Your prostate

How much do you know about the inner workings of your prostate? Should you get yours checked?

The prostate gland is part of the male reproductive system. It produces some of the fluid that makes up semen. Prostate cancer affects one in 11 Australian men and is common in the over-65 age group. Around 3,000 Victorian men are diagnosed with prostate cancer every year. Many cases are not life threatening because the cancer may be slow growing and usually occurs in older men.

Symptoms
Early prostate cancer usually causes no symptoms. When symptoms do occur, they may include:

  • Difficulties starting and stopping urination
  • Pain or a burning sensation when passing urine
  • Urinating more often than usual, particularly at night
  • The feeling that the bladder can’t be fully emptied
  • Dribbling urine
  • Blood in the urine or semen
  • Pain during ejaculation

All of these symptoms can also be caused by conditions other than prostate cancer. You should discuss them with your doctor.

The cause is unknown

The exact causes of prostate cancer are unknown. However, the chance of getting prostate cancer increases:

As you get older, if you have a father or brother who had prostate cancer. The risk becomes greater if they were diagnosed at an early age.

Diagnosing prostate cancer

Prostate cancer is diagnosed using a number of tests, which may include:

PSA test – the prostate makes a protein called prostate specific antigen (PSA). Large quantities of PSA in the blood can indicate prostate cancer or other prostate problems.

Digital rectal examination – using a gloved finger in the back passage, the doctor feels for enlargement and irregularities of the prostate.

Biopsy -Six to 12 tissue samples are taken from the prostate and examined in a laboratory for the presence of cancer cells.

If prostate cancer is diagnosed, other tests may be needed to see if the cancer has spread to other areas of the body.

Treatment options

Treatment for prostate cancer depends on a range of factors, such as the man’s age, physical condition, the stage of his prostate cancer and his personal preference.

  • Watchful waiting – sometimes your doctor will advise that treatment is not needed. However, you will still need to be examined and have PSA tests regularly to monitor any changes.
  • Surgery – removal of the prostate is called a radical prostatectomy and will involve a six to 10 day stay in hospital. If the prostate can’t be removed, other surgery may be performed to remove blockages in the prostate to relieve urination problems. This operation is called transurethral resection of the prostate (TURP).
  • Radiotherapy – x-rays are used to target and destroy cancer cells. Treatment usually lasts a few weeks, although this depends on the cancer and the person’s general health
  • Brachytherapy – a radioactive implant is placed inside the prostate to target cancer cells. The implant may be temporary or permanent.
  • Hormone therapy – prostate cancer relies on the hormone testosterone for growth. Hormone therapy reduces testosterone levels and ‘starves’ the tumour, this is given with either medication or hormone injections. Sometimes surgical removal of the testicles (orchidectomy) is suggested which has the same effect.

Possible side effects of treatment

The side effects of treatment can be distressing. You should talk through options and concerns with your doctor before making a choice. Typical side effects include:

  • Surgery – many men will have temporary urinary incontinence (loss of bladder control). Almost all men will have a change to their sexual function and most men will have erectile dysfunction (impotence).
  • Radiotherapy – A small number of men will have bowel problems. Between 40 and 80 per cent of men who have radiotherapy will experience erectile dysfunction (impotence).
  • Brachytherapy – erectile dysfunction (impotence) and bowel problems can occur. Some men may experience painful urination and irritation of the bladder for several months after therapy. Urinary incontinence is not usually a problem.
  • Hormone therapy – side effects may include erectile dysfunction (impotence), tiredness, hot flushes and loss of sex drive.

Consult your doctor if you feel you have one or more of the above symptoms.

For more information on your prostate click here.

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