Prostate cancer has become the second most common cause of cancer death in men, with around 12,200 deaths every year. The number of cases is rising – whether this is due to earlier diagnosis, as men become more aware of the condition, has not been established.
Currently, incidence stands at one in eight for men in the UK. It mainly affects men aged 50 or over. However, if someone in the family has had prostate cancer, the risk rises. Evidence shows that men from black ethnic groups also have a greater risk.
Any change in when and how you pass urine should be investigated, as should any persistent symptom, whether it is a pain or cough that does not settle after 2–3 weeks. The experience of Olympic cyclist, Sir Chris Hoy, is a salutary warning. Hoy went to his doctor with rib and shoulder pain and was found to have prostate cancer.
Your prostate
This is your prostate, sitting either side of your urethra. It is a smooth walnut sized gland that helps in the production of the fluid that aids ejaculation.
It is normal for the prostate to enlarge as you grow older (benign hypertrophy). However the symptoms for a normal enlargement may also be the symptoms of prostate cancer.
Most common symptoms may include:
- Difficulty in passing urine
- Poor flow
- Frequency — having to pass urine often, especially at night
- Dribbles
I am writing this from my perspective as both wife and retired Registered Nurse, as my lovely husband, Ben (not his real name) didn’t have any of these symptoms.
A prostate cancer journey
Over an eight-week period, Ben had three episodes of persistent urinary tract infections (UTI). In the normal course of events men, unlike women, do not have problems with urinary infections. So after the third lot of prescribed antibiotics in response to a left urine sample, a trip to the local surgery to actually see a doctor was in order.
During the examination, the doctor examined rectally and felt for the prostate; Ben was found to have a roughened surface to his prostate, which is not normal.
Next stop, a urology consultant and further testing.
Ben had also been having routine blood tests to measure his Prostate Specific Antigen (PSA), which at this time, had not been raised at all. So, while raised levels can indicate an underlying problem, it doesn’t always show up. For this reason, it is not routinely used as a screening tool, unless you ask for it.
If you are having any of the above issues, please go to your doctor and be checked, as with any cancer, early detection is vital.
Further testing revealed that Ben did indeed have malignant cells present. However, the consultant reassured us, saying that there are two types of prostate cancer – an aggressive one and a non-aggressive one. In our case, it was too early to tell which he had. So, he would be monitored by having his PSA checked every three months to test if it was rising and how quickly.
Time passed, life became complicated
Monitoring went on for a couple of years. Then, when the PSA test detected a rise in the amount of PSA protein in his blood, it was decided that surgery was required.
Unfortunately, that January, Ben was diagnosed with Type 2 diabetes. This was a surprise. At 6 foot, and weighing only 11 stone, his physique is not typical for a diabetic. What was worse, was that his surgery had to be delayed until he’d had three consecutive months of stable blood sugar to avoid risk of stroke or death during the operation. This took until September.
The operation
Eventually, Ben had his operation – a Robotic Radical Prostatectomy. You can watch on YouTube, it’s quite fascinating.
Modern surgery is far less invasive and causes far fewer side effects than earlier treatments. In the past, prostate removal surgery was performed through the back passage. Unfortunately, this often left the patient with double incontinence, pain and impotence.
Today, a prostatectomy is done laparoscopically via the abdomen. The midriff is inflated and bits moved out of the way so that the prostate, nerves and muscles can all be visualised through a camera lens.
The urology surgeon performs the operation with the aid of a robotic tool, which can be worked in confined spaces.
The aftermath
Ben did well post operatively – no dribbles, nor pain. The surgeon was confident that the cancer was completely contained and further intervention would not be required, except for regular PSA tests which, after surgery, were zero.
After a couple of years, the regular testing identified that the PSA protein levels had started to rise again. To say this was concerning is an understatement. Consequently, he was scheduled to have a specialised scan involving the injection of a short-lived radioactive tracer dye delivered to the hospital daily. The dye, delivered in a lead-lined container and administered by staff dressed in radioactive protective equipment, attaches to PSA proteins only on cancer cells, making them visible.
Thankfully, after a month-long wait, the results come back negative and the urology surgeon passed any future care to an oncologist (cancer doctor) for ongoing monitoring. The thing with cancer is having one sort doesn’t stop you developing either another one, or the original returning.
Then and now
When I started nursing back in the early 1970s, the link between hormones and breast and prostate cancers had been discovered. However, at that time, the only treatment was removal of the organs that produced the hormones – a hysterectomy for women, and physical castration for men.
Things have moved on since then. Ongoing treatment is usually something that blocks or removes hormonal action, and which psychologically, is far less traumatic.
Back then, we were taught that prostate cancer was something men died with, rather than of. But as with any cancer, early diagnosis is vital. And today, the outcome, post treatment, is very positive.
The author is a retired State Register Nursing Sister with 35 years experience in the NHS. For reasons of privacy, she has chosen to remain anonymous.
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