Prostate Cancer Prevention

Another prominent Canadian, 53-year-old federal Health Minister Alan Rock, has been struck with prostate cancer. The recent famous Canadians in the news with prostate cancer were Pierre Trudeau and Preston Manning.

In the last one-year, we have discussed prostate cancer in this column at least twice. The last one was as recently as two months ago. After the column appeared, a reader asked several questions. These will be answered today.

The reader also adds, “It is often important to get down to very basics of human body when we talk about this stuff – without making someone gag on his cornflakes in the morning, of course!” Let’s see what we can do!

Is Medicine Hat high in prostate cancer?

According to Alberta Cancer Board (ACB) document (Cancer in Alberta – A Regional Picture – June 2000) the incidence of prostate cancer seems to be higher in the south and lower in the north. But this is not a real increase. This may reflect different patterns of PSA testing in the province, although other explanations are possible.

The higher proportion of older adults in our region compared to other regions in Alberta will contribute to greater number of cancer cases in this region but this should not affect the region’s cancer rates, says the ACB document. So, there is no real increase in prostate cancer incidence in our health region.

What does prostate gland do? What happens if it is removed? Do we need the prostate? Why not remove it if all men are eventually going to get cancer?

The main function of the prostate is to provide the proteins and ions that form the bulk of the semen. Prostate produces enzymes like acid phosphatase and prostatic specific antigen (PSA). A normally functioning prostate is important for normal reproductive function. In conjunction with other smaller glands in the vicinity, the prostate gland produces secretions that serve to lubricate the system and provide a vehicle for storage and passage of sperms.

Yes, we need the prostate gland as it has important functions. Most people survive the removal (part or whole) of the prostate gland with no or minimal complications. But a small percentage of patients end up with urinary incontinence and impotence. So I am not sure if prophylactic removal of the gland would be acceptable to many people.

Where is the prostate gland?

The prostate gland lies below the urinary bladder in front of the lowest inch of the rectum, through which it can readily be felt on digital rectal examination. The gland is only present in men. The urethra from the bladder passes through the gland before it enters the penis. The gland has an important role in proper flow of urine.

In summary, the prostate, a small gland weighing only 20 g in a young man, becomes increasingly irrelevant with age, is eventually a nuisance to almost all men and, by the end of the average male life span, has a 70 per cent chance of harbouring malignant cells. Prostate cancer is about fear, sex, indignity and death (Canadian Medical Association Journal). But we can change it by regular PSA testing and digital rectal examination.

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