Welcome to the next part of the male reproductive system and today an overview of the prostate and health issues to be aware of. Also a repeat of the guest post by John Maberry on Prostate cancer and the treatments available.
As women face problems with their uterus, and possible hysterectomies, so men are faced with problems with their prostates. The good news is that in the majority of cases the conditions are benign, and are not going to lead to cancer, but symptoms should always be checked out.
In a young man the prostate is about the size of a walnut and it slowly gets larger as a man matures. If it gets too large, however, it can begin to cause problems with the urinary tract resulting in frequent urination and in some cases discomfort. This is called benign prostatic hyperplasia (BPH) and is very common in men over 60 years old. If problems with urination occur especially at night then a doctor should be consulted. Usually a rectal examination or scans will detect the enlarged prostate and appropriate treatment prescribed. If the enlargement of the prostate and the urination problems are relatively mild then it is usually left for a period of time to see if the normal reduction in testosterone will result in a decrease in the size of the prostate.
If the enlargement of the prostate or the symptoms warrant medical intervention it is usual to prescribe either alpha-blockers (can have some nasty side effects) or a testosterone lowering drug. As the testosterone levels decrease the prostate shrinks and the urination problems are solved. However there can be side effects such as loss of sex drive and possible erectile problems.
There is a herb called Saw Palmetto that is taken by many men, who have been diagnosed with an enlarged prostate. As always, I prefer the natural approach but it is important that you consult your doctor before taking any herb in preference to medication to ensure that your progress is monitored carefully.
In extreme cases surgery may be advised if the urination problem does not improve. It can however result in other problems and should be considered carefully beforehand.
Now for the guest post by John Maberry author of Waiting for Westmoreland and please feel free to comment and share his post.
PSA Tests—Yes or No by John Maberry
You know about PSA tests, right? A simple blood test that measures the level of prostate specific antigens in the bloodstream. The purpose is to detect the likelihood of cancer. This article is about whether to have one or not. First some background.
The prostate is a walnut sized gland that’s wrapped like a horseshoe around a man’s urethra. It’s primary function is to produce semen. Unfortunately, it can also become cancerous. In the U.S. 1 in 7 men will get prostate cancer in their lifetime. It’s the second leading cause of cancer death among American men, behind only (surprisingly) skin cancer. [American Cancer Society] Sounds scary, but only 1 in 38 men will die of it—a statistical disconnect between cancer-caused and other deaths. How so? Most prostate cancer progresses very slowly and starts after age 50, consequently most men die of something else in their senior years—heart attack, stroke, etc. But if it is cancer that kills them, prostate cancer is #2 on the list.
What about elsewhere in the world? According to 2012 statistics from World Health Organization, the incidence is similarly high in the rest of North America, Australia/New Zealand, Northern and Western Europe—probably because of the high level of PSA testing. Mortality is similar in those developed areas but higher in the Caribbean and most regions of Africa, probably as a result of medical treatment not being as available or affordable.
So, you’re a guy or you have one you care about, what about a PSA test? What follows is a whole lot of discussion of what it is and things for you to consider. But before we get to that, let me give you the bottom line—if you’re like me and have a family history of prostate cancer, ignore generic pros and cons and get the test every year or two.
The test entails drawing a small blood sample from a vein (usually in the arm) and sending it to a lab. What happens after that depends on the PSA level detected. Recently the PSA test has come under scrutiny, with one group in America recommending against routine screening. Others still recommend it. See this website for the pro position. Most other groups focused on men’s health or cancer disagree with the con position and have varying qualifiers related to age and family history—with the final decision to be an agreement between the man and his primary care physician. Medicare, and many private insurers still pay for it. Medicaid may or may not. Why the controversy? It relates in part to the limitations of the test itself and in part to what happens after the results come in. See more on the test at the Mayo Clinic site.
Limitations of the test include:
- False positive results due to prostatitis, BPH, urinary tract infection or other conditions
- False negatives due to taking certain drugs such as statins, obesity or low PSA despite a tumor
- Age—PSA rises with age
- The test by itself doesn’t correlate highly with the age-related risk of death from cancer
- The risks of side effects from further testing
- Side effects from treatment that may not be necessary (see more below on what happens after the test
What happens after the test: If the level is high, a retest may be done. A digital rectal exam (a doctor inserts a gloved in finger in the rectum to feel for hardened lumps on the prostate—which may be done in conjunction with or instead of the PSA test as a routine screening test for BPH (benign prostatic hyperplasia—enlargement of the prostate that is very common as a man grows older; it causes more frequent urination as the gland squeezes the urethra). Beyond that, a whole host of potentially more costly and invasive (not to mention worrisome) procedures may be done:
- A test for a urinary tract infection that might inflame the prostate (raising the PSA) as well
- A transrectal ultrasound to look for tumors
- A biopsy of the prostate (accessed through the rectum, the perineum or up the penis); this procedure itself can have side effects such as bleeding, infection and irritation
If the follow up tests confirm the presence of cancer this is where things get complicated
- Is it the typical slow-growing cancer that will cause no problems before you die or the faster growing kind that requires action?
o Newer PSA velocity tests will note whether your PSA level is climbing quickly—a sign of a fast growing cancer
o The Gleason score measures how fast a cancer is growing—it ranges from 2-10, with 10 being quickest and most likely to spread. [My father died of prostate cancer in 1954 at age 48 and it had metastasized widely; my brother had his prostate removed in 1999 at age 68 when an ultrasound confirmed tumors after a high PSA score of 9.9 and a medium Gleason score—he is still alive and kicking at 84] See more on Gleason score here.
- You have two basic options—watchful waiting or active surveillance with periodic retests (depends on your age) or treatment to remove the cancer
- Treatments include [See more at Mayo]:
o Radiation—external beamed into the body or brachytherapy (rice grain sized pellets inserted in your body)
o Hormone therapy that reduces testosterone (the hormone helps the cancer grow)
o Cryotherapy (freezing prostate tissue)
o Biological therapy, also known as immunotherapy
o Surgery to remove the prostate
- The bad news: all of the treatments, except possibly the hormone therapy, have a significant risk of urinary incontinence or erectile dysfunction. This is where the issue of overtreatment becomes real and is a core part of the argument against screening—the doctor finds a cancer and the man gets treatment with side effects when if the prostate were left alone the cancer wouldn’t kill him.
So, as noted before, if you’re like me with a family history of prostate cancer the answer is clear—get the test. If you are of African descent, probably should get the test too. In any case, ask your doctor. Don’t stick your head in the sand and hope for the best.
About John Maberry.
John Maberry dreamed of being a writer from second grade. Life got in his way. Like what, you may ask. Find out the details in Waiting for Westmoreland, the memoir he wrote about how he came to have a happy and successful life. That, after surviving a hard childhood, failed marriages, an eye opening year in Vietnam and more. He finished the memoir five years after retiring from a local government job in busy Northern Virginia.
That’s John in the photo, relaxing with his friend Larry the Lizard. He met Larry in Mimbres,
New Mexico. John and his wife relocated to scenic New Mexico six years ago. That move and other priorities, stalled the transition to speculative fiction, mysteries and writing genres. Finally, The Fountain, a collection of speculative fiction stories, is coming out in July, 2017. He’s also working on a few novels, planning for one every one to two years. No more delays, time is fleeting.
When not working on the novels or the websites, the family enjoys life in their dream home high atop a hill. His wife of 35+ years has her quilting/craft room. He has an office shared with an energetic dog who lounges on a loveseat behind him when not out chasing rabbits. He’s a happy man and a funny guy (strange/weird his wife says).
Books by John Maberry
About John’s latest release – The Fountain and six more fantasy & Scifi stories.
Humor, twists and more in this collection of seven fantasy and sci-fi short stories. Karma can be painful in “The Fountain”–when a plunderer meets a long-dead shaman. A family adopts a retriever with special talents in “Lily, an Amazing Dog.” A vampire has a strange problem, in “Alfred’s Strange Blood Disorder.” A perennial favorite, dimensional travel, with a strange twist in “The Closet Door.” What could that column of fire be, rising from the Atlantic off the Outer Banks? Read “The Flame” to find out what it meant to troubled writer Carson. A wizard casts a spell that works well for a princess, but will it be as good for him? Check out “The Wizard.” Finally, “The Fribble” offers an alien encounter of an odd sort, to a pharmaceutical company rep searching for new drugs in the Amazon Rain forest.
One of the early reviews for the book
If you enjoy short stories in fantasy/sci-fi genres, and stories that make you think then look no further than Maberry’s tales which will engross you with stories about karma, greed, time travel, aliens and muses.
In this book you will read stories about: a dog with extra sensory perception, a writer battling his own sub-conscience, a wizard who wonders if the spells he casts for others will work for himself, a man who experiences 2 lifetimes by opening a closet door. These are just a few of the stories to stimulate your reading appetite.
Maberry is a prolific writer who knows how to keep a reader captivated till the end and finishes his stories with an unexpected twist. This book also offers an excerpt to the author’s next upcoming novel. As in true Maberry style, he leaves us hanging in anticipation with more to come. A great read!
Read the reviews and buy the collection: https://www.amazon.com/Fountain-more-fantasy-sci-fi-stories-ebook/dp/B071KLTTJR
Read all the reviews and buy both books: https://www.amazon.com/John-Maberry/e/B002BM82FU
Connect with John.
My quarterly webzine on my Eagle Peak Press site
My book website, Waiting for Westmoreland
Writing blog, John Maberry’s Writing
Eclectic blog, Views from Eagle Peak
My thanks again to John for sharing this post and it is worth sharing as the message needs to be driven home…. #Get Checked
All the top to toe posts can be found in this directory: https://smorgasbordinvitation.wordpress.com/smorgasbord-health-2017-top-to-toe/