Understanding prostate cancer

Posted on 11 September 2012

Meet our expert Dr Rupert Rencken, a urologist at Mediclinic Pietermaritzburg who has been in practice for 21 years already. ‘Urology is a wonderful discipline of medical care. I get to see a wide spectrum of patients, from newborns to the very elderly,’ he says. ‘I find it rewarding to treat and often cure conditions of parts of the body that patients feel uncomfortable discussing.’

A prostate exam sounds uncomfortable. Why is it necessary?
It’s one of the most important tests for detecting prostate cancer at an early stage. The exam will detect any irregularity, called a nodule, in the prostate, which may be the first sign of prostate cancer. By the time prostate cancer causes problems with urination, it is generally at a stage where it may be incurable, so it’s better not to wait until you have difficulty passing urine before you have your prostate checked.

What should I expect during the exam?
The doctor will put a gloved finger into the anus to feel the consistency of your prostate. This may indeed be embarrassing and uncomfortable but if performed properly it’s not painful. The examination is performed in the doctor’s rooms. You may feel the desire to pass urine during the examination, but no urine will leak out. The examination takes about 20 seconds, after which your doctor may ask you about prostate-related problems such as the passing of urine and erection function.

How often should men have a prostate exam?
If they’re 50 years or older, they should have your prostate checked once a year. Prostate cancer rarely develops in men under 50. However, if you have a father or brother who has been diagnosed with prostate cancer, you should have your first annual exam at the age of 40 already. This is because the cancer is about two to four times more common in people with a family history, and tends to occur at an earlier age.

What other tests can be done to screen for prostate cancer?
About 90% of all early prostate cancers will show up with the help of a blood test that measures the level of a substance called prostate-specific antigen (PSA) in your blood. PSA is produced only by the prostate and higher-than-normal blood levels mean that something is wrong in the prostate. However, the PSA test is not a test for prostate cancer only: other prostate problems such as swelling or infection can also push the blood PSA level higher. If a suspiciously high PSA level is found, the urologist could perform an ultrasound scan of the bladder and prostate, along with special urine tests, to evaluate the prostate further.

Can prostate cancer be treated? If so, what does treatment involve?
Prostate cancer is an extremely curable disease if it is caught in the early stages. Treatment could take the form of radiation, surgery or medication, depending on the specific type and degree of spread of the cancer. After the initial diagnosis of prostate cancer, further tests such as scans will need to be performed to guide the treatment decisions.

Will prostate cancer affect my bladder function or my sex life?
Yes, if left untreated prostate cancer will affect bladder function as well as your sexual function. However, if caught early, prostate cancer is highly treatable.

I’m a cyclist. Could I have an increased risk for developing prostate cancer?
There is no evidence that cycling causes prostate cancer. In fact, regular exercise may help to prevent prostate cancer. Known risk factors for developing prostate cancer include increasing age, a high-fat diet and a family history of prostate cancer.

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Published in Cancer

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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