Prostate Cancer

 When I was still a medical student my grandfather started complaining of back pain. Still very early in my studies I nonchalantly recommended swimming as a great help when my grandmother asked what they could do. To be fair to myself I was ignorant of the fact that he had had treatment for prostate cancer some years earlier, and he had seen his own GP a few times before he was diagnosed with bony metastases in his spine.
 March is prostate cancer awareness month and this is really an area we need to work to raise awareness in.
 Breast cancer, ovarian and cervical cancer all have huge and effective awareness campaigns from running in pink spangly bras to posting vaguely cryptic Facebook updates we are all aware of the importance of self examination, attending smears and reporting unexpected abdominal bloating.
 Yet the 'men's cancers' still present late, at incurable stages, reminding me of the viral photo that did the rounds a few months back.

 It made me smile, and reminded me of my own father, but also made me think of the men I have met during my career who have either avoided the doctors, or been unable to open up about their symptoms until it was too late.

 So what are the symptoms to look out for? Cancer Research list symptoms as:

Need to rush to urinate
Passing urine more often (especially at night)
Difficulty in flow, having to strain  or stopping and starting
A sense of bot being able to completely empty the bladder
Pain when passing urine
Blood in urine or semen

 These are symptoms a lot of men will pass off as being due to getting older, and the thought of a rectal examination puts others off presenting (and that is still one of the best methods of diagnosis) but it really is worth seeing a doctor if you have any of these.

PSA screening.

 PSA is a protein produced by the prostate gland. In the UK levels may be checked if there is a suspicion of prostate cancer or to monitor treatment and recurrence in people who have already been diagnosed.
 I am frequently asked to do this as a screening test and while I will order it for patients on request they need to be aware that this is not an accurate screening tool. The problem with PSA is that a lot of other conditions can raise it (infection, enlarged prostate, physical exercise, prostate examination for a few) and there is no defined level at which we say prostate cancer can be completely included or excluded.
 It produces a lot of borderline raised results in otherwise well patients which can cause unnecessary worry, unnecessary and risky investigations, and a lifetime of repeated monitoring and stress.

 Prostate cancer in its early stages is very treatable, so if you, your partner or any man you know is having these symptoms, encourage them to see their GP,