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August 2007 Volume 1 #2
 Prostate problem primer Prostate awareness and Rider pride Molecule helps predict PCa outcome Prostate Cancer Conference 2007 |
Prostate problem primer  According to experts at the Vancouver General Hospital, "Gram for gram, the prostate gland is the most diseased organ in the human body." And women don't even have prostates!Some prostate conditions, such as prostatitis (an inflammation of the prostate), can occur in men of any age. About half of all men will experience symptoms of prostatitis during their lifetimes. Other diseases, such as benign prostatic hyperplasia (BPH) and prostate cancer, become more common as men age. A man over 50 has a roughly 50 per cent chance of developing BPH, or enlargement of the prostate. And, although the risk of a man developing prostate cancer before the age of 50 is low, men in Canada have a 13.2 per cent lifetime probability of developing prostate cancer -- that works out to 1 man in 7.6. But all prostate diseases are not created equal. And even a potentially life-threatening disease such as prostate cancer, if diagnosed early, can be treated effectively, even cured. Let's consider these three most common prostate problems more closely. Prostatitis is not cancer and having prostatitis does not increase a man's risk of developing prostate cancer. What is it? Simply put, prostatitis is an infection or inflammation of the prostate gland. Acute bacterial prostatitis, an infection of the prostate caused by bacteria, usually starts suddenly. "One evening I woke up with a fever, chills, nausea, and an urgency to urinate," writes Rudy. "While urinating, I felt a strong involuntary urinary spasm, which completely cut off my urine stream -- very painful." Other symptoms include pain in the lower back and between the legs. Doctors treat this form of prostatitis with antibiotic drugs. Chronic prostatitis, which can be bacterial or non-bacterial, is more common and usually less severe. Still, the problem is chronic; it keeps coming back time after time. And sometimes these outbreaks are debilitating, as Mark reports: "My symptoms (in the worst outbreaks) were these: dull but intense perineal pain (vaguely located between scrotum and the anus), frequency (about four times a night and about every hour and a half during the day), and a constant sense of urgency (a component of the feeling of pain) that returned within ten or twenty minutes after urination." Chronic prostatitis can be hard to treat, but, often, taking antibiotics over a long period of time does help. Benign Prostatic Hyperplasia (BPH) is very common in older men, but not all men with BPH experience symptoms. (Autopsy studies have shown some degree of BPH in about 90 per cent of men over 80 years old.) BPH is not cancer, does not become cancer, and does not indicate that a man will develop cancer. It is a benign or non-cancerous overgrowth of the prostate. The symptoms of BPH usually come on gradually. As the prostate gets larger, it can slowly narrow the urethra, making urination difficult and interfering with the bladder's ability to expel urine. Typically, men with BPH experience one or a combination of these signs: trouble starting and stopping urination; a weak urine stream, often accompanied by dribbling at the end of urination; an increased frequency of urination, which can be especially troubling at night; and an urgent need to urinate or a feeling that, even after urination, the bladder is still full. "I'd be up a couple times every night because my bladder wouldn't empty completely," says Bob. "My stream was so weak, it'd split in two and be hard to aim. It got so bad I had to sit on the toilet." When his frequent need to urinate interfered with his golf game, Bob consulted his doctor. There are many treatments for BPH, including surgical removal of part of the prostate, the use of medications (alpha blockers and enzyme inhibitors), and minimally invasive therapies that use non-surgical methods (e.g., heat from microwaves or radio waves) to destroy specific areas of the overgrown prostate. Prostate cancer is the most common cancer in Canadian men. According to the Canadian Cancer Society, an estimated 22,300 Canadian men will be diagnosed with prostate cancer in 2007, and 4,300 will die of the disease. But what is prostate cancer? Obviously, prostate cancer is cancer that starts in the prostate gland. And a cancer cell is an uncontrolled, abnormal, and potentially invasive cell. In other words, a cancerous cell no longer responds to the body's usual control processes that regulate cellular growth and death, it has lost its normal structure and cannot function as it should, and it can escape the area in which it first grew and invade other parts of the body. In its early stages, prostate cancer may not cause any signs or symptoms. These often appear only when the tumour is large enough to interfere with urination or ejaculation. Two tests are useful for detecting prostate cancer in its early stages, before men experience symptoms: the prostate-specific antigen (PSA) blood test and the digital rectal examination (DRE). CPCN urges men in their forties to start a yearly regimen of PSA testing and digital rectal exams. (Click here for the CPCN position on early detection.) More tests, such as a biopsy, are used to distinguish prostate cancer from BPH or other conditions that also enlarge the prostate or cause a higher than normal PSA level. But many men credit these two tests, and particularly the PSA test, with saving their lives. As Ray writes, "PSA blood testing saved my life.... I had no idea what a prostate was or what its role was. When the PSA numbers rose significantly within a year, my family doctor sent me to a urologist.... I insisted on a biopsy, and the rest is history." The CPCN's online guide "Understanding Prostate Cancer" provides detailed information on prostate cancer and its diagnosis and treatment. As well as CPCN resources, you may find the following websites and online documents useful: The Canadian Prostate Health Council The Prostate Centre at Vancouver General Hospital The Prostate Centre at Princess Margaret Hospital Prostatitis Canadian Prostate Health Council, Prostatitis, CPHC Online Pamphlet Murray Koffler Urologic Wellness Centre, Prostatitis: A Patient's Guide Prostatitis Foundation BPH Canadian Prostate Health Council, BPH, CPHC Online Pamphlet The Mayo Clinic, Enlarged Prostate (BPH)
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