by Dr. Brian S. Seaman, DC, FRCCSS(C), FICC

What is it?

The prostate (not prostrate) is a walnut sized gland in the pelvis of each man that sits just below the bladder and in front of the rectum. During our young years, it produces fluid but as we get older, and certainly beyond the age of 40, it can become a concern.

Obviously the prostate does not change and become a problem overnight. Over the years, it can gradually become enlarged. This is called BPH or benign prostatic hypertrophy. In other words, it is not cancerous - it just gets bigger.

BPH - What's That?

That means the gland swells and can affect your ability to completely empty your bladder. You may also notice that you are getting up during the night to go to the bathroom more often. You may dribble a bit after passing your water or feel like your bladder is not completely empty. So what to do? Be sure to see your physician and discuss any problems you may be having. Other things to watch out for include:

" Frequent, difficult or painful urination.
" Appearance of blood or pus in your urine.
" Painful ejaculation.
" Unexplained pain in your lower back, pelvis or upper thighs.

Did you know?

According to the Prostate Cancer Research Foundation of Canada, 1 in 8 men will be affected by prostate cancer during their lives. Up to 19,000 Canadian men are diagnosed with prostatic cancer each year. Prostate cancer is the most common cancer and is second only to lung as the most deadly form of cancer in men. It is estimated that one in four men will succumb to prostatic cancer.

Early detection is the key!

Prostatic cancer is generally very slow growing. Consequently, it is very important that as you get older, that the prostate is checked as part of your regular annual examination. Be sure to discuss this with your physician and in particular have the following two tests:

" Digital rectal examination (DRE) - Your physician will actually palpate or feel the prostate by doing a rectal exam. Although you may feel a bit uncomfortable with this procedure, it only takes seconds, is painless and is invaluable in assessing the prostate.
" Prostate specific antigen - PSA is a check with a blood test. This can help to detect prostate cancer in the very early stages. The PSA is a protein normally produced by the prostate. Usually it is present at only very low levels in the blood stream but it can be elevated if cancer cells are present. It can also be elevated if you have BPH or an infection in your prostate (known as prostatitis). If it is elevated, your physician may repeat the test or refer your for further evaluation.

Are there other tests?

If an abnormality is detected by your physician with your rectal examination, or your PSA, he/she may advise further evaluation, which could include:

" Trans-rectal ultrasound - the sound waves create an image and help to assess the volume of the prostate as well as any abnormal growth.
" Biopsy - a needle biopsy will take samples of the prostate cells which will be examined for any abnormalities.

If cancer is detected, your physician may schedule advanced imaging such as a CAT scan, MRI (magnetic resonance imaging) or bone scan. A referral will also be arranged to a urologist who specializes in oncology (cancer treatment).

What factors should I be aware of?

There are a variety of factors such as:

" Age - prostate cancer is most common in men over the age of 40.
" Race - gentleman of black decent have the greatest incidence and east Asians less than average.
" Family history - If you have a brother or father who has been diagnosed with prostate cancer, your risk doubles.
" Diet - Following a low fat diet with ample fruits and vegetables, as well as bread and grains is recommended.

Why not just a concern for men?

Quite often in life, we rely on our partners or spouses with decisions regarding our health. On occasion, I have seen patients in this age group (over the age of 40) who have avoided having the prostate examination (DRE). Often these gentlemen are uncomfortable with the thought of the rectal exam - please don't be! Talk to your spouse. Wives - encourage your husbands to schedule an appointment with their physician to discuss their prostate. Having an examination done once, does not give you a 'clean bill of health' for the rest of your life. Having your prostate examined only takes a few minutes every year and is a very important part of a man's health and well being.

Want more information?

Log onto the website of the Prostate Cancer Research Foundation of Canada (www.prostatecancer.ca). On the website there is a risk assessment tool (scroll down on the left side of the home page). This only takes 3-4 minutes to complete (I tried it) and provides some interesting information.

The PCRFC can also be reached at 145 Front Street East (Suite 306), Toronto, ON, M5A 1E3. Toll free - 1-888-255-0333.

Reprinted with permission of
The Seniors' Advocate. P.O. Box 5005, Waverly, Nova Scotia, B2R 1S2

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