Prostate cancer is one of the most common cancers in men worldwide. The Caribbean region has a particularly high incidence of this type of cancer. Throughout the month of November, the Cayman Islands Cancer Society is partnering with the Lions Club of Grand Cayman and the organisers of Movember to raise awareness of male cancers, especially Prostate Cancer.

What is cancer?

Our body consists of cells. Normal cells grow, multiply and die in an orderly manner and are replaced by new cells. Cancer cells do not die but continue to multiply in a disorderly manner. Over time they can form a mass which may be malignant, in other words, cancerous.

What is prostate cancer?

Prostate cancer develops when this process occurs in the prostate. This type of cancer often develops slowly.

Where is the prostate?

The prostate is a walnut-sized gland that is part of the male reproductive system. It is located below the bladder and in front of the rectum. Its function is to produce fluid that protects and enriches sperm.

What increases my risk?

A RISK FACTOR increases the likelihood that you will develop a disease. Having a risk factor does not mean that you will develop a disease. Different cancers have different risk factors. Risk factors for prostate cancer include:

Age: Risk increases with age. 2 out of 3 cases are diagnosed in men over 65.

Race: This cancer is more common in African American Men. African Caribbean men are 3 times more likely to get it than men of other races.

Family History: Having a father or brother diagnosed with prostate cancer will increase a man’s risk of developing prostate cancer particularly if the relative was diagnosed at an early age.

If a close female relative has been diagnosed with breast cancer there is evidence to suggest a man will have an increased likelihood of a prostate cancer diagnosis.

Diet: Research suggests that eating a diet high in fat and red meat consumption will increase the risk of developing prostate cancer.

What decreases my risk?

Any factor that lowers your risk of developing a disease is known as a PROTECTIVE FACTOR. These factors do not guarantee that a disease will not develop. Different cancers have different protective factors. Possible protective factors against prostate cancer are:

Diet: Foods rich in lycopene such as tomatoes, pink grapefruit, papaya and watermelon may reduce your risk by helping to prevent damage to the DNA of cells. Additionally, selenium, which is found in liver, seafood, brazil nuts and whole grains may also lower risk.

Physical Activity: Exercising on most days of the week may contribute to a reduction in risk.

What are the signs and symptoms?

There are often no signs or symptoms in the early stages. Some of the following signs may often be mistaken for other disorders. Typical signs and symptoms of prostate cancer are:

• Weak or interrupted flow of urine
• Trouble starting the flow of urine
• Pain or burning during urination
• Frequency of urination especially at night.
• Urgency to urinate
• Blood in your urine or semen
• Painful ejaculation
• Frequent pain or stiffness in the lower back, hips or pelvis.

Screening

Screening tests are done on persons who have no signs or symptoms of a disease.

There is no standard or routine screening test for prostate cancer recommended by any major scientific or medical organization at this time.

The Cayman Island Cancer Society supports the American Cancer Society’s position that men should be offered a digital rectal exam (DRE) and prostate specific blood test (PSA) annually at age 50 or earlier, between the ages of 40 – 45, if considered to be high risk.

What is a PSA blood test?

PSA is a substance that is made only in the prostate. The level of this substance in your blood increases with age. It is measured by a blood test. The blood test is NOT cancer specific. Elevations in levels of PSA may be because of prostate cancer but there are many other reasons why a man can have an elevated PSA level including having sexual intercourse up to 48-hours before the test.

Men should know that the PSA blood test can produce a false negative result which means that the blood test result is within normal limits but prostate cancer has in fact developed. The test can also produce false positive results with elevated levels prompting investigative studies when in fact there is no cancer present.

What is DRE?

A DRE is a manual examination of the prostate. The doctor will insert a gloved finger through the rectum to feel for any abnormality in the size or shape of the prostate.

Special considerations

Screening for prostate cancer is not recommended for all men at this time because these tests are not perfect and uncertain or false results can cause con-fusion and worry. Although the PSA test can help spot cancer early, it cannot tell how dangerous the cancer is. Due to the fact that prostate cancer is usually a slow growing cancer, in many cases it never causes any problems.

For these reasons, each man should talk to his doctor about whether or not testing is the best option for HIM.

There are a number of treatment options for prostate cancer. Side effects of many of these treatments include incontinence and impotency. There are ways of regulating both of these problems. Men should consider having both PSA and DRE tests as they do not replace each other but in fact complement each other.