Dylan Stoll | Health Editor
Featured image courtesy of Pixabay
November is half-way through, and with it, the bearded faces of the many men willing to make that ultimate sacrifice in the name of men’s health awareness: refusing to shave their facial hair. Sure, this incredibly easy and rather lazy form of raising awareness has done its part in shining the light on several men’s health issues, but simply knowing the diseases or issues exist hardly does anyone any good.
All that being said, those unshaven faces have certainly opened the door for the ignorant, but what is really needed is a good shove into the foyer of enlightenment.
And what better way to do that than to provide the hard facts associated with prostate cancer — the facts that will really make somebody go and get themselves checked.
Let’s start with the symptoms. Are you frequently urinating? Are you experiencing a weak or interrupted urine flow or the need to strain when emptying your bladder? Are you commonly urinating at night? Is there blood in your urine or in your semen? Have you had a sudden onset of erectile dysfunction? Does it hurt when you urinate? Is it uncomfortable to sit?
If you are experiencing any, some, or all of these symptoms, it would be in your best interest to ask your doctor for a prostate examination. It may just save your life.
But how does one get their prostate examined? Through a digital rectal exam (DRE) of course. What is that? Some kind of scan? Unfortunately, no. There is nothing “digital” about this exam, not in the general sense of the term, at least.
The “digital” part of a DRE is, you guessed it, a digit, or finger up the rectum. Thankfully, the prostate gland is located relatively close to the rectum, adjacent to be exact, so there won’t be much searching and prodding happening. After this examination, he or she will inform you if there are any irregularities that he or she has noticed. Such irregularities include abnormalities in the shape, size and texture of the gland. This is a diagnosis that one would assume to be rather difficult to ascertain with the simple use of one finger; nonetheless, this is the method still commonly used.
If you feel that you cannot trust this examination, or if your doctor recommends you receive further testing, the next step would be a blood test referred to as a Prostate Specific Antigen test (PSA). In the case that you decide to take the PSA test, a blood sample will be drawn from a vein in your arm and will be analyzed to determine if your PSA levels are abnormal. PSA will naturally be in your blood, albeit in low quantities. If a higher-than-average amount is discovered, it may indicate a prostate infection, inflammation, enlargement, or cancer.
So let’s say you have prostate cancer. You bit the bullet and powered through the DRE, then you took that needle in your arm for the PSA test and alas, the results came back positive: what options do you have now?
Don’t worry, all hope is definitely not lost. There are many treatment options available today. Fortunately, we are alive in a time full of wonderful new advancements and in a time where the average man has an excellent fighting chance against the plagues that life hath wrought.
The first stage of your treatment plan will be to determine what your treatment plan is. This plan will be personalized to you based upon your personal circumstances and your own input because as with anything involving your body, you are free to do with it as you please.
They will first ascertain the type and stage of your prostate cancer. After that, they will determine its Gleason score — a measure of how aggressive your particular form of prostate cancer is. This score will range from one to five, with most average prostate cancers achieving a level of three. The higher the score, the more abnormal the tissue will appear, and the lower the score, the healthier the tissue will appear.
After this is completed, the possible side effects of particular treatment plans will be considered. Depending on the condition of health that you are in, your age, and your life expectancy, certain side effects may be too much for you to handle. In such cases, a more suitable treatment option will be chosen to fit your personal needs.
It should be noted that in those men who have been diagnosed with a high-risk of prostate cancer reccurance, more aggressive treatment options are considered to prevent the cancer from returning after the treatment is completed.
But what treatment options are available, exactly?
As stated, there are many treatment options, but first, they must put you under what is known as active surveillance. Every three to six months, you will receive a test from your doctor to analyze the progression of your cancer. If the tests determine that it is spreading, you will begin treatment.
Treatment thereafter, depending on the characteristics of both yourself and the cancer that you have, may involve: surgery, radiation therapy, hormonal therapy, chemotherapy, high-intensity focused ultrasound, or corticosteroids.
In the case of surgery, there are a few options that may be considered.
One option is a radical prostatectomy which involves removing the prostate and some tissue around it, including seminal vesicles. This is the most common type of surgery and can be completed in five different ways: retropubic radical prostatectomy, perineal radical prostatectomy, laparoscopic radical prostatectomy, robotic radical prostatectomy, and last but not least, nerve-sparing radical prostatectomy.
Another surgical option is the transurethral resection of the prostate, so eloquently referred to as TURP. TURP is honestly as great as it sounds: it involves the removal of part of the prostate through the urethra as a means of relieving urinary problems caused by an enlarged prostate. This method of treatment is often saved for those with advanced prostate cancer or for those who aren’t healthy enough to receive a radical prostatectomy.
There is also the pelvic lymph node dissection. Don’t worry, you’re not some lab rat being dissected for a class project. This surgery requires the removal of the lymph nodes in the pelvis and may even be completed during a radical prostatectomy.
The final form of surgery is known as cryosurgery. This one is definitely as cool as it sounds: this involves the freezing of abnormal cells with liquid nitrogen or liquid carbon dioxide. This form of treatment is still very experimental and is often used if the prostate cancer comes back after radiation therapy.
This brings us to our next treatment option: radiation therapy. Radiation therapy, like some kind of space-age death ray, is where high doses of radiation are used to kill cancer cells,. There are three different types of radiation therapy: external beam radiation therapy, brachytherapy, and systemic radiation therapy.
Hormonal therapy is yet another promising choice. This form of therapy involves the addition, blockage or removal of hormones, so as to shrink tumours, slow cancer progression, and help the individual receiving treatment live longer. Unfortunately, this form of treatment will not cure one of prostate cancer, but it will certainly help mitigate it’s effects.
Next, there is chemotherapy. The only way you haven’t heard of this option is if you’ve been living like Patrick the starfish, stuck to the underside of a rock at the bottom of the ocean. This form of treatment requires the use of drugs to combat the spread of prostate cancer. This treatment is commonly used if the cancer has returned after hormonal therapy, or in conjunction with hormonal therapy if the cancer is metastatic.
If you think we’re all out of options, think again. High-intensity focused ultrasound is the same sort of idea when viewing a baby, but it is certainly not used to view one; the “high intensity” part produces an intense heat capable of destroying cancer cells. Unsurprisingly, this treatment is still experimental.
Finally, the final form of treatment is corticosteroids. Corticosteroids are steroid hormones; these are used to diminish inflammation and lower the body’s immune system response. This is done to help chemotherapy achieve its goal as well as to assist in relieving some of the symptoms associated with chemotherapy. Corticosteroids are also a great option for those who are too sick to receive chemotherapy.
So, you’ve completed your treatment and you are in remission. However, it’s best to remain vigilant. The cancer can return, so it is best to consistently see your healthcare team for at least five years after treatment. Besides, wouldn’t you feel better knowing that your cancer is gone, rather than fearfully waiting for it to rear its ugly head again?
The next time you see that Movember bearded face, remember all the symptoms, examination options, and forms of treatment. Most importantly, remember you aren’t only getting yourself checked for yourself, but you’re getting checked for your family and your friends — those who want to see you live a long, fruitful, and cancer-free life.
