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Dr Ciara Kelly: Prostate cancer is not something to keep quiet about

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Prostate cancer is mainly a disease of older men (although 25pc of cases are in younger men) and is often slow growing.

Prostate cancer is mainly a disease of older men (although 25pc of cases are in younger men) and is often slow growing.

Get checked out: ‘Trouble with the waterworks, Stanley?’

Get checked out: ‘Trouble with the waterworks, Stanley?’

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Prostate cancer is mainly a disease of older men (although 25pc of cases are in younger men) and is often slow growing.

I think it's great we're focusing on men's health this week. Men's health does seem to get overlooked and despite (or could it be because of…) the facts that men don't live as long as women, and up until recently, most doctors were male - it never seems to take centre stage. Men are often apologetic about seeking help with their health.

"Sorry, Doc, I'm only here because herself sent me..." And I sometimes wonder is it part of that 'Boys don't cry' ethos that prevents men from looking after their own needs and maybe causes them to suffer in silence. Prostate disease is a good example of this.

Your prostate is a small doughnut shaped organ that sits just below your bladder, and your urethra (outflow pipe) passes through the centre of it. It's normally about the size of a chestnut but it enlarges with age.

Prostate cancer is mainly a disease of older men (although 25pc of cases are in younger men) and is often slow growing. And the symptoms - caused by the prostate cancer pressing on the urethra, sometimes partially blocking it - are often difficult for men to discuss.

'Waterworks problems' as the euphemism goes, include; poor stream, hesitancy, dribbling, urgency, incomplete voiding and incontinence. But these are not easy things to bring up, so men often don't mention it and put up and shut up about their symptoms. I should point out that these symptoms don't mean you have prostate cancer, they can be caused by normal, age-related enlargement of the prostate, but they do mean you should be checked out. Other symptoms such as pain at the base of the penis or passing blood are not normally caused by benign enlargement and should be checked out straight away.

The normal first line tests are a PSA blood test and a rectal examination. Which is not nearly as bad as people fear it to be. There's quite a bit of controversy about prostate screening using the PSA blood test. International guidelines state men under 50 and over 69 should not be screened and that those in between those ages, should be told that the test, which is non-diagnostic, may lead to over investigation or over treatment - which can cause real side-effects. In a chestnutshell, what that means, is if you have a high PSA blood test, you're obliged to go on for further investigations and biopsies and these investigations can cause problems, with urinary continence or with erections and ejaculation. Hence the controversy.

If you're diagnosed with prostate cancer, the treatments are varied from 'watchful waiting' through to surgery, radiation and chemo. Watchful waiting for many older men is preferable, as prostate cancer in the elderly, often runs an indolent, slow, non-lethal course. If however you're younger or the cancer is more advanced or aggressive - more invasive, surgical treatment is likely to be right for you.

Age is the single biggest risk factor for prostate cancer. With heredity and race also playing a role. But in terms of protective factors - having low blood cholesterol and a healthy diet seem to be the biggest game-changers. Keeping your cholesterol low is the most closely linked factor for remission and all prostate cancer sufferers should stick to a very low fat diet and may need a statin. Regular ejaculation has been shown in some studies to lower your risk of prostate cancer - so far from being bad for you, masturbation may in fact prevent prostate cancer. There's something you were never told in school.

If you're suffering from any of the symptoms mentioned above, don't be afraid to talk to your doctor about it. Particularly if you're a younger man and you have a family history. It's time men came out of the closet and opened up about their health.

@ciarakellydoc

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