YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

This is part 1 of a 5 part Information Guide. Introduction: Index

 

PREPARING FOR THE JOURNEY

WHERE IS IT?

To help you orientate yourself in this Strange Place, 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 only men 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 the sides and at the base of the gland. Damage to the nerves during treatment 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 incid-ence of erectile dysfunction, but most men will have some erectile problems after treatment. The degree of erectile dysfunction can vary significantly and may be temporary or permanent depending on the individual, the treatment option chosen and the skill of the person carrying out the treatment.

The relative positions of bladder, prostate and urethra

HOW DO I GET TO THE STRANGE PLACE?

So, how do you get to the Strange Place? What's the procedure? Let's start with some background information to answer frequently asked questions:

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 (such as pain or discoloured ejaculate) 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, such as 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 is 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 procedures such as a TURP (Transurethral Resection of the Prostate), TUNA (Transurethral Needle Ablation) TUMT (Transurethral Microwave Thermotherapy) 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.

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.

What causes prostate cancer?

No one can answer this question, but one school of thought links inflammation of the gland to a potential for tumour to form and grow. Even if this is not correct, there is general agreement that a healthy life style - good eating habits, correct weight, exercise, stress reduction - will lead to a lower probability of prostate cancer and may well inhibit the growth of any tumours. A healthy life style would also help in the recovery process after any treatment.

Can prostate cancer be spread to my partner from our sexual activity?

There is no evidence that cancers can be spread in this way.

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 in this Strange Place - 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 rarely agreement amongst medical practitioners who often use differing definitions of "cure" for the same therapies. A recent study found over 200 definitions of failure so that means there are as many definitions of "cure". The achievement of a "cure" follows observation for signs of any recurrence of the disease once it has been treated. This is true of all treatments, including surgery and can stretch over a period of many 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".

Even the word "cancer" can be misleading. To quote Dr Chris-topher Logothetis, a leading specialist in advanced prostate cancer : "One of the problems with prostate cancer is definition. They [the pathologists] label it as a cancer, and they force us all to behave in a way that introduces us to a cascade of events that sends us to very morbid therapy." This view is shared by well known and respected pathologist Dr Jon Oppenheimer who believes that there should be a clear distinction between what we call the aggressive forms of the disease and what we call those that are less likely to prove fatal.

There are other words and phrases you will need to understand. Many are three-letter acronyms, such as PSA, DRE and HDR: some are 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. For easy reference there is a short glossary of common terms and expressions.

GO NOW to Part 2 - Getting Started - The Forest of Fear