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The following personal experience was sent to us in the hope it can help other Guild members. We welcome your feedback.

Men, you probably have one of these. I truly hope so. And I hope you continue to have a good healthy one for a long, long time to come. Just a month ago I had a surgeon remove mine. I’m talking about the prostate gland. Until I was diagnosed with cancer of the prostate this summer, I really did not know much about this walnut-sized gland. Since then I’ve learned a few things, and I hope that this article will pass some of the ones I have found useful along. But let’s back up a little.

From time to time my father sends me articles from various publications. Recently he mailed me Men’s Health Guide from the September 26, 2005 issue of U.S. News & World Report. The article’s title is ”Survival Skills: Smart Behavior and New Ways to Beat Five Killers - Heart Disease, Cancer, Accidents, Stroke, and Lung Illness - Will Help Guys Live Longer.” A couple of items in particular got my attention, and the article begins:

“... medical consultants specialize in advising every institution from labor unions to the insurance industry on how to improve the health of American men by improving their behavior. For there is a growing awareness that men don’t take very good care of their bodies and minds. Indeed, they are killing themselves by ignoring their medical needs and acting in destructive ways that simply make their health problems much, much worse.

“Of course, women can be self-destructive, too, but the strong consensus among healthcare providers is that it’s men, far and away, who are taking the most health risks.”

Later in the article, Michael Addis, a psychologist at Clark University, commented, “Men view their bodies as machines, not things in need of caring.”

I can think of lots of times when that fit for me. On turning 20 I recall being amazed that I actually was, more or less, still in one piece! One writer has suggested testosterone as part of the issue. This amazing hormone that has helped us survive for eons, also has its dark side. Accidents often seem to be associated with this. Men have nearly twice as many harmful and life-threatening accidents as women, making unintentional injuries the third-leading cause of male death, and it is number 1 for males between the ages of 1 and 44. The number 1 overall cause of death is, of course, heart disease, and number 2 is cancer. All the experts say the same thing: smoking, diet, exercise, and lifestyle are the main factors that affect our health.

Here is a brief introduction to some of the information about prostate cancer.

For men prostate cancer is the most common cancer, except for skin cancer.

The prevalence of prostate cancer increases with age, such that the incidence nearly doubles every 10 years after the age of 40. The risk is about 10% of men in their 50s increasing to 70% for those in their 80s. However, in most older men, prostate cancer does not grow and many men die of other causes before prostate cancer is discovered.

Prostate cancer is 66% more common in African-American men and it is twice as likely to be fatal than in Caucasian men in the U.S. However, black men in Africa have one of the lowest rates in the world. Japan has the lowest death rate and Switzerland the highest. The lowest occurrence rate is in China and the highest is among African-American men, with the next highest among Caucasian men in the U. S. and then in Canada.

Prostate cancer is related to high levels of testosterone.

Smoking does not appear to increase the risk of having prostate cancer but smokers tend to have more aggressive cancer.

The effects of a vasectomy are unclear.

Men at risk should have a screening for prostate cancer every year beginning at age 50, unless a man is in a high-risk group, such as African-American men, or men who have a father or brother who has had prostate cancer, then screening should begin at age 40. The screening needs to consist of both a Prostate Specific Antigen (PSA) blood test, and a Digital Rectal Examination (DRE). It is very important that both of these tests be used. For example the type of cancer I had was only detectible with a DRE. My PSA was 0.89, a very low number; a number as high as 4.5 would still be in the normal range for someone my age (62). The rate of change of the PSA from year to year is also useful information.

Some prostate cancers spread very slowly, especially in older (80+) men. However some cancers are aggressive, which means they have a tendency to grow quickly, and to move out of the prostate and into other parts of the body. (This is the type of cancer I had.) A checkup once a year covers this. Early detection is the key as this will allow you to have more treatment options. More options = good.

Possible Signs

There are many signs that may indicate the presence of prostate cancer, but may also indicate other issues with your prostate, such as benign prostatic hyperplasia (BPH). Simply stated, BPH is an enlargement of the prostate that is not caused by cancer. Or Prostatitis is a condition characterized by burning during urination or pain in the pelvic region. If any of these signs show up, it is worth a trip to your doctor to get things checked out. (This is what motivated me to go in for a visit.) Because the prostate gland moves around a little in your body, and for other reasons as well, these signs are not always constant. That is, one of these items my be present for a while, and then go away for a bit, then come back. In any event, check it out!

Here is a list of possibilities, in no particular order:

• Getting up to urinate more often than 1 or 2 times a night (for very light sleepers, this may be normal)
• Urinating more frequently than every two hours during the daytime
• Feeling that you have to urinate, but when you attempt to, finding that it takes a while for the urine to come out (hesitancy)
• Pain or urgency to urinate
• Decreased force of urinary stream
• Incomplete voiding
• Erection difficulties/impotence
• Lower back pain (What log builder doesn’t have lower back pain? So this will have a different quality to it.)
• Discomfort when sitting
• A dull ache in the area of the perineum – sometimes related to stress
• Discomfort in the groin, penis, or testicles
• A constant feeling of fullness in the bladder

Just one of the things that I learned from my experience is that simply because your doctor feels a “node” on your prostate during a DRE, that does not necessarily mean there is anything wrong. A node can come and go. For example, I saw my urologist the week following the first discovery of a node during my physical. My urologist checked out the node with another DRE and then had me return in about three weeks to confirm it was still there. It was, so we scheduled a biopsy for the following week. I got another DRE just before the biopsy in case the node had disappeared, which would have allowed me to not need the biopsy.

The biopsy came back indicating there was cancer on one side of the prostate. Prostate cancer tends to spread to bones, and large bones especially, so a full body bone scan was scheduled for the following week to check if there was any evidence of the cancer having spread. The scan came out OK.

The next step for me was to read, read, and read some more, and then visit the radiologist to find out his perspective. The next step was to make a choice about what I wanted to do. For me the best options were surgery (have the prostate removed), have radiation therapy, or a have a combination of these. (Chemotherapy or hormone therapy are also used in some cases.)

Everyone on my team concurred with my decision that surgery was my best choice. Once the prostate was removed, it and some nearby lymph nodes were sent to the lab for careful analysis. The result was good news. The cancer was completely contained in the prostate, and there was healthy tissue surrounding the tumor. The lymph nodes were clear. All of this was due to early detection.

Possible Causes

So, what causes prostate cancer? Studies indicate that diet is one factor. High-fat diets stimulate prostate cancer growth; in particular, beef and high-fat dairy products. Conversely, a low-fat diet rich in fruits and vegetables may help decrease the risk. Such foods include soy (tofu and soy milk), cooked tomatoes, green tea, red grapes, strawberries, raspberries, blueberries, peas, watermelon, rosemary, garlic and citrus. Certain dietary supplements also show up in studies as helpful. For example, selenium, catechins (flavanols), aspirin as small as 30 mg, betacarotene, lycopene (cooked tomatoes), fiber, phytoestrogens (soy, isoflavonoids, flaxseed, lignans), vitamin D and E.

Another item worth considering is blood circulation to the prostate, which contains many small blood vessels. Tight clothing has been suggested as a possible contributing factor. The tightening of the muscles in the pelvic floor and surrounding areas in a habitual manner, for example during stress, may create problems.

Check your diet, and how you deal with stress. Consider dietary supplements – do the research. Get an annual checkup that includes the PSA blood test, and the DRE, or as my urologist calls it, the “finger wave.” Pay attention to changes in your body, and do something to check things our. A phrase I like is, “The facts are always friendly.” Because when you know what the facts truly are, you are the best informed you can be, and can make the best possible choices. And the earlier you get the facts the more options you have.

Resources

• Prostate Cancer, Treatment Guidelines for Patients – American Cancer Society 100 Questions & Answers About Prostate Cancer by Pamela Ellsworth, MD, John Heaney, MD, Cliff Gill. Available as a free download in PDF format from the American Cancer website.
• Prostate Health in 90 Days, by Larry Clapp, Ph.D., J.D. Available at Amazon.com.