Cancer Council that may support conventional cancer treatments.
To help support Movember this year, I’ll be hand-knitting moustaches in return for a donation to Movember. Look out on the facebook page soon for sample mo’s, and send me a message if you’d like one !