Prostate Cancer

Inspirational Testimonial

Survivor Anthony Walton

“I don’t have the time.” “It’s too expensive.” “I’m afraid of what I might find out.” “I’m fine.” “It’s no big deal, I’ll tough it out.” If you are a wife, girlfriend, mother, sister, daughter friend or loved one of a man who refuses to see a doctor, these are some of the excuses you may have heard from him for avoiding a medical check-up. Unfortunately however studies have shown that men die at higher rates than women for all the leading causes of death and that men “live sicker and die younger than women.” So the time has come for men to make the time, cough up the money and “man up” to the reality that they need to be more proactive about their health.

Mr. Anthony Walton, a 53 year old carpenter in Cayman Brac and local prostate cancer survivor, learned this lesson the hard way… read more

Explanation

The prostate is a gland about the size of a walnut that is unique to men and is located below the bladder and in front of the rectum.

Signs and Symptoms

Usually no symptoms occur, but if there is a sudden change in urinary function exhibited by the following list, see your doctor right away. All of these symptoms may be present with benign prostate problems. Check with your doctor if you have persistent symptoms.

Weak urinary stream
Frequent and/or urgent urination, especially at night
Difficulty starting or stopping the urinary stream
Incomplete emptying of the bladder
Painful or burning urination
Blood in the urine or semen
Painful ejaculation
Pain or stiffness in the lower back, hips or upper thighs

Who is at risk?

The higher risk categories for these cancers are:

Sedentary lifestyle and obesity may increase risk.
Men over age 40: risk increases with advancing age, with over 80% of prostate cancers diagnosed in men over age 65.
Men with African ancestry: prostate cancer is more common in black men with average onset 10 years earlier in age than white or Asian men.
Men with a family history of prostate cancer (risk doubles with affected father and triples with affected brother).
Hereditary prostate cancer may occur at an earlier age.
Men who eat a high-fat diet, particularly high saturated fats and low amounts of fresh fruit, vegetables and fish.
Men exposed to chemicals such as cadmium (a heavy metal) and radiation. Cadmium is present in cigarette smoke.

Prevention and Diagnosis

Many uncertainties persist regarding the early detection and treatment of prostate cancer. Cancers found by DRE and PSA testing are, on average, smaller and have spread less than cancers discovered because of symptoms they cause. Men should consider having both PSA and DRE tests as they do not replace each other but in fact complement each other.

Digital Rectal Examination (DRE)
- Digital Rectal Exam- The physician feels the prostate gland for symmetry and consistency. This should be performed annually in all men over 40 years.
Prostate Specific Antigen (PSA) Test
- Prostate Specific Antigen blood test measure blood levels of PSA which is only secreted by the prostate gland. Elevated PSA levels may be due to benign prostate problems as well as cancer and further follow up is necessary. The first PSA should be done at age 50, and earlier for men at high risk. PSA should be done every 3 years (if results are normal) until age 60, every 2 years until 70, and yearly thereafter. More frequent PSA tests may be necessary in some cases.

Treatment Options

There are a number of treatment options for prostate cancer. Side effects of many of these treatments include incontinence and impotency. However, There are ways of regulating moth of these problems so do not be intimidated into delaying screening if you are concerned about treatment options.

Radical Prostatectomy
- This operation removes the entire prostate gland plus some tissue around it and is used most often if the cancer is thought not to have spread outside of the gland.
Radiation Therapy
- uses high energy rays (such as x-rays) and particles (such as electrons, or protons) to kill cancer cells. Radiation therapy is sometimes used to treat prostate cancer that is still confined to the prostate gland, or has spread to nearby tissue. If the disease is more advanced, radiation may be used to reduce the size of the tumour. The two main types of radiation therapy are external beam radiation and brachytherapy (internal radiation).
Hormone Therapy
- used on patients whose prostate cancer has spread beyond the prostate or has recurred after treatment. The goal of hormone therapy is to lower levels of the male hormones, androgens.
Chemotherapy
- An option for patients whose prostate cancer has spread outside of the prostate gland and for whom hormone therapy has failed. It is not expected to destroy all of the cancer cells, but it may slow tumour growth and reduce pain.
Cryosurgery
- Cryosurgery of the prostate involves the freezing of the gland in order to destroy it. This is done by inserting probes into the prostate, which are then reduced to a very low temperature.