September is designated prostate cancer awareness month. Prostate cancer occurs in the prostate gland which is found just beneath the urinary bladder of men. It is about the size of 2 cashew nuts unshelled and its main purpose is to produce secretions which make up part of the semen produced by men. Like all other cancers, prostate cancer occurs when there is uncontrolled dividing of prostate cells which have undergone change or have become abnormal. These abnormal cells group together to form a tumor and they can invade the whole prostate gland and go beyond its walls into other parts of the body. Not all prostate cancers are the same. There are slow growing and fast growing types of prostate cancer. A man may have prostate cancer, but will not die from it because it is slow growing. Others may have an aggressive type which spreads fast and may cause death. Like any disease, the development of prostate cancer is associated with certain risk factors. A risk factor is something that increases your chances of getting a particular disease or condition.

What are the Risk Factors for Prostate Cancer?
These include: (1) Men over the age of 50 years; (2) Black men; (3) Family History (if your father or brother has had prostate cancer); (4) Infection and inflammation of the prostate; (5) Obesity or excessive weight; (6) Diet high in fat, red meats or dairy products; and (7) Lack of exercise. In some western countries 8 out of 10 men with prostate cancer are older than 65 years of age.

Symptoms of Prostate Cancer
Prostate cancer, depending on the stage of the disease, may or may not present with symptoms. Some of the symptoms may also be similar to symptoms that men with enlarged prostates or Benign Prostatic Hyperplasia (BPH) may experience. This condition is not cancerous. Symptoms of prostate cancer include:
Poor stream of urine, difficulty starting urination, dribbling after finishing urination, pain with urination, blood in the semen, urinary frequency especially at night; painful ejaculation, unintentional weight loss and pain in lower back, pelvis and hips

Screening Tests for Prostate Cancer
A Prostate cancer patient has a greater than 95% chance of survival if it detected early before it has spread beyond the prostate gland. Screening for it is easy and there are two ways
By a digital rectal exam (DRE) - For this exam, a doctor uses a lubricated gloved finger to exam the prostate through the rectum. He or she can feel the size, shape and consistency of the gland. If there are hard areas felt further tests are needed
Another method to screen for prostate cancer is by a blood test which measures the amount of a chemical called a PSA (Protein Specific Antigen) in your blood. It is more relevant for people who are 50 years and above, because prostate cancer tends to occur in men older than 50 years. Men who have prostate cancer may have a high level PSA and further tests may have to be done. Some other prostate problems which are not cancer may also present with high PSA levels and so your physician will explain what other tests would be needed. When cancer is suspected a prostate biopsy is usually done.
Discuss with your doctor if you need to be screened. There are advantages and disadvantages to screening for prostate cancer. The decision to do so is determined by the risk factors mentioned above. Every adult person can reduce their risk for prostate and other cancers by adopting a healthy lifestyle, healthy diet consisting of fruit and vegetables, fewer intakes of fatty foods, increased fiber as in whole wheat grains, oats, sorghum, beans etc., regular exercise, not smoking and alcohol in moderation




Treatment of Prostate Cancer
Early non aggressive forms can be treated by “watchful waiting”. The cancer’s progress is tracked by your doctor, however such observation can be switched to other treatment methods if the cancer changes. Aggressive ones may be treated by methods including surgery, radiation therapy or drug therapy. Each method has its advantages and disadvantages. Careful discussion with your doctor is important at all times. Do not feel shy in discussing these issues with your regular doctor.

Finally, a healthy lifestyle is a key prevention tool to avoid many other diseases. We are quickly developing diseases of the more developed countries due to unhealthy life styles we are adopting. Exercising by walking and controlling portion sizes of foods especially carbohydrates will go a long way to prevent heart disease, strokes, hypertension, diabetes and cancers.



Dr. Barbara Entsuah (Nee Amoo-Lamptey) MD (Family Medicine Specialist).