What’s a prostate for? It seems the prostate gland provides a lot of the fluid that makes up semen, and helps make semen alkaline. This is important because it neutralises the hostile acidity of the vaginal tract into which lucky sperm may enter, and prolongs their lucky little lifespans. It also seems that the prostate gland helps with ejaculation. So remember all that in case you ever forget why you should be prostate-proud, fellas.
However, as you get older, it seems to become a bit of a liability.
I’ve heard said (and seen read) that a healthy prostate gland is slightly larger than a walnut. A good old-fashioned digital rectal examination (it’s the doctor’s finger, nothing to do with a set-top box) will investigate the walnut-like qualities of your prostate, and if it is found wanting in that department you may be referred to a urologist for additional testing.
‘Additional testing’ unfortunately may still these days be rather unpleasant (as if the finger in the bum wasn’t bad enough), for example having a bunch of needle injections into your perineum. Each one takes a tiny amount of prostate gland tissue that is analysed for the presence of cancer.
There’s lots more useful information about prostate cancer at Prostate Cancer UK, which looks quite Movember-heavy at the moment. No surprises. As I’ve mentioned in a previous entry, there isn’t a routine screening programme for prostate cancer in the UK. I’ve now found out more on this, and it seems to be that routine screening may well do more harm than good. A problem with the diagnostic pathway described above is that men are too often found to have an enlarged prostate and get referred for the sort of unpleasant procedure described above, only to find no cancer. More on this later.
Some say that ‘milking’ the prostate can reduce your chances of later developing prostate cancer. Not for the faint-hearted: here’s a rather explicit article on Vice all about that subject. You have been warned.
Where I work, we run a few very interesting prostate cancer trials (I don’t mean to contrast that against some dull ones; they’re all good). In a nutshell:
- STAMPEDE: best named trial I’ve ever heard of, and a real pioneer. It involves comparing a series of new prostate cancer treatments against a control arm of hormone therapy (a standard treatment in prostate cancer) on its own. Treatments can be dropped from the trial if they are shown not to be effective, and more arms can be added as new treatments become available. In this way the trial could in theory keep going for ever. One of the advantages of this approach is that several treatments can be evaluated in one trial, where setting up separate trials could take much more time and resource.
- PATCH: investigates whether hormone therapy could be given via patches placed on the skin. This approach may reduce the risk of bone thinning associated with hormone therapy treatment. As the treatment with patches is still relatively new, PATCH is looking first at whether the patches are safe to be used.
- RADICALS: some men with prostate cancer will have surgery to remove the cancer. The best post-surgery treatment for these men is not agreed, and RADICALS aims to find out an ideal combination of radiotherapy and hormone therapy for this population.
- PROMIS: keeping in mind all that stuff I said above about unpleasant testing procedures, PROMIS is looking at the impact MRI scans could have on the testing procudure; whether they might remove the need for biopsies (the needles in the perineum) in some men, and facilitate better targeted biopsies in others.
P is also for…Penis
I couldn’t not, could I? Though I’ve said a lot already, so I’ll just link you somewhere else. Here’s a useful page on penile cancer, which is rare but should not be overlooked.
P is also for…Procrastination
Don’t delay, get your walnut checked out today!
Please feel free to donate to my Movember campaign – all donations very much appreciated!