Every year approximately 189,000 men in the U.S. are diagnosed with prostate cancer, the second leading cause of cancer death (lung cancer is first) in men----and while prostate cancer is not necessarily a condition that impacts gay/bi/queer men differently than other men (unless, of course, they are avoiding medical care because they fear homophobia), it certainly does affect the men in our community and so it is worth addressing here.
Before we can discuss prostate cancer, however, let’s quickly overview the prostate. The prostate is a gland about the size of a walnut located just beneath the bladder that completely surrounds the urethra. Its primary biological function is to produce much of the fluid that makes up semen. (Many men believe that the prostate makes testosterone---testosterone impacts prostate development/functioning but is NOT produced in the prostate itself). Many men have also found that the prostate has a second function: sexual pleasure. The prostate and surrounding area are rich in nerves that can create intense and/or pleasurable sensations when stimulated.
While there is no clear indicator what actually causes prostate cancer, there are some important risk factors worth mentioning. Age, race & heredity are the most important. Men over 50 seem to be highest risk and that risk increases with age. In addition, African-American men and any man whose immediate family members (father, brothers, etc.) have had prostate cancer are at higher risk. Studies suggest that diet, exercise, and smoking can all affect risk as well.
Prostate cancer is the development of cancerous cells in the prostate gland. It can also spread, or “metastasize,” into surrounding areas such as the bladder, colon, rectum, and bone if left undiagnosed or untreated…so early diagnosis is critical. There are a number of ways to diagnose prostate cancer. The two most common are a digital rectal exam, in which a doctor inserts a finger into the rectum to actually feel the prostate for physical irregularities, and a PSA (prostate-specific antigen) test, a blood test for a prostate-generated protein that increases in men with cancer. Other tests are available that different providers may recommend or provide. These might include biopsy, CT scans, ultrasound, or an MRI scan.
Once cancer is detected, a doctor will generally “stage” the cancer and discuss treatment options. Staging is a way to evaluate how far the disease has progressed. Staging looks at a number of factors including the size and location of the tumor, the arrangement of the cancer cells, and if/how far the cancer has spread outside the prostate.
Based on the stage of the disease and the individual patient, there are a number of options the doctor may pursue for treatment. Prostate cancer grows slowly; so for some men, including those who are over 80 or who have other significant health problems, no treatment may be used at all. Those diagnosed at a younger age or in early stages of disease, however, have a number of options including: radiation, chemotherapy, cryotherapy (freezing cancer cells), hormone therapy (to reduce testosterone levels which can speed cancer growth) and prostate removal. All of these have some risk and may have short and/or long term effects (including illness, pain, impotence, problems urinating, and inability to produce semen). For this reason, it is very important to discuss with a trusted physician how best to proceed with treatment.
As stated earlier, some people are naturally higher risk for prostate cancer. There are, however, some ways to reduce cancer risk and to facilitate early detection. These include:
· Take Care of Yourself: Eating a low fat, high fiber diet and getting plenty of exercise helps.
· Smoking: Not smoking will reduce risk.
· Be Aware of Symptoms: Early cancer has few/no symptoms but at a more advanced stage you may notice problems urinating, pelvic pain, impotence, or blood in your urine and should be investigated by a physician immediately.
· Early Detection: If you are 50 or older, your doctor should do a digital rectal exam and a PSA test annually. If you are African-American or have a family history of cancer, these tests should start by age 40.
Most of all, being aware of your body, having a good relationship with your physician, and getting regular check-ups is an important way to have a happy and healthy prostate!!