Unlike other types of cancer, Prostate cancer could be prevented if the entire male fork above 50 years underwent medical check- up.

Robert Zulu consultant surgeon at the University Teaching Hospital (UTH) said of the 60 per cent urology patients received at the Hospital, 20 per cent have prostate cancer.

Mr Zulu said urological services for prevention of prostate cancer in Men were readily available at UTH and Men above 50 years should take advantage of them.

“American Urological Association and the American Cancer Society have published guidelines advocating annual Digital Rectal Examination and Prostate Specific Antigen testing for men over the age of 50.These guide lines are available from your doctor and every male above 50 years should visit his doctor to discuss this,” he said.

Genetic studies suggest that a strong familial predisposition may be responsible for as many as 5-10 per cent of prostate cancer cases. Dr Zulu who is also Zambia Medical Association (ZMA) spokesperson said Men with a family history of prostate cancer have a higher risk ofdeveloping prostate cancer and are also likely to present it 6-7 years earlier.

He added that Epidemiological studies which is the study of people in the community that has had prostate cancer, have shown that diet also played a role in the development of prostate cancer.

He said studies have identified a variety of dietary factors, particularly fat intake and obesity as causes of prostate cancer and Hormonal causes.

It has been observed that in the era before testing of the blood to diagnose cancer (Prostate Specific Antigen) by clinics, patients with prostate cancer commonly showed symptoms confirmed to the urinary system.

Inability to pass urine developed in 20-25% of these patients, back or leg pain developed in 20-40 per cent, and blood in urine developed in 10-15percent.

Dr Zulu said with the current Prostate Specific Antigen screening, Urinary, Decreased urine stream, Urinary urgency and Blood in urine has proved to be the typical symptoms of prostate cancer.

“The typical symptoms of prostate cancer and their frequency are Urinary with 38 percent) frequency, Decreased urine stream with (23percent), Urinary urgency (10percent) and blood in urine at (1.4percent),” he said.

He said manifestations of advanced prostate cancer may include weight loss and loss of appetite, anaemia with or without fracture and lower extremity pain and oedema. Dr Zulu said initial work-up for prostate cancer involves testing of the blood (Serum Prostate-Specific Antigen),examining the extent of cancer using fingers (Digital Rectal Examination) and  rostate Biopsy which is the test done to ascertain the problem by the of the affected flesh.

He added that further workup depends on how far the disease has progressed. “A higher clinical stage of cancer determined by Digital Rectal Examination (DRE) findings, Prostate-Specific Antigen (PSA) level, correlates with an increased risk of spread to distant organs, andthese tests are considered key factors in determining the staging, work-up and predicting patient prognosis,” he said.

He said standard treatments for clinically early prostate cancer include radical prostatectomy or removing the prostate, radiation therapy, or active surveillance.

He said for locally advanced prostate cancer, radiation therapy along with androgen ablation which is the blocking of the male sex hormone on which prostate cancer rely upon for its growth in order to treat it, was generally recommended, although radical prostatectomy may beappropriate as an alternative to radiation therapy in some cases.

The Importance of Annual Prostate Cancer Screenings

When September rolls around, people often think about the beginning of school and fall, but a select few may remember that September is Prostate Cancer Awareness Month. According to the American Cancer Society, prostate cancer affects one in six men, with skin cancer being the leading cause of cancer-related death. As a preventative measure, men should get checked annually for prostate cancer. Fortunately, prostate cancer treatment is available and the cancer is curable if detected early.

When should I get Checked for Prostate Cancer?

An annual physical examination can help detect the symptoms of prostate cancer in men. It is suggested that all men age 50 and above have an annual prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE). If your father or brother has prostate cancer, you may want to consider getting tested before the age of 50.

Listed below are the most common symptoms of prostate cancer. There are no specific warning signs or symptoms of early prostate cancer, which is why annual prostate screening is so important.

Symptoms of Prostate Cancer:

- Weak or interrupted flow or urine- Urinating often (especially at night)- Difficulty urinating or holding back urine- Pain or burning when urinating

Other Symptoms of Prostate Cancer:

- Blood in the urine or semen- Pain in the back, hips or pelvis- Difficulty having an erection

Remember, the symptoms of prostate cancer may resemble other conditions or medical problems, so consult your physician for a diagnosis. your physician will also be able to answer any questions about prostate cancer and discuss prostate cancer treatment options.

Why you should get Tested for Prostate Cancer Annually:

The majority of men diagnosed with prostate cancer had no symptoms when prostate cancer was first detected. an annual PSA blood test can detect prostate cancer quickly. Even if your PSA levels are normal (e.g., below 4) an increase in your PSA levels can help detect prostate cancer in its early stages.

What is a PSA Test?

A PSA test is a blood test that detects the amount of prostate-specific antigens (a protein) in the blood. As the prostate enlarges, more of this protein is produced and the increase is detected by the test. During a PSA test, a nurse or doctor takes a sample of blood from your arm and sends it to a lab for analysis. After the test, you will receive a copy of the results with your PSA levels.

A high PSA level may indicate prostate cancer. however, any activity that irritates the prostate may also cause PSA levels to rise.

Causes of an Elevated PSA:

- Benign Prostatic Hyperplasia (BPH), an enlarged prostate- Prostatis, a condition where the prostate becomes inflamed due to an infection- a Prostate Biopsy- recent Ejaculation- Bicycle Riding

Information about PSA:

- According to the American Cancer Society, a PSA level between 4 and 10 may indicate prostate cancer. If this is the case, prostate cancer surgery and radiation are treatment options.- PSA is measured by nanograms per millimeter of blood.- PSA is released into the blood by the prostate gland.- PSA is common in semen.

The most common symptoms of prostate cancer are urinary problems, which include the need to urinate often, trouble urinating and the decreased force in the stream of urine. Other indicators include blood in the urine or in semen as well as frequent pain in the lower back and hips. however, the best way to detect prostate cancer early is by getting an annual PSA test.

Prostate cancer affects more than 186,000 American men each year. Remember the importance of having your doctor check for prostate cancer before you develop any symptoms. If you have any concerns or questions, talk to your doctor. Men diagnosed with prostate cancer have many treatment options, and the sooner you get treated, the sooner you can recover.

For the sake of marital harmony, people ?occasionally do things they would rather avoid. That’s why retired ?business consultant Simon D’Arcy went to his doctor for a PSA test. He is glad he did, as is his wife, Gina, because that simple blood test saved his life.

It detected signs of a cancer which is so common that three men in Simon’s family have been struck by it (they are not related by blood).

Prostate cancer kills one man every hour in the UK, yet seven out of 10 who are at risk know nothing about the test.

In the clear: Gina and husband Simon D’Arcy, who had no symptoms. a PSA test revealed he had prostate cancer

The prostate is a tiny gland, around the size of a walnut, located around the urethra, which makes the fluid that carries semen.

The PSA test measures levels of a protein produced by the cells of the prostate gland — prostate specific antigen (PSA) — in the blood. Raised levels can be a sign of a ?problem, which may be cancer.

‘I had no idea what a PSA test was,’ admits Simon, 59, from Headley, Hants. ‘my wife is a practice nurse and two years ago, when I was going to my GP for a blood pressure test, she told me to ask for the PSA test too. I now know the chances of developing prostate cancer increase with age, but I had no symptoms.

‘I was a fit, active, non-smoker. I couldn’t see the point. my brother-in-law Charles had died from it 14 years earlier at 46 but I thought that was an unlucky one-off. I thought if I had cancer, I’d know about it. I was wrong on both points.’

To Simon’s surprise, his PSA reading was high. Two subsequent tests were higher still, and his GP referred him to Haslemere Hospital in Surrey. Gina, 55, advised him not to worry.

‘she explained that there was no reason to expect it to mean cancer,’ says Simon. this is the problem with the test: the results are never clear-cut. Raised levels of PSA can be a sign of prostatitis (often caused by an infection) or benign prostatic hyperplasia, a relatively harmless and fairly common condition in which age and hormones cause the prostate to enlarge.

Complicating matters further, prostate cancer can range from an aggressive form which kills, to a much more common cancer which is so slow-growing most men will die of other causes. The PSA test can’t differentiate between the two, which means men may end up having unnecessary treatment.

This includes radiotherapy, which can lead to bowel and ?urinary problems; hormone therapy, which may cause loss of libido and fatigue, and surgery, which can lead to erectile ?dysfunction and incontinence.

For these reasons the test has been the subject of debate for years among medical professionals. some doctors are ?reluctant to offer it: a survey last year by the Prostate Cancer Charity showed that one in five men who requested the test had been turned down by their GP.

Earlier this month health authorities decided against a national screening programme using the test because the risks posed are greater than potential benefits, the UK National Screening Committee said.

This announcement was described as ‘extremely disappointing’ by John Neate, the chief executive of the Prostate Cancer Charity.

However, experts believe all men should be informed about the test and make their own decision about whether to have it.

‘While there are benefits, there are risks of over-diagnosis and over-treatment,’ explains John Anderson, consultant urological surgeon at Sheffield Teaching Hospitals.

Unnecessary? Most men who have the test do not have cancer but go through the fear (posed by model)

‘a European screening study of 200,000 men, published last year inthe new England Journal of Medicine, showed a reduction in the numberwho died from prostate cancer among those who had the test, but therewas also an enormous incidence of over-diagnosis. Forty-eight men weretreated to save one from death.’

Dr Richard Ablin, researchprofessor at the University of Arizona, is the man who identified the?antigen. ‘I believe testing for PSA in healthy men has been a hugewaste of money and led to many men being left unnecessarily frightened,frustrated, impotent and incontinent,’ he wrote in the Daily Mail lastyear.

‘The majority of these patients could have lived painlessly with their tumours until the natural end of their lives.’

Simon takes a different view. His high test results led his consultant to recommend a biopsy.

‘The whole thing brought back vivid memories of Charles’ death. I felt very vulnerable and thought: am I going to go through the same thing?’ Simon recalls. ‘He was incredibly fit, had three teenage children with my sister Sarah and had settled in

Wiltshire where he was a ?senior partner at a GP surgery.

‘one somehow felt that as a GP he’d have spotted the symptoms and known — but like me, he didn’t have any. Charles died three years after the diagnosis.’

Simon and Gina discussed his condition with their three children, then aged 26, 24 and 22, and he had the biopsy at the Royal Surrey Hospital in Guildford.

When he returned with Gina to get his results on Valentine’s Day last year his consultant confirmed that he had moderately aggressive prostate cancer.‘On the way home in the car I was angry,’ he remembers.

‘why didn’t men know more about this cancer? my stepfather had died two years before in his 90s, and died with the disease rather than of it, but it brought it home to me how common this is.’

In a four-hour keyhole procedure, Simon’s prostate was removed in August last year. ‘I woke up feeling tremendously relieved. They’d managed to avoid most of my nerves, so side-effects should be minimal.

‘Three days later I was out of hospital. I did experience a little incontinence, but things were soon back to normal.’

Two weeks later the surgeon confirmed that there was no ?evidence the cancer had spread, though it was only just ?contained within the prostate.

Simon will have regular PSA tests for three years to check the cancer has not returned, and in response to the experience he has retired to spend more time with his family and doing the things he loves. this summer he sailed solo around the UK in a 24ft Cornish Crabber to raise awareness of the test and highlight that it is available to men over 50 in request from their GP.

‘I understand the test is controversial and not right for everyone, but I believe men ought to know about it,’ says Simon. ‘It’s an absolute tragedy that it won’t be used for national screening.

‘The utterly shocking thing is that I was not in an at-risk group and I had been living a normal, symptomless life with this ?cancer for four or five years.

‘Had I ignored my wife’s ?suggestion to have the test, the cancer would have spread outside the prostate in the not-too-distant future. that is a terrifying thought.’ n To find out more, go to ?prostate-cancer.org.uk or call 0800 074 8383.in the clear: Gina and Simon D’Arcy, who had no symptoms

Prostatecancer is on the rise in the US and it is no longer considered an older man’s disease. More than 1 in 5 men will be diagnosed with prostate cancer this year and in many urologist offices across the nation, more and more cases involve men in their 40′s. to consider this statistic, it is fair to think that all men–both young and old–should understand the symptoms and problems associated with thiscancer. the truth, however, is that most men don’t have an understanding ofwhat prostate cancer entails—at all.

With one simple PSA (prostate-specific antigen) test, Jeff, a 45-year old IT support representative, got the news that he had prostate cancer. For weeks he had a slight burning sensation during urination, but nothing else that would cause great alarm. A quick visit to a urologist provided him with the early diagnosis that probably saved his life.

The truth behind prostate cancer is that for most men, symptoms do not appear at all. Urination trouble, a burning sensation while urinating, trouble maintaining an erection and other male dysfunction troubles that may occur may come and go at times without causing concern. Many of the early symptoms typically are brushed off as part of life’s little annoyances. While the symptoms of prostate cancer do become more troublesome and evident as the disease progresses, experts recommend seeing a doctor with the first onset of symptoms.

Dr. mark Allen, MD, a North Texas Urologist, recommends that all men–regardless of their age–take control of their health and request a PSA test during their annual routine physicals. “Because prostate cancer is a disease that starts slowly and presents little symptoms at first, it is hard to detect without a PSA blood test. these tests are generally not given during annual exams to men under the age of 45 because prostate cancer has always been considered an older man’s disease; these tests can be given upon request. these simple prostate cancer screening tests willprovide red flags for these common cancers,” says Dr. Allen.

As menincrease in age, their risk of developing prostate cancer increasesdramatically. although only 1 in 10,000 under age 40 will be diagnosed, therate shoots up to 1 in 39 for ages 40 to 59, and continues to radicallyincrease thereafter.”

Understanding prostate cancer

The prostate gland is a small, walnut-sized structure thatmakes up part of a man’s reproductive system. it is the organ that helps a man urinate as well as maintain an erection. it also plays a vital role in the production of semen. Prostate cancer is a malignant tumor that forms in the prostategland. this particular cancergrows slowly and typically produces little symptoms until it progresses. when prostate cancer symptoms doappear, in many cases the cancer has usually progressed and is in afurther stage.

The good news for men who are diagnosed with prostate cancer, there are many new and advanced prostate cancer treatment options to consider—each with a number of pros and cons. it is important to discuss each prostate cancer treatmentoption carefully with your urologist or oncologist.

According toUrologist, Dr. mark Allen, MD, “The Calypso® 4D Localization System is a revolutionary radiation treatment that is helping to eliminate the cancer within the body. it acts as a GPS for the body, directly targeting the cancer cells without affecting nearby tissue. By using real-time tracking of the radiation beam, this incredible piece of technology is as precise as it gets in terms of radiation therapy.”

Similar tothe new advances in guided radiation therapy, there are also huge strides thathave been made in surgeries to treat prostate cancer. A standard course of treatment is a radicalprostatectomy where either all or some of the prostate, as well as tissuesurround the organ, is removed. there are side effects to this surgeryincluding impotence and urinary incontinence.

According to experts, the da Vinci robotic surgery is a highly advanced technical procedure that hasbeen proven to be more effective, quicker to perform, and dramatically lessinvasive than a traditional prostate surgery.

Thisbreakthrough in prostate surgery uses robotic hands to perform the actual surgery. By making very tiny incisions to thelower abdomen, tiny instruments are inserted into the patient along with a 3D camera. the surgeon then sits at a nearby station where he or she can view the entire prostate image in a perfectly magnified 3D image. the da Vinci system then flawlessly translates the surgeon’s hand,wrist and finger movements into precise, accurate, real-time movements ofsurgical instruments inside the patient. Intrinsically, every maneuver performed with the da Vinci roboticsurgical device is performed with direct input from the surgeon.

Becauserobotic prostate cancer surgery, in general, is relatively knew, it is hasn’tyet been adopted by many Dallas area urologists. Dr. Allen explains, “Many patients are still mostcomfortable with traditional surgery. For a surgeon, it is a significant investment to make to bring theequipment in-house and the learning curve is pretty extent. however, once mastered, usingrobotic prostate cancer surgery as a treatment for prostate cancer provides thesurgeon with instinctive control, range of motion, tissue manipulation andcapabilities that are characteristic of open surgery but with the side effectsof a more minimally-invasive procedure.

Dr. Allencontinues to say, “Regardless of the prostate cancer treatment options apatient might choose, it’s important to detect and diagnose this cancer beforeit progresses. there are severaldistinct warning signs that men should be aware of to help catch thisincreasingly widespread cancer.” he offers some important symptoms to be cognitive of:

· Difficulty or inability tourinate

· Frequent urge to urinate

· Blood inurine or semen

· Painful or burningurination

· Difficulty in having ormaintaining an erection

· Painful or uncomfortable ejaculation

· Frequent pain or stiffness inlower back, hips, or upper thighs

While thesesymptoms could possibly be another condition—such as an enlarged prostate, BPH(Benign prostatic hyperplasia) or prostatis—which is a common inflammationof the prostate gland, it’s important to have a physical and the necessarytests performed so that cancer can be ruled out.

Medical Content Editor,eMedical Media

Contributors: Dr. mark Allen, MD is a skilled urologist practicing inDallas, Texas. he offers urological services to patients throughout the greaterDallas, Frisco, McKinney, Fort Worth and Arlington areas.