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Most prevalent cancer

Prostate cancer is the most prevalent cancer among white South African males.

However, recent statistics indicate that black men are at increased risk of prostate cancer and often develop an aggressive type of prostate cancer.

More 2 000 men die from this disease each year which may, in part, be due to the fact that the level of awareness, understanding and support for prostate cancer lags significantly behind that of women’s health causes.

The facts

  • South African men have a 1 in 23 lifetime risk for prostate cancer.
  • One in seven men will be diagnosed by age 75.
  • One in four will be diagnosed by age 85.
  • Around five men die from prostate cancer each day in South Africa – calculation based on 2000 men dying yearly.
  • Only one in four men who have a positive PSA test turns out to have prostate cancer.
  • It is estimated that 238 590 men will be diagnosed with and 29 720 men will die of cancer of the prostate in 2013

What is the prostate?

The prostate is a gland forming part of the male reproductive system.

It is located immediately below the bladder and just in front of the bowel.

In younger men the prostate is about the size of a walnut. It is doughnut shaped as it surrounds the beginning of the urethra, the tube that conveys urine from the bladder out through the penis.

What is prostate cancer?

Prostate cancer occurs when some of the cells of the prostate reproduce far more rapidly than in a normal prostate, causing a tumour.

If left untreated prostate cancer cells may eventually break out of the prostate and invade distant parts of the body, particularly the bones and lymph nodes, producing secondary tumours, a process known as metastasis.

Once the cancer escapes from the prostate, treatment is still possible but a “cure” becomes impossible.

Provided appropriate treatment commences while the cancer is still confined to the prostate gland, it is possible to prevent the progression of the disease.

One of the most worrying aspects of the disease is that most prostate cancers develop without men experiencing any symptoms.

Risk factors?

  • Gender: prostate cancer affects men only as women do not have a prostate gland.
  • Age: the older a man is the more likely he is to be diagnosed with prostate cancer.
  • Family history: a man with a father or brother who developed prostate cancer before age 60 is twice as likely to develop the disease
  • Ethnicity: increased occurrence in black African males
  • Lifestyle: poor diet and lack of exercise

Symptoms

The majority of prostate cancers have no symptoms, and it is really only advanced cancers that have spread throughout the prostate (and beyond) that cause urinary symptoms such as:

  • Slow flow: urine flow is slow and difficult to stop.
  • Hesitancy: difficulty starting flow of urine.
  • Frequency: need to urinate more frequently.
  • Nocturia: need to urinate during the night.
  • Urgency: urgent need to urinate.
  • Blood in the urine or semen.
  • Reduced ability to get an erection.
  • Painful ejaculation.

It’s important to talk to your doctor about prostate cancer testing, as there are advantages and disadvantages of testing.

It’s important to note that these symptoms are common to many different conditions, not just prostate cancer.

Talking to your doctor about prostate cancer testing

It’s important to talk to your doctor about prostate cancer testing, as there are advantages and disadvantages of testing.

It’s important to note that these symptoms are common to many different conditions, not just prostate cancer.

The purpose of testing is to detect prostate cancer at its earliest stages, before any symptoms have developed.

There are two tests:

  • Physical Examination (DRE: Digital Rectal Exam)
  • n Blood Test (PSA: Prostate Specific Antigen)

The PSA

The PSA blood test looks for the presence in the blood of a protein that is produced specifically by prostate cells called Prostate Specific Antigen (PSA).

The presence of an elevated PSA does not necessarily mean prostate cancer is present as there are other medical conditions that can lead to a PSA result outside the normal range. These include enlargement of the prostate (Benign Prostatic Hyperplasia or BPH) and inflammation of the prostate (prostatitis).

The DRE

The DRE involves the doctor inserting a gloved finger in the anus, where it is possible to feel part of the surface of the prostate.

Irregularities include swelling or hardening of the prostate, or lumps on the surface that may indicate development of a tumour or other problems.

The drawback to this test is that the doctor can feel only part of the prostate, so some irregularities may be beyond reach.

If the results of the test are abnormal your GP would refer you to a specialist to take a tissue sample in the form of a biopsy.

A biopsy is the only way to determine if cancer is present.

A doctor typically diagnoses prostate cancer after closely examining biopsy cells through a microscope.

There are several types of cells in the prostate and each contributes in its own way to the prostate’s development, architecture and function.

Cancer cells look different than normal prostate cells. Pathologists look for these differences first to detect the presence of cancer and then to determine the cancer grade.

Doctors will perform various tests to stage the cancer, determine its risk and develop a treatment plan.

* For Movember’s list of men’s health sources, please email: info.za@movember.com

* Information from www.za.movember.com

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