Watching your Walnut (The facts about prostate cancer)

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I’m sure many of you have heard or read about prostate cancer, but do not have specific information about how serious this cancer can be, or how to check for symptoms. Hopefully, this article will shed some light on the importance of looking after your prostate, not only because it can provide great pleasure for those of you who engage in anal sex (or play with anal toys), but it can also affect your overall health if it becomes cancerous.

Prostate cancer affects one in 11 Australian men. In Australia, prostate cancer is the most common cancer in males with 1,230 new cases recorded in WA in 2003. It is the 3rd most common cause of cancer death in males, being the cause of 202 deaths in 2003. It is generally a disease of older men with 65% of WA cases occurring in men 65 years or older. It is advised that guys above 45 should start regular check ups. The diagram below shows you where your prostate is. The prostate gland is part of the male reproductive system. It produces some of the fluid that makes up semen.

Anatomy of a prostate

The Link between Prostate Cancer & Sexual Behaviour

Young men who are sexually active with more than one person (regardless of whether you’re gay or straight) face an increased risk of prostate cancer in later life. Research to emerge from the Karolinska Institute in Stockholm points to sexual promiscuity as a leading risk factor in contracting human papilloma virus (HPV). Already linked to cervical cancer in women, HPV may explain why there has been a recent upsurge in prostate cancer in men. If correct, the theory is that once young men are exposed to HPV it kick-starts a chain of genetic mutations that can eventually lead to cancer decades later.

Symptoms of Prostate Cancer

Early prostate cancer usually causes no symptoms. When symptoms do occur, they may include:

Difficulties starting and stopping urination
Pain or a burning sensation when passing urine
Urinating more often than usual, particularly at night
The feeling that the bladder can’t be fully emptied
Dribbling urine
Blood in the urine or semen
Pain during ejaculation.

All of these symptoms can also be caused by conditions other than prostate cancer. You should discuss them with your doctor.

The cause is unknown

The exact causes of prostate cancer are unknown. However, the chance of getting prostate cancer increases:

As you get older
If you have a father or brother who had prostate cancer. The risk becomes greater if they were diagnosed at an early age.
Diagnosing prostate cancer

Prostate cancer is diagnosed using a number of tests, which may include:

PSA test - the prostate makes a protein called prostate specific antigen (PSA). Large quantities of PSA in the blood can indicate prostate cancer or other prostate problems.
Digital rectal examination - using a gloved finger in the back passage, the doctor feels for enlargement and irregularities of the prostate.
Biopsy -Six to 12 tissue samples are taken from the prostate and examined in a laboratory for the presence of cancer cells.
If prostate cancer is diagnosed, other tests may be needed to see if the cancer has spread to other areas of the body.

Treatment options

Treatment for prostate cancer depends on a range of factors, such as the man’s age, physical condition, the stage of his prostate cancer and his personal preference. Treatment options include:

Watchful waiting - sometimes your doctor will advise that treatment is not needed. However, you will still need to be examined and have PSA tests regularly to monitor any changes.
Surgery - removal of the prostate is called a radical prostatectomy and will involve a six to 10 day stay in hospital. If the prostate can’t be removed, other surgery may be performed to remove blockages in the prostate to relieve urination problems. This operation is called transurethral resection of the prostate (TURP).
Radiotherapy - x-rays are used to target and destroy cancer cells. Treatment usually lasts a few weeks, although this depends on the cancer and the person’s general health.
Brachytherapy - a radioactive implant is placed inside the prostate to target cancer cells. The implant may be temporary or permanent.
Hormone therapy - prostate cancer relies on the hormone testosterone for growth. Hormone therapy reduces testosterone levels and ‘starves’ the tumour, this is given with either medication or hormone injections. Sometimes surgical removal of the testicles (orchidectomy) is suggested which has the same effect.

Possible side effects of treatment

The side effects of treatment can be distressing. You should talk through options and concerns with your doctor before making a choice. Typical side effects include:

Surgery - many men will have temporary urinary incontinence (loss of bladder control). Almost all men will have a change to their sexual function and most men will have erectile dysfunction (impotence).
Radiotherapy - A small number of men will have bowel problems. Between 40 and 80 per cent of men who have radiotherapy will experience erectile dysfunction (impotence).
Brachytherapy - erectile dysfunction (impotence) and bowel problems can occur. Some men may experience painful urination and irritation of the bladder for several months after therapy. Urinary incontinence is not usually a problem.
Hormone therapy - side effects may include erectile dysfunction (impotence), tiredness, hot flushes and loss of sex drive.

Where to get help

Your local doctor
Urologist specialist
Urology or continence nurse
The Cancer Council Helpline13 11 20 state-wide
The Cancer Council Western Australia (08) 9212 4333
Lions Australian Prostate Cancer website at www.prostatehealth.org.au

Things to remember

Prostate cancer affects one in 11 Australian men and is most common in men over 65.
Prostate cancer can be treated in a variety of ways, including watchful waiting, surgery, radiotherapy and hormone therapy.
Possible side effects of treatment include incontinence and impotence; treatment options should be discussed thoroughly with your doctor.
Masturbation May Prevent Prostate Cancer

Frequent masturbation may help men cut their risk of contracting prostate cancer, Australian researchers have found. It is believed that carcinogens may build up in the prostate if men do not ejaculate regularly, BBC News reported on Wednesday. The researchers surveyed more than 1,000 men who had developed prostate cancer, and 1,250 men who had not. They found that men who had ejaculated the most between the ages of 20 and 50 were the least likely to get cancer. Men who ejaculated more than five times each week were a third less likely to develop prostate cancer.

Sexual intercourse may not have the same effect because of the higher risk of contracting a sexually transmitted infections, which could in turn raise the risk of cancer. "Had we been able to remove ejaculations associated with sexual intercourse, there should have been an even stronger protective effect of ejaculations," Graham Giles of the Cancer Council Victoria, who led the researchers, said in the article.

The prostate produces a fluid that is incorporated into ejaculation, which activates sperm and prevents them from sticking together. Studies on animals have shown that carcinogens like 3-methylchloranthrene can be harboured in the prostate. Frequent ejaculation encourages the cancer-inducing fluids to "flush out."

References

http://www.gay.com/news

http://menshealth.about.com

http://www.betterhealth.vic.gov.au

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Peer Support

Want to find out what it is like for other guys? Want to get support and information from guys who understand where you are coming from? The Project X Team from the Gay/MSM Program at the WA AIDS Council adopts a peer education model in our health promotion, outreach and education. All our programs are run by Gay/MSM guys and one to one peer support is also available.

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