When I’m abroad talking to groups of runners, or to the media, I always say that, while cancer has never posed a bigger global threat, there are three things we can do to protect ourselves and our loved ones :
- Donate to Cancer Research ;
- Live an active, healthy lifestyle (40% of cancers are avoidable!) ;
- Be vigilant – and do what you can to check for cancer and catch it early.
So, when I got the Movember email from Big D(arren) saying that he wanted us all to get checked for prostate cancer, and that this was more important to him than any donation we might make, I felt obliged to follow his advice.
In truth, the bit that really caught my eye in his email was that it’s apparently no longer necessary to have a DRE – Digital Rectal Examination. Instead you can just have a simple blood test (the PSA). Phew!
So, when I was seeing my GP, Dr Ronald Arulnesan, last week (about a nasty little cough that I’d picked up on my last running trip) I mentioned the blood test. We discussed the PSA, including the fact that it can give false positives that can lead to unnecessary biopsies. Eventually we concluded that I should go ahead with the test.
At which stage he turned to his diary. To put in a date for my physical examination. Aaargh! It seemed I wasn’t going to get away without a DRE! Help!!
Now I don’t know why many men (yours truly included) are quite so uneasy about a finger up the bottom. It can’t just be about the size of the finger because, let’s be honest, something larger that way passeth most days. It is, I guess, an invasion of privacy in an area that, while often a source of humour, is also quite delicate. It may even be that your average heterosexual male is unduly sensitive about anything involving his bottom and another man.
In any event I was feeling quite queasy as I showed up with my freshly showered body at the Highgate Group Practice for the dreaded appointment with Dr Arulnesan. We started with a little chat about my various other ailments and I found myself looking at the good doctor’s hands. Hmm. Not as small as I might have liked….
Anyway, let’s cut the crap (so to speak). What was it like ?
Well, it’s certainly uncomfortable. And undignified as you lie there with your knees pulled up towards your chest.
On the other hand, they use a lubricant, it doesn’t take very long and, if Dr Arulnesan is anything to go by, they’re well practiced in making the whole thing as painless as possible.
You know how, when you have an injection, you wouldn’t dream of making a fuss about it? In fact, since you’re a real man, you’d probably pretend you didn’t even feel it. Well, a DRE is a lot less painful than an injection. (And, believe me, I know what I’m talking about. I had an injection against every disease known to mankind before I started running round the world.)
Why is this all so important? Because approximately 11 000 men in the UK, and about 27 000 men in the US, die each year from prostate cancer. Globally, there are over a million new cases of prostate cancer recorded each year. Yet, if you catch it early, you have about a 98% chance of survival (decreasing to 26% if you catch it late.)
So, if you have any of the symptoms, or you’re on the cusp of middle age (i.e. you’re over 50), man up, get your arse in gear, and get checked. I can’t tell you that you’ll enjoy it. But it’s not that bad and IT MIGHT SAVE YOUR LIFE!!!
And thanks for asking. No, the DRE didn’t reveal any obvious problems. PSA is on Friday and I should get the results in the New Year.
Finally, since it’s the giving season, and since I don’t have any photos from the actual examination, here’s a picture of my bottom full of needles. Taken during an acupuncture session I had in the Caymans (to try and resolve yet another running related injury), it’s the best I could come up with. Merry Christmas one and all!
Finally, finally, thank you Dr Arulnesan. you were great!
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Facts & Stats
All About Prostate Cancer From the UK’s NHS
Prostate cancer is the most common cancer in men in the UK, with over 40,000 new cases diagnosed every year.
Prostate cancer usually develops slowly, so there may be no signs you have it for many years.Symptoms often only become apparent when your prostate is large enough to affect the urethra (the tube that carries urine from the bladder to the penis).When this happens, you may notice things like an increased need to urinate, straining while urinating and a feeling that your bladder has not fully emptied. These symptoms shouldn’t be ignored, but they do not mean you definitely have prostate cancer. It is more likely that they are caused by something else, such as benign prostatic hyperplasia (also known as BPH or prostate enlargement).
What is the prostate?
The prostate is a small gland in the pelvis found only in men. About the size of a satsuma, it’s located between the penis and the bladder and surrounds the urethra.The main function of the prostate is to help in the production of semen. It produces a thick white fluid that is mixed with the sperm produced by the testicles, to create semen.
Why does prostate cancer happen?
The causes of prostate cancer are largely unknown. However, certain things can increase your risk of developing the condition. The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.For reasons not yet understood, prostate cancer is more common in men of African-Caribbean or African descent, and less common in men of Asian descent.
Men who have first degree male relatives (such as a father or brother) affected by prostate cancer are also at slightly increased risk.
Tests for prostate cancer
There is no single test for prostate cancer. All the tests used to help diagnose the condition have benefits and risks, which your doctor should discuss with you.The most commonly used tests for prostate cancer are blood tests, a physical examination of your prostate (known as a digital rectal examination or DRE) and a biopsy.
The blood test, known as a prostate-specific antigen (PSA) test, measures the level of PSA and may help detect early prostate cancer. Men are not routinely offered PSA tests to screen for prostate cancer, as results can be unreliable.This is because the PSA blood test is not specific to prostate cancer. PSA can be raised due to a large non-cancerous growth of the prostate (BPH), a urinary tract infection or inflammation of the prostate, as well as prostate cancer. Raised PSA levels also cannot tell a doctor whether a man has life-threatening prostate cancer or not. This means a raised PSA can lead to unnecessary tests and treatment.
However, you can ask to be tested for prostate cancer once the benefits and risks have been explained to you.
How is prostate cancer treated?
For many men with prostate cancer, treatment is not immediately necessary.If the cancer is at an early stage and not causing symptoms, a policy of “watchful waiting” or “active surveillance” may be adopted. This involves carefully monitoring your condition. Some cases of prostate cancer can be cured if treated in the early stages. Treatments include surgically removing the prostate, radiotherapy and hormone therapy.
Some cases are only diagnosed at a later stage when the cancer has spread. If the cancer spreads to other parts of the body, typically the bones, it cannot be cured and treatment is focused on prolonging life and relieving symptoms. All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary incontinence. For this reason, many men choose to delay treatment until there is a risk the cancer might spread.
As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment. Nevertheless, it can have an effect on your life. As well as causing physical problems such as erectile dysfunction and urinary incontinence, a diagnosis of prostate cancer can understandably make you feel anxious or depressed.
UK Prostate Cancer Statistics from Prostate Cancer UK
Across the UK
- Prostate cancer is the most common cancer in men.
- Over 47,000 men are diagnosed with prostate cancer every year – that’s 129 men every day.
- Every 45 minutes one man dies from prostate cancer – that’s more than 11,000 men every year.
- 1 in 8 men will get prostate cancer in their lifetime.
- Over 330,000 men are living with and after prostate cancer.
US Prostate Cancer Statistics From Cancer.org
How common is prostate cancer?
Other than skin cancer, prostate cancer is the most common cancer in American men. The American Cancer Society’s estimates for prostate cancer in the United States for 2017 are:
- About 161,360 new cases of prostate cancer
- About 26,730 deaths from prostate cancer
Risk of prostate cancer
About 1 man in 7 will be diagnosed with prostate cancer during his lifetime. Prostate cancer develops mainly in older men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66.
Deaths from prostate cancer
Prostate cancer is the third leading cause of cancer death in American men, behind lung cancer and colorectal cancer. About 1 man in 39 will die of prostate cancer. Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.
For statistics related to survival, see Survival Rates for Prostate Cancer.
Global Statistics About Prostate Cancer from the World Cancer Research Fund International
Prostate cancer is the second most common cancer in men worldwide.
Prostate cancer statistics
More than 1.1 million cases of prostate cancer were recorded in 2012, accounting for around 8 per cent of all new cancer cases and 15 per cent in men.
Age-adjusted incidence rates of prostate cancer have increased dramatically and this is largely because of the increased availability of screening for prostate-specific antigen (PSA) in men without symptoms of the disease. This test leads to detection of many prostate cancers that are small and/or would otherwise remain unrecognised, and which may or may not develop further into higher stage disease.
The Continuous Update Project Panel made the following judgements; greater body fatness is probably a cause of advanced prostate cancer, and developmental factors (marked by adult attained height) are probably a cause of prostate cancer.
- Martinique had the highest rate of prostate cancer, followed by Norway and France.
- About 68 per cent of prostate cancer cases occurred in more developed countries.
- The highest incidence of prostate cancer was in Oceania and Northern America; and the lowest incidence in Asia and Africa.