With Movember underway, you may have already started to notice the increase in mustaches around you. This initiative, inspired by the international charity Movember, raises money and awareness for men's health. While they address testicular cancer, mental health, and physical activity, prostate cancer is the main focus of the movement.
What is Prostate Cancer?
The prostate is a gland, found only in men, located directly below the bladder and in front of the bowels. The function of the prostate is to produce fluid that protects & enriches sperm and creates semen. Prostate cancer develops when cells in the prostate can no longer control their own growth and division. The cancer often develops silently, with many men never experiencing symptoms in the early stages. This increases the risk that the cancer cells with migrate and the disease will metastasize.
Prostate Cancer by the Numbers
Prostate cancer is one of the most commonly diagnosed cancers in Canadian men. One in 8 men in Canada will be diagnosed with prostate cancer in their lifetime; each day roughly 66 Canadian men are diagnosed with prostate cancer, and approximately 11 men die from the disease. It is the most commonly diagnosed non-skin cancer in men, and the third leading cause of cancer-related death among men in Canada. It is estimated that by the end of 2015 24,000 men will have been diagnosed with prostate cancer and 4,100 men will die from the disease. That being said, the prognosis for prostate cancer, especially if identified early, is usually quite good.
- Age: the older you are, the greater your risk of developing prostate cancer - the disease is not very common in men under 50
- Family history: you are twice as likely to develop the disease if you have a father or brother who has been diagnosed
- Ethnicity: there is an increased occurrence of prostate cancer in black African & Afro-Caribbean men compared to their Caucasian and Asian counterparts
- Other possible risk factors include: a diet high in fat and dairy products, a diet high in red or processed meats, and overweight or obesity
Many men do not experience the symptoms; prostate cancer is often first detected during routine check-ups by a physician. Symptoms may include:
- Frequent urination, especially at night
- Difficulty starting & holding back urination
- Weak or interrupted flow of urine
- Painful or burning urination
- Difficulty having an erection
- Painful ejaculation
- Blood in urine or semen
- Frequent pain or stiffness in lower back, hips, or upper thighs
The Controversy of Screening
There are two common screening tests for initial detection of prostate cancer
- Digital rectal exam (DRE) - the physician feels part of the prostate to detect any abnormalities
- Protein specific antigen (PSA) - the physician runs a blood test to detect the protein levels produced specifically by prostate cells
The PSA test has generated quite a bit of controversy in recent years. Organizations such as the Canadian Cancer Society, the College of Family Physicians of Canada, and the Canadian Task Force on Preventative Health Care have stated that "research currently shows that the risks of testing for prostate cancer may outweigh the benefits of screening men at average risk of developing prostate cancer". These groups argue that the harms of false-positives, unnecessary biopsies, and over-diagnosis of cancers outweigh the potential benefits of early screening through PSA. Read more about their stance here.
On the other side of the debate is Prostate Cancer Canada and the Prostate Cancer Centre in Alberta, who recommend that men get a PSA test in their 40s to determine their baseline level of PSA. These groups believe that the benefits of early detection are key in reducing morbidity and mortality of prostate cancer and the high survival rate is due to early detection. Hear more on this perspective from a CBC interview here