‘Prostate cancer is not necessarily an old man’s disease’

Early diagnosis of prostate cancer key to positive outcomes

Last year, Gary Brooks underwent a routine prostate examination and, following tests, it was discovered that he had cancer.

“I moved into a new area last July and as I had had some symptoms for a while, I decided to get a routine check from my new doctor,” says the 64-year-old. “For some time, I had been having issues with my waterworks, such as getting up in the night to pee, never quite finishing a pee, feeling there was a loss of strength in the flow and also an increased frequency in needing to go.

“I had a blood test which showed up a high PSA [prostate specific antigen] level and a follow-up test the next month showed the same. Then I had a prostate examination which identified enlargement, so I was sent for an MRI in January, which revealed a shadow in the prostate and the biopsy in March revealed cancer cells.”

Gary, who is a semi-retired consultant, was told that he had two possible choices to treat the cancer – radiotherapy or surgery. He chose the latter. “I got the diagnosis in around April or May and, being an optimist and pragmatist, I went see the consultant on my own,” he said. “He told me that I had an aggressive form of prostate cancer in its early stages, which was concentrated in a small area on the left side of the gland. The two treatments which were available to me were radiotherapy or surgery [radical prostatectomy]. It took a while for the information to sink in and I think the shock and worry came onto me gradually – my wife was very worried and more shocked than I was.

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“I had several appointments with the head of radiotherapy and my consultant surgeon and while radiotherapy seemed like the right fit for my lifestyle, I decided to explore surgery further with the consultant. I also did a lot of research, spoke to others who had experience of the disease in their family and also my GP.

“The meeting with the surgeon confirmed in my mind that surgery, while intrusive, painful and disruptive in the short term, was probably the best option for the medium to long horizon. So, I had the procedure in August – was admitted on a Sunday and underwent robotic keyhole surgery the following day.”

Healthy lifestyle

Gary, who lives in Clare, was kept in hospital for several days and after being discharged, has been recovering well and says he is now very mindful of the need to live a healthy lifestyle. “I was allowed to leave hospital a few days after surgery with a catheter and six neat little wounds which were healing well,” he says.

“The catheter was removed after 10 days, along with the staples in the wounds and, as it takes time for the bladder to heal and to be retrained using pelvic floor exercises, I had to wear incontinence pants in the beginning. But as time went on, I have been wearing lighter and lighter pads in the underwear as bladder control returned. Pain control was also important for the first couple of months, but as the healing process continues, the discomfort receded.

“In my six-week review, the consultant told me I was cancer-free and was making good progress and my latest PSA test showed a level of zero. But when examined post-removal, the prostate revealed that the cancer had spread between the biopsy and the surgery, even though it was still contained within the gland. So, hopefully, it will not travel anywhere else.

“It is now three months since I had my surgery, and I am feeling fit and well. I am doing regular, brisk three-mile walks, playing golf twice a week and exercising four or five days a week. [Bouts of] pain and discomfort are very limited, as long as I drink plenty of water, take cranberry juice and lay off the caffeine. Of course, I am concerned about the disease returning, but am modifying my lifestyle to prevent it as far as I can – that and keeping a positive head, reducing stress and focusing on the important part things in life.”

Treatable

Prostate cancer affects almost 3,900 men in Ireland each year – that equates to one in seven men being diagnosed with the condition during their lifetime. But while these figures are alarming, it is a very treatable form of cancer, particularly if detected early.

November is Men’s Health Awareness month when men are encouraged to seek medical advice if they are worried about any aspect of their health, as early treatment for conditions such as prostate cancer can have a very positive outcome.

Having thankfully been diagnosed early so his cancer could be treated, Gary would encourage other men to go for regular check-ups and seek medical advice if any concerns whatsoever. "Prostate cancer is not necessarily an old man's disease and guys from their mid-40s upwards should be asking for a PSA test when they have a check-up," he advises. "Also, any concerns around urinary or sexual function, or any pain or anomaly in the undercarriage area should be discussed with a doctor. There is plenty of information available and support from excellent organisations such as macprostatecancersupport.ie.

“I am also writing a blog about my experience with the disease, which I hope to share with people who have been diagnosed or have concerns. There is no shame involved whatsoever and men need to be realistic and pragmatic.”

Kevin O'Hagan, cancer prevention manager with the Irish Cancer Society (1800 200 700, email SupportLine@IrishCancer.ie), agrees and says great progress has been made in the treatment of prostate cancer, but the long-term survival and quality of life for men who have been treated for prostate cancer still depends on getting that early diagnosis.

“Because early prostate cancer does not usually cause any symptoms, it is often identified through regular check-ups,” he says. “If you are over 50, you should see your doctor every year for a check-up. If you have a family history of prostate cancer you should have regular check-ups from the age of 40. Your GP can check for the possibility of prostate cancer when you have no symptoms.

“The message for older and younger men alike is get informed about risk factors of cancer, and what you can do to protect your health. Know your body; look out for any unusual changes and take action. Early detection can greatly increase your chances of living a healthy life after prostate cancer.”

ABOUT PROSTATE CANCER

– Prostate cancer happens when the normal cells in the prostate gland change and grow to form a mass of cells called a tumour.
– Early prostate cancer doesn't normally cause any symptoms. Prostate cancer usually causes symptoms only when it has grown large enough to disturb your bladder or press on the tube that drains urine, causing problems passing urine.
– These symptoms are called prostate urinary symptoms and include a slow flow of urine, trouble starting or stopping the flow, passing urine more often, especially at night, pain when passing urine and the feeling of not emptying the bladder fully.
– In Ireland, prostate cancer is the second most common cancer in men, after skin cancer.
– About 3,900 men are diagnosed with prostate cancer each year; this represents almost a third of all invasive cancers in men.
– This means that one in seven men will be diagnosed with prostate cancer during their lifetime.
– An average of 540 men dies from prostate cancer each year.
– Survival rates for prostate cancer has improved over the last number of years and is relatively high compared to many other cancers. Five-year survival averages 92 per cent.
– Less common symptoms include pain in lower back, hips or upper thighs, trouble getting or keeping an erection, blood in the urine or semen.
– It is important to visit your GP if you have any worries or if you have any of these symptoms so that they can be discussed and assessed.