Help us to stop prostate diseases ruining lives

Men’s attitude towards their health has traditionally been ‘if it ain’t broke, don’t fix it’.   These days, the thinking should be more along the lines of ‘if you look after your body (and particularly your heart and your prostate), it has less of a tendency to go wrong’.

All three prostate diseases − prostate cancer, benign prostatic hyperplasia (BPH) and prostatitis − tend to have a greater impact on a sufferer’s quality of life than is, in fact, necessary.   These conditions frequently reach a relatively advanced stage before men seek medical help, which is often the result of men’s laissez-faire attitude to lower urinary tract symptoms, embarrassment about discussing this area of their anatomy with their doctor, and their general reluctance to undergo and act on regular health checks.

In fact, each of the three major prostatic diseases eloquently illustrate the ‘stitch in time’ principle.   A ‘window of curability’ exists for prostate cancer, but once this is closed, neither surgery nor radiotherapy is likely, ultimately, to be successful.   With BPH, several studies have confirmed that there is a level of secondary damage to the bladder caused by obstruction after which complete recovery becomes less likely.   And if prostatitis becomes chronic, then repeated and prolonged courses of treatment are often needed.

Of course, problems may develop before any symptoms arise.   For this reason, it is generally advisable for most men over 50 to have an annual health check, which often includes an assessment of the prostate, including a PSA test.   Remember, while a one-off PSA check provides a certain amount of information, regular checks are more informative because they show the rate of the rise in PSA (sometimes called the 'PSA kinetics').   A sudden rise in PSA is rather like a flashing light on the dashboard of your car; it tells you that something is amiss, which, if responded to, will help to prevent eventual breakdown.

Points to remember:

• If men wait for symptoms, they wait too long
• Men with prostate disease can be cured by a little knowledge and timely action
• A 'window of curability' exists for prostate cancer
• If cancer is to be identified at a stage when it is still curable, then it should be detected before the PSA rises much above 10 ng/mL
• More than 80% of men who have had a radical prostatectomy are alive 10 years afterwards, and 60% are alive at 15 years
• With a radical prostatectomy, the success rate in removing the tumour and preventing recurrence is commonly over 80%
• If cancer is present, it can stay dormant, grow slowly or accelerate rapidly, for reasons that are not yet fully understood

Regarding prostate health, regular prostate checks allow disease to be detected at a stage when it can generally be resolved, while preventive strategies may reduce the risks of disease developing in the first place.   It makes good sense to combine these with regular, more general health checks to diagnose other potentially dangerous conditions such as high blood pressure, lipid disorders and diabetes.   In a sense then, the prostate provides the key to more general men's health.