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27 June 2002

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Prostrate Cancer

Iím writing this article in the hopes of increasing awareness in men of the issues of prostrate cancer. Now this is the second biggest killer in men, the first being lung cancer, and some 19,000 men every year are diagnosed with this form of cancer, some 10,000 of those die of it usually within 5 years of diagnosis. It is generally a disease of older men, around 80% of prostrate cancers occur in men over the age of 65, and is very hard to detect, as there are very few signs to look for. This is due to the fact that they are slow growing and often do not cause any symptoms at all during a manís lifetime. By the age of 80 about half of all men will have some cancer cells in their prostrate gland, but only 1 in 25 will actually die from them. On the other hand, though some types of prostrate cancer are faster growing and can spread to other parts of the body causing bone pain and eventual death.

At the moment scientists donít know what causes prostrate cancer but there are some things which can affect your chances of developing the disease, obviously age is one of those factors, if your under 50 then the risk is very low. If you have a relative who has had prostrate cancer then your risk almost doubles, if you have had two relatives then the risk is quadrupled. If you are of African-American or African-Caribbean stock then you are at more risk than most. There is some evidence that eating a diet low in animal fat and protein will decrease your risk, and on the flip side there is evidence that consuming Vitamin E, Selenium and Lycopene can help to protect you from the disease. And finally if you have been exposed to cadmium or X-rays then you have also increased you risk of getting the disease.

As has already been mentioned there are very few early symptoms, but when they do appear what are they? The symptoms when they do appear resemble simple enlargement of the prostrate, which are, pain or difficulty when passing urine, and passing urine more frequently, especially at night. Rarely blood in the urine or sperm. Although it must be noted that not all men with these symptoms will have prostrate cancer. Because the cancer can be so slow growing even advanced prostrate cancers may not cause any urinary symptoms, although if the cancer has spread to the bones then there could also be pain in the back hips and pelvis. 

So how can you test for prostrate cancer? Well there are three main ways of checking, the first is digital rectal examination, this involves the doctor checking the prostrate gland physically with a finger via the rectum, although this is less than 50% accurate, although itís quick and painless. The PSA test which is a blood test, a little painful but a lot more accurate. And then the final and most accurate method which is the Transrectal Needle Biopsy. This replaces the doctorís finger with a metal probe, which can then be put under a microscope to see if there are any cancer cells present. This is usually only performed after a PSA and Rectal examination though.

So, what are the options if a cancer is found? The first method is watchful waiting; this consists of regular check-ups and then treatment if the cancer is growing. This is a long process and involves a lot of PSA tests and rectal examinations, this does avoid the need for surgery but some men find it difficult just to wait and see if their cancer progresses.

The second treatment method is Radical Prostatectomy, which is a surgical procedure, which removes the entire prostrate gland. Appears to prolong life in men with malignant cancers and in younger men, although the benefits are debatable. In 40% of men, the operation doesnít entirely remove the cancer cells so the operation for them isnít curative. The risks are around 0.5% of men will die, up to 20% will develop a leaking of urine, and about 50% will develop problems with erections.

The third treatment method is Radiotherapy, this method tends to achieve a cure in early prostrate cancers, but the benefits to less malignant cancers is debatable. A complete course takes up about 6 weeks; giving hormone treatment at the same time may improve the results. The risks are in 30% of men they will develop lasting discomfort or bleeding in the rectum, and around 50% will develop erection problems, although this depends on age.

The fourth and final method at least at the moment, is Brachytherapy, this is the insertion of radioactive seeds into the prostrate. Success canít be completely measured at the moment as this is still a new treatment, although reports from the states are very promising, and it only requires a 1 or 2 day stay in hospital. The risks are bladder side effects may be more severe than the radiotherapy, but bowel and impotence problems are expected to be a lot less of a problem.

Where do you go to get further advice, well your GP should be the first choice, then you could go to Sefton Cancer Support Group, Tel: 01704 879352, or the Cancer Resource Store, Tel: 01704 537079, NHS Direct, Tel: 0845 4647,  The Prostrate Cancer Charity, Tel: 020 8222 7622, or Cancer BACUP, Tel: 0808 8001234 or 020 76969003.

Thanks to all at Norwood Surgery for the help in compiling this research and thanks to Menís Health Matters. 

Article by Eric Lion Taylor.

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