YANA
- YOU ARE NOT ALONE NOW
PROSTATE CANCER SUPPORT SITE
AN
INFORMATION GUIDE
TO
PROSTATE CANCER
This is part 1 of a 5 part Information Guide. Introduction: Index
To
help you orientate yourself in this Strange Place, the first thing you might
want to know is the answer to these two questions:
Where is my prostate gland and what does it do?
That's not as silly as it sounds. Most men don't know where the prostate gland
is, even though they are the only ones who have them. This is not really surprising.
It is one of the best-protected glands in the human body; it rarely causes any
trouble until after the age of fifty and it is not very big - about the size
of a walnut. So why would you know where it is?
The prostate gland will usually have a volume of about 25 cc. It is contained
within the bony structure of the pelvis and is very close to the bladder and
rectum. In fact the duct that empties the bladder (urethra) passes through the
prostate. This means that both prostate disease and treatment of the prostate
gland after a diagnosis of prostate disease can cause problems with urination.
The main function of the prostate is to provide the fluid that carries the sperm
on ejaculation. The nerves that control erections are along both sides, just
beneath the surface of the gland. This makes treatment very difficult as damage
to the nerves can, and often does, cause erectile dysfunction or impotence.
This means that attaining an erection can be difficult or impossible after treatment.
New techniques have reduced the incidence of erectile dysfunction, but most
men will have some erectile problems after treatment.
How will I know if I have prostate cancer - what are the
symptoms?
Most prostate cancer diagnosed is asymptomatic. Simply, there are no symptoms.
In most cases, diagnosis occurs following a routine examination, including a
PSA blood test. If the PSA level is elevated, the normal process of diagnosis
follows as described below.
Where there are symptoms, they are likely to include urinary problems (like
frequent or painful urination, difficulty in starting urination, blood in the
urine), problems with erections and ejaculation and pain in the bones.
But before worrying too much about these symptoms, it is important to know that
many other, less dangerous diseases than prostate cancer can also cause them.
Infection of the bladder or prostate (prostatitis) can be responsible for many
of them. Nevertheless, anyone with these symptoms should seek medical advice
- and sooner rather than later.
Older men all tend to have some urination problems - often frequency and urgency
issues. The most common cause of these is known as BPH (Benign Prostatic Hyperplasia)
or enlargement of the prostate. As the prostate grows it restricts the channel
that passes through it carrying urine from the bladder. BPH is not a malignant
disease and often starts showing up when men reach their 50s. It can be dealt
with by means of a simple surgical procedure known as a TURP (Transurethral
Resection of the Prostate), or with drugs. A herbal treatment known as Saw Palmetto
has been reported as being helpful in relieving some of the symptoms of BPH,
as have pumpkin seeds.
HOW DO I GET THERE?
So, how do you get to the Strange Place in the absence of symptoms? What's the
procedure?
The only way prostate cancer can be diagnosed with any certainty is by a biopsy
of the gland. Before that happens there are usually some preliminary steps.
These are described below. In reading them you will start to learn some of the
language and customs that might be new to you.
Basic Language Hints
Before moving onto the diagnostic procedures, there are some basic language
issues to be learned. Firstly and most importantly, many words have acquired
specific meanings - meanings that differ from those you may have attached to
the words in the past.
The best example, perhaps, is the use of the words "positive" and "negative."
In your usual "pre-cancer" place, broadly speaking, positive = good and negative
= bad or not good. These positions are somewhat reversed in Strange Place talk.
You soon learn that a positive result to a test is not one you want to have.
A positive result means that there are definite signs of the disease. On the
other hand, as you are frequently told, a negative result does not mean you
are disease free. There are merely no positive signs. So in this Strange Place,
positive = bad and negative = not positive.
Another very important word to understand is "cure". This word has many meanings
in the Strange Place. There is a different definition of "cure" for each treatment
mode. Often there is no absolute agreement amongst medical practitioners, who
use differing definitions of "cure" for the same therapies. Usually the achievement
of a "cure" follows observation for signs of any recurrence of the disease once
it has been treated. This can stretch over a period of years, making the journey
a long one. For many people the main goal is "remission" - a freedom of any
signs of the disease - rather than "cure".
There will be other words and phrases you will need to understand. Many of these
are three-letter acronyms, such as PSA, DRE and HDR. There are even some two-
and four- letter acronyms such as RP, SI and EBRT. All of these will seem tremendously
confusing at first, but will hopefully become clearer as you learn the language.
You will also find that prostate cancer is commonly referred to by non-medical
people as PCa or PC or PCA but usually by the medical people as CaP (cancer
of the prostate).
For easy reference you will find a short glossary
of the most common terms and expressions at the back of this document.
Travelling Companions
It is much more difficult to deal with the process of diagnosis and treatment
alone than it is with the support of other people. So family and friends should
be told and be involved in the process of sifting information and coming to
a decision. A word of warning here - the help offered by well-meaning people
can be somewhat overwhelming at times, so it may be best to keep the circle
of helpers small initially.
Support groups - too few at present - can provide invaluable encouragement and
advice. Most men and their companions who join these groups speak highly of
the comfort provided by meeting others in the same position. Participants in
support groups know they are not alone, and they can speak to people who have
already travelled some way on the same journey they are on. The Cancer Association
of South Africa - CANSA - has branches in all the major centres and should be
able to help with information and addresses. There is a huge wealth of information
and help on the Internet. Even talking to strangers can help - there are many
men who have travelled this way before and most will be only too pleased to
pass on what they have learned. By taking these steps some of the feeling of
"aloneness" is dissipated.
GO
NOW to Part 2 - Getting Started - The Forest of Fear