It’s not too late to start growing a moustache for November as a
during November each year, Movember is responsible for the sprouting of millions of moustaches around the world. With their “Mo’s” men raise vital funds and awareness for prostate and testicular cancer and mental health. As an independent global charity, Movember’s vision is to have an everlasting impact on the face of men’s health.
On this occasion I will focus on prostatic cancer, which a very dear friend of mine died of five years ago and unfortunately presented with very late symptoms of back pain. It became worse after doing a sponsored walk along the coastline of Wales in aid of the Church of Wales Children’s Society. This illustrated how it can present with few symptoms.
He was a man of great fortitude, intellect and humour and my memories are of laughter and fascinating intellectual discussions.
What is the prostate?
Men have a small gland about the size of a walnut called the prostate gland. The prostate surrounds the first part of the tube (urethra) which carries urine from the bladder to the penis. The same tube also carries sex fluid (semen). The prostate gland is divided into 2 lobes, to the left and the right of a central groove.
The prostate gland produces a thick clear fluid which is an important part of the semen. The growth and function of the prostate depends on the male sex hormone testosterone, which is produced in the testes. Some treatments for prostate cancer work by lowering the levels of testosterone.
Symptoms of non cancerous and cancerous prostate conditions
As men get older their prostate gland often enlarges. This is usually not due to cancer. It is a condition called benign prostatic hyperplasia.
The symptoms of growths in the prostate are similar whether they are non cancerous (benign) or cancerous (malignant).
The symptoms include:-
- Having to rush to the toilet to pass urine
- Difficulty passing urine
- Passing urine more often than usual, especially at night
- Pain when passing urine
- Blood in the urine or semen
The last two symptoms – pain and bleeding – are very rare in prostate cancer. They are more often a symptom of non cancerous prostate conditions.
It is important to realise though, that very early prostate cancer generally does not cause any symptoms at all.
If a tumour is not large enough to put much pressure on the tube that carries urine out of the body (the urethra), you may not notice any effects from it.
Other symptoms of prostate cancer
Cancer of the prostate gland often grows slowly, especially in older men. Symptoms may be mild and occur over many years. Sometimes the first symptoms are from prostate cancer cells which have spread to your bones but this is not common. Cancer cells in the bone may cause pain in your
- Other bony areas
Cancer that has spread to other areas of the body is called metastatic or secondary prostate cancer. In this section there is information about the treatment of prostate cancer that has spread.
Other symptoms that may occur are weight loss, particularly in elderly men, and difficulty getting an erection (where you haven’t had difficulty before).
We as GP’s have guidelines that tell them the symptoms to look out for, and when we should send you to a specialist for tests. The guidelines say that men who have symptoms that could be due to prostate cancer should be offered.
PSA stands for prostate specific antigen. This is a substance made by normal and cancerous prostate cells and released into the bloodstream. The level of PSA in your blood may go up in prostate cancer because more PSA leaks into the bloodstream from the cancerous cells. PSA levels also go up as you get older and if you have a benign (non cancerous) enlarged prostate. So the PSA test is not a specific test for cancer. There is a range of normal PSA readings for every age group. The upper normal limit for a man aged 50 is around 3.0 ng/ml but this increases to 5.0 ng/ml if you are 70.
This is not done aaa a routine screening test due to the non specificity of the test.
If your PSA level is slightly raised (a borderline result), the guidelines say you should have another PSA test in 1 to 3 months time. The second test checks if the PSA is going up or is staying the same.
If you have a suspicious PSA reading and other symptoms that could be related to prostate cancer, the guidelines say your GP should consider referring you to a specialist for an appointment within 2 weeks.
Your GP may decide to delay doing a PSA test sometimes. There are a few situations that can affect the reading and make it less accurate – for example, if you have a urine infection. A test should be delayed for a month after you’ve had treatment for a urine infection.
Your GP puts a gloved finger into your back passage (rectum) to feel your prostate gland and check for abnormal signs, such as a lumpy, hard prostate. Doctors call this test a digital rectal examination (DRE).
Screening for men at higher risk of prostate cancer
There is some evidence to show that prostate cancer can run in families. This means that if a relative has been diagnosed with prostate cancer your risk is higher than in the general population. The risk is higher if it is:-
- Your brother who was diagnosed
- The relative was younger than 60
- You have several relatives diagnosed with prostate cancer
If your GP suspects a cancerous prostate gland an urgent 2week referral can be made but if you have any concerns you must inform your GP As soon as possible in order that more detailed tests can be performed as outlined in the following link:-
GROW YOUR MOUSTACHE AND BECOME AWARE OF PROSTATE CANCER