Enyeribe Ejiogu (enyeribee@yahoo.com)
Every man who is 40 years or older needs to read this piece with rapt attention. In the same way, every woman who has a husband, brother, uncle, cousin or male co-worker should also draw their attention to this piece about the prostate, which plays a vital role in the life of any man.
The prostate is a small gland located just below the bladder. It produces semen, a whitish fluid that is very important for the storage and transport of sperm cells during human reproductive process.
As a man advances in age, the prostate can enlarge to the point of squeezing the bladder or urethra. This kind of ordinary enlargement is called benign prostatic hyperplasia (BPH), and can be treated when the symptoms become a real problem for the man. In some instances a man may have prostatitis, which is an inflammation or infection prostate. This may cause urinary symptoms that could be accompanied with fever, but the good news is that prostatitis is treatable with medication.
Prostate enlargement may also be caused by cancer. Doctors say that prostate cancer is the most common kind of cancer that men suffer. Prostate cancer often grows very slowly and may not cause significant harm. But some types are more aggressive and can spread quickly if not discovered early and appropriately treated.
Symptoms of prostate cancer
The worrisome thing about prostate cancer is that in the early stages, most men may not show any symptoms. But as the medical condition progresses, you would begin to notice symptoms that include the following:
Frequent urination, especially at night
Difficulty starting or stopping urination
Weak or interrupted urinary stream
Painful or burning sensation during urination or ejaculation
Blood in urine or semen
When prostate cancer is in advanced stage, it can cause deep pain in the lower back, hips or the upper part of the thighs.
Are you at risk for prostate cancer?
Just for getting older, every man is at risk, and this is the biggest risk factor for prostate cancer, particularly after age 50. Medical researchers have found that after age 70, about 31 to 83 per cent of men have some form of prostate cancer, though there may be no outward symptoms. Again, family history increases a man’s risk. If a man’s father or brother had prostate cancer, then that fact doubles the risk. Africans and people of African descent (African-American and Caribbean men) are at high risk and have the highest rate of prostate cancer in the world.
Diet has been found to be a key culprit in the development of prostate cancer. So if you love and eat a lot of meat as well as high-fat dairy products, then know that you are on the radar of prostate cancer and need to watch what you eat henceforth. Medical science has not clearly and absolutely established the exact link between meat, high-fat dairy products and prostate cancer. One plausible explanation is that dietary fat, particularly animal fat from red meat, may boost male hormone levels. And this may in turn fuel the growth of cancerous prostate cells. A diet too low in fruits and vegetables may also play a role.
Early discovery of prostate cancer
Tests that screen for early signs of prostate cancer are now available, but unfortunately men are not bothering to go prostate test, probably because they are not aware of them. That is why this piece opened with the advocacy for men above 40 to go routine testing. The tests may find cancers that are so slow-growing that medical treatments would offer no benefit. And the treatments themselves can have serious side effects. It is strongly advised that men should go to see a doctor for prostate cancer screening once they reach 40 years.
How screening is done
There are two main types of tests. The first is digital rectal exam (DRE), which the doctor would do to feel for bumps or hard spots on the prostate. The second is the PSA test in which a blood sample is taken, to measure the level of prostate-specific antigen (PSA), a protein produced by prostate cells. An elevated level may indicate a higher chance that the person has cancer, but you can have a high level and still be cancer-free. It is also possible to have a normal PSA and have prostate cancer.
A PSA level that is under 4 nanograms per milliliter (ng/mL) of blood is considered normal while a PSA above 10 suggests a high risk of cancer. It is to be noted that a man can still have prostate cancer with PSA of less than 4. Some drugs used to treat BPH can lower PSA levels, despite the presence of prostate cancer; this is called a false negative. Also, when a person has prostatitis or BPH, this can raise the PSA level but further testing may show no evidence of cancer. In a case where either the PSA or DRE are abnormal, the doctor may then require that you have a biopsy.
Prostate cancer biopsy
The purpose of the biopsy is to take some cells from the prostate for analysis. To get the cells, a special needle is inserted either through the rectum wall or the skin between the rectum and scrotum. Multiple small tissue samples are removed and examined under a microscope. A biopsy is the best way to detect cancer and predict whether it is slow-growing or aggressive.
Biopsy and Gleason score
A pathologist looks for cell abnormalities and “grades” the tissue sample from 1 to 5. The sum of two Gleason grades is the Gleason score. These scores help determine the chances of the cancer spreading. Gleason grades of 1 and 2 are not usually given in biopsies. So, for prostate cancer 6 is typically the lowest score. Cancer with Gleason scores of 8 to 10 is called high-grade, and can grow and spread more quickly. Gleason scores help guide the type of treatment the doctor will recommend.
• Adapted with material from webmd.com