Don’t miss your prostate exam due to misconceptions

With June being Men’s Health Month, the Herald spoke to a urologist about prostate cancer awareness.

Urologist at Robinson Private Hospital Dr Deon Knoesen explained that the small walnut-sized gland around the bladder neck that produces seminal fluid that nourishes and transports sperm is called the prostate.

“Prostate cancer is diagnosed by conducting a prostate-specific antigen (PSA) blood test and a sonar, and should the results indicate elevated levels, the patient will undergo a digital rectal examination (DRE) and a biopsy to confirm the diagnosis,” said Knoesen.

He added that 60% of men over the age of 65 may be diagnosed with prostate cancer and the average age is 66. This form of cancer is rare amongst men between the ages of 20 and 40 years, but more common in men 50 years and older, therefore men are advised to undergo PSA tests yearly after the age of 50.

“Prostate cancer can be genetic; should there be prostate cancer in a man’s family history, it’s suggested to do yearly check-ups from the age of 45.”

Treatment options depend on the stage of the cancer. If detected early it’s 100% treatable and can be cured as long as it’s followed up. Treatment options if diagnosed early are Brachytherapy or surgical removal.

“Brachytheraphy is a form of radiation therapy and involves placing radioactive seeds in the prostate gland. The seeds release radiation, which can kill the cancer cells, and the treatment is less damaging to healthy tissue nearby. Brachytheraphy is conducted in theatre and the patient is sedated. He is admitted and discharged from hospital on the same day. It’s not a lengthy procedure which requires an extensive hospital stay.”

Should prostate cancer be diagnosed at a progressive stage and has spread, treatment options include chemotherapy and hormonal therapy.

Prostate cancer does not present with symptoms, especially in the early stages. In later, more advanced stages patients may experience the following:

• Difficulty starting urination
• Weak or interrupted flow of urine
• Frequent urination, especially at night
• Difficulty emptying the bladder completely
• Pain or burning during urination
• Blood in the urine or semen

Men generally avoid prostate examinations due to the misconception that they entail rectal examinations. A digital rectal examination is mostly performed only to confirm the diagnosis after the first initial sonar and blood test, and if the blood test results indicate possible prostate cancer.

Another perception is that prostate cancer treatment causes erectile dysfunction. This is not the case; treatments do not cause erectile dysfunction.