November every year is considered as Men’s Health Month, it celebrates the health of men every year and I want to speak to you today on a very important aspect of men’s health. You may have all heard of an organ called the prostate gland, a small organ the size of a walnut below the urinary bladder through which the urinary passage flows and urine goes out when you pass urine. This organ is very important at younger ages to provide fluid which protects the sperm and helps in producing children. After 45 or 50 years of age, when you reach middle age, this organ gives you a few problems.
The normal problem is a normal ageing problem, just like we get grey hair when we grow older or get blood pressure or diabetes, the same way the prostate also enlarges. Sometimes it enlarges and squeezes the urine passage that goes through it and produces some difficulties in urination like reduced flow, increased frequency, getting up at night to pass urine and a feeling of incomplete evacuation.
More importantly, after the age of 60, one out of 14 men can get cancer of the prostate. It is the second most common site for cancer in the human body after the age of 60. I advise all men over the age of 50 to have a consultation lasting 15 minutes with their urologist to just assess their prostate and rule out the possibility of prostate cancer. Whether or not you have any symptoms regarding the prostate with your urination.
How common is prostate cancer?
As I said, it is a common cancer but it is more common in the Western world in white-skinned populations and in the African world. As we go to the Middle East and the Far East, the incidence of prostate cancer comes down. But if any family member or male family member in the family has prostate cancer, our chance of having prostate cancer increases exponentially.
So how do we decide whether we can prevent prostate cancer?
It is very simple. If you have a family history of prostate cancer, you should start checking yourself after the age of 45 every year. It involves a simple consultation with the urologist, a physical examination and a blood test called the PSA or prostate-specific antigen. Prostate-specific antigen levels increase in the blood in the presence of prostate infections and prostate cancer. When we combine it with a physical examination, we can have a high sensitivity of doubt whether the patient has prostate cancer.
The next step is to evaluate a patient with a high PSA level. This involves a simple test called an MRI, which is very accurate in detecting suspicious prostate cancer. If the MRI looks suspicious and the PSA is elevated, we suggest that the patient undergoes a prostate biopsy, which currently with modern technology is a very simple process with very few side effects.
Why is it important to detect prostate cancer?
This is because, unlike other cancers where you have breast cancer, for example, where you have to have extensive chemotherapy, and radiotherapy with all the side effects to achieve a cure. Prostate cancer, if detected early, can be treated easily with good-quality surgery and good-quality radiation, giving long-term lifetime survival of over 30 years. It is very important to detect prostate cancer in an early stage. An early stage indicates that the prostate cancer is still confined to the organ. A late stage indicates that prostate cancer has spread either below the organ or to distant sides. If the prostate cancer is still confined to the organ, curative treatment is possible. The organ treatment includes surgical removal of the prostate or radiation for the prostate.
As far as surgical removal is concerned, in the past, it was open surgery, with large incisions, needing prolonged recovery, prolonged pain, and certain complications like bleeding needing transfusions. One technique of surgery for the prostate includes laparoscopic and robotic surgery. These surgeries involve procedures by which, through small little keyholes of 5 millimeters and 10 millimeters, the surgery can be completed. The patient can be discharged in three or four days from the hospital and he can get back to normal life with minimal pain and minimal side effects after three weeks.
For most patients who refuse surgery who are not fit for surgery, we advise radiation therapy. The process involves seven weeks of procedure with certain medications, but ultimately the results of surgery and radiation are very good and patients can have very long-term, happy, comfortable survival life of more than 25 to 30 years.
Our hospital in Alzahra is offering a package for cash-paying patients of 350 dirhams, whereby you can have a consultation, a physical examination, and a blood test, to early detective prostate, whether it is cancerous or not. All insurance companies cover screening for prostate cancer. So my advice is every November, please visit your urologist if you are over 50 years of age, and spend 15 minutes for your health and longevity.