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Probing The Prostate

by Duff McCutcheon
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Probing The Prostate
Prostate cancer is the number one cancer threat to the lives and health of Canadian men - it will afflict one man in eight and is a greater threat for those with a family history of prostate cancer. Getting annual prostate checks after age 50 is the only way of ensuring you catch a growth early, which is the key to survival.

The five or 10 seconds spent bent over an examination table, pants around your ankles, while a doctor is probing your prostate can leave you feeling somewhat vulnerable, but the annual prostate exam for men over 50 is one of the most important health checks you can do.

It's invasive, it's embarrassing, and it's a lifesaver. You catch a cancerous growth on your prostate early, and it's usually a simple matter of removing the prostate for a cure. Left unchecked, the cancer can spread to the neighboring lymph nodes and on to your pelvis and lower spine. The annual discomfort of a prostate exam far outweighs the risks.

So what exactly is a prostate anyway?
It's a small gland that sits underneath the bladder and surrounds the urinary tract that connects the bladder to the urethra. For a healthy man in his 30s, it's normally the size of a walnut. "We don't know 100 percent what it's for, but it produces a lot of the fluid in semen and is important in fertilization," says Dr. Alan So, a urologist with the Prostate Centre at Vancouver General Hospital.

When you're young, you'd hardly know it was there, but as a man ages, the prostate gets bigger. "All men with testosterone will develop an enlarged prostate, but it doesn't bother everyone," says Dr. So. "Some men with really large prostates have no bother, and some with small ones have significant bother." An enlarged prostate is called benign prostatic hyperplasia (BPH). It often causes discomfort and problems urinating. In Canada, more than half of men over age 50 have BPH.

Another common prostate ailment, which can also affect younger men, is an infected prostate - or prostitis. Symptoms include a sudden inability to urinate, a burning sensation, or sometimes a fever. A trip to the doctor and a urine test will confirm whether you're suffering from either a bacterial or viral infection. Prostitis can be treated with antibiotics.

General prostate health
There are some additional risk factors to prostate cancer and if you have a family history of prostate cancer, have high testosterone levels, have diabetes, or are black, then you should talk to your doctor about starting annual prostate checks before age 50.

Fortunately, being a trucker does not in itself put you at higher risk for prostate cancer - all that bouncing around in the air chair will do your prostate no particular harm. However, there are some elements to life on the road that you should consider to maintain a healthy prostate.

First there's proper diet, and traditional high-fat, meat-and-potatoes truckstop fare is not conducive to prostate health - the disease has been linked to diets rich in fatty foods. "Foods rich in lycopenes, a micronutrient found in fruits, and especially in cooked tomatoes, can reduce a man's chance of prostate cancer. The ideal prostate-friendly diet would be something that's low in fat and high in vegetables," says Dr. So.

Exercise is important as well, with the aim being to limit body fat as much as possible. Body fat, obesity, and diabetes are all linked to prostate health, so be sure to get out of the cab once in awhile for some regular exercise and do your best to watch your gut.

The Aging Prostate
If you're closing in on 50, there's a good chance your pee isn't flowing as freely as it once did. Your prostate's likely to blame, but there's no reason to panic. As mentioned earlier, BPH is common in over 50% of Canadian men and is easily treated with drugs and/or minor surgery.
Dr. So says doctors will typically try treating the problem with drugs first, usually with a family of drugs called alpha-blockers that help urine flow by relaxing the prostate.

The surgical options involve reaming the prostate out. The doctor inserts a tiny camera through the urethra to the prostate and then uses electricity to scrape the prostate and open up a channel. It's a day surgery, and patients can expect to go home with a catheter that comes out the next day. Doctors can also use a laser to open up a channel in the prostate. "If the prostate is huge, like the size of a grapefruit, then we'll make a small incision in the abdomen and scrape out the prostate surgically," says Dr. So.

And if you're approaching 50, it's time to take a deep breath, swallow your pride, and have a physical prostate exam. That, coupled with a blood test called a prostate-specific antigen (PSA) test, is the best (and only) way of detecting early prostate cancer. PSA is a chemical that's produced by the prostate. Men with large benign prostates produce more PSA than others, and doctors use the test as a screener to see who needs a biopsy. "We look at how PSA numbers change over time. If a man comes in one year and tests for a PSA of 1, if we see it rising very quickly then we'll consider doing a prostate biopsy."

The physical exam is also part of the screening process and is very important for the urologist to identify the size of the prostate, and to see if there are any nodules. "A nodule itself does not necessarily mean cancer, but it gives us a rough indication as to how large a small cancer might be or how aggressive it is," says Dr. So.

Bottom line? Eat well, exercise, and get the tests done every year. Consider your first prostate exam as another of life's milestones, one that can potentially save your life.