By Clive Turner
There are around 50,000 men in Cyprus aged between 50 and 60 (according to the 2011 census) and a sizeable percentage of those will be expat retirees. And of those a sizeable percentage again will be bothered with prostate problems – not all of them cancerous but nevertheless worrying and disturbing and of a nature truly unwise to ignore.
The trouble with prostates is that they are out of sight, out of mind, and easy to push out of one’s consciousness – most of the time. But, gentlemen, if pushed aside for too long, prostate worries can become serious and indeed become killers. It is notable that some 1 in 8 men experience prostate cancer in their lifetimes, making it the third most common male cancer after lung and bowel.
Around 6 in 10 cases are diagnosed in men aged 65 and older. At least it is rare before 40, with the average age of diagnosis being 66. Worldwide, in 2012 there were1.1 million cases diagnosed – with 307,000 deaths, while in the UK, some six per cent of all male deaths were from prostate cancer.
That said, following successful prostate cancer treatment, the survival rate after five years is 99%; after 10 years 98%; and after 15 years 96%; which statistics indicate not bad odds.
However, even if cancer does not invade, the gland enlarges as a man ages, which can reduce or block the flow of urine – and this can be a medical emergency. Or you could suffer from prostatitis, a sometimes painful inflammation of the prostate.
One of the disappointing, if not tragic, issues is that men do not like to talk about – or even think about – ‘down there’. Unlike women, who openly discuss breast cancer and have little concern about any embarrassment, a man will prefer to hide away his concerns and hope it will go away. But it won’t and the longer it is left, the less likely it is that a cure will be possible. Yet cures are not only possible but increasingly so, providing the issue is tackled early on. And that is key.
Tackling the matter means undergoing a simple blood test annually, this being called a specific antigen (PSA) test. This test is not infallible and there can be, and are, false results, but it is currently the best indicator we have, taken together with a brief and painless rectal examination. And there are other (more intrusive) investigations, where thought necessary, called biopsies.
The current pros and cons of prostate cancer screening are not hidden away – and this recent research from major medical institutions is readily available – and a urologist should be in possession of all the latest facts and considerations. Examinations can include bone scans, CT scans and MRI scans, so there is plenty of opportunity for thorough analysis. There is a cancer grading system and also a measurement termed the Gleason Score which helps your specialist to decide what treatment to offer.
There are several advisory options to consider – from so called ‘watchful waiting’ to different surgeries that have their advantages and disadvantages and suitabilities for a given patient. And apart from surgery, there are radiation techniques which today are really powerful and effective in certain cases. There are hormone treatments, cryotherapy (the controlled freezing of the prostate), chemotherapy, cancer vaccines and immunotherapy and high intensity focused ultrasound – all of which have their place depending upon the exact medical situation, condition of the patient and progress of the cancer.
Additionally, along with the new improvements in diagnosis, there are some very recent curative discoveries and medicines being tested which initially appear promising and highly effective.
But then again, cancer may not be indicated at all and something called benign prostatic hyperplasia (BHP) could simply be the problem, and this is no more than an enlarged prostate. In fact, 90 per cent of men in their 80s have BHP. So this is really extremely common and is easily treated. Or, your problem may be prostatitis – a non-cancerous condition that often has no identifiable cause and again, treatment is swift and easily available.
But whatever the problem and extent of it, leaving it to worry you, inconvenience you with frequent runs to the loo, or ignoring it as no more than a nuisance, could be foolish and perhaps fatal.
Still, it has to be said that post-prostate cancer treatment, even when successful in terms of clearing the cancer, is what terrifies many men because they read and hear that the price of clearance is so often the loss of erectile function. Now although there are several drugs available like Viagra and Cialis which can offset this condition, too many men will not take the risk of losing such a function and consequently lose their lives instead!
One of the unfortunate facts is that prostate cancer is too often a condition which runs through families and given, say, a father who has suffered, his son(s) may be at increased risk.
Anyway, instead of quietly laughing it off and putting up with getting up too often in the night, or trying to find a loo quickly when away from familiar locations, do yourself a favour; have annual PSA tests, and if the figures creep up over what your doctor considers normal readings, do something positive and see what might be wrong…
It must be admitted that even when one’s doctor pronounces you clear, prostate cancer can return if a minute bit of diseased tissue is missed or another unfortunate and unpredictable situation arises. As with almost all cancers, clearance is only permanent in 99 per cent of cases. There is no guarantee you will not be within that one per cent. But isn’t that statistic more comfortably handled than the near certainty of a life lost because of ignorance, fear or embarrassment?