Why are blokes so weird when it comes to talking about illness? There are some encouraging signs that attitudes are gradually changing, though

We all know only too well that men aren’t great at opening up and discussing health issues and their bodies. Even when it’s as vitally important as the prostate. Well, next month it’s Prostate Awareness month organised by Prostate Cancer UK, which helps to inform, educate and encourage guys to talk about down there…

In the UK, about 48,600 men are diagnosed with prostate cancer each year. It’s a common cancer that starts in the cells of the prostate and if you’re over 50, or you’re black, or your dad or brother had it, you’re at even higher risk. But please don’t panic – there are many treatments aimed at controlling, or completely clearing, the disease.

SYMPTOMS

The prostate is a small gland that’s part of the male reproductive system just below the bladder and in front of the rectum (back passage). It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). It produces fluid that makes up a part of semen.

As a man ages, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow. This is called benign prostatic hyperplasia, and it is not the same as prostate cancer.

Prostate cancer can be slow growing. In its very early stages, it may have no symptoms at all, or only mild ones which occur over a long period. It is often only when the cancer is large enough to press on the urethra that symptoms can occur. For some people, the first symptoms are only when cancer cells spread to the bones, which can cause pain in the back, hips, pelvis or other bony areas. Like all cancers, the important thing is to be vigilant and if possible catch it as early as possible.

So, things to look out for include:

• Needing to pee more often than usual, especially at night.
• Difficulty peeing – for example, a weak flow or having to strain to start peeing.
• Feeling like you have not completely emptied your bladder.
• Dribbling urine after you finish urinating.
• A sudden need to urinate – you may sometimes leak urine before you get to the toilet.

Sometimes the symptoms of benign (non-cancerous) prostate conditions and prostate cancer are similar. If you have any prostate cancer symptoms, it is important to have them checked by your doctor.

DIAGNOSIS AND TREATMENT

There are a number of different types of prostate cancer:

• Early prostate cancer.
• Locally-advanced prostate cancer.
• Advanced prostate cancer.

In addition, the doctor will give your prostate cancer a stage, a grade and a risk group to help decide on the best treatment for you. Once a diagnosis has been made, an appropriate management strategy can then be determined and the good news is that every year, thousands of men are declared clear of the disease.

There are various treatment options that may be considered by your clinician and again these will depend on the state and stage of the disease. These include active surveillance where the disease is growing very slowly and may never even progress or have symptoms. In the same way ‘watchful waiting’ might be adopted where the cancer is not causing symptoms or concerns. The aim is to monitor closely over the long-term, but to hold off on any treatment unless the cancer progresses.

Ultimately, there’s no way of knowing if you have prostate cancer without visiting your doctor because you can’t check for prostate cancer yourself – so please talk to your GP who can do tests to find out if you need a referral to a specialist doctor.