Take it Like a Man

Dr Bill Nielsen has been practising in Duncan for thirty years

Welcome to November, the season of mists. Last month was breast cancer awareness month. You probably heard how screening for breast cancer with self-examination and mammography in women age forty to seventy-four can reduce deaths by 25%. Yup, mammography is a pretty good deal. But let’s not forget that breast cancer has a fraternal twin on the groom’s side of the aisle – also a hormonally sensitive, fluid-producing organ that sometimes gets cancer…the illustrious prostate.

The prostate may not be the hardest working organ in a man’s body, but it does manage to squeeze out a protein that makes sperm swim. That’d be PSA. Without PSA, sperm would float around forever in a lazy white jam called semenogelin. Add some fresh Grade-A PSA (that’s what prostates do) and that jam magically liquefies and the sperm cells awaken. Then, like at the starting horn of the Stampede chuck-wagon races, all those tiny palominos charge off into the sprint to deliver their package first! The funny thing about prostate cancer cells is they make way too much PSA. Serendipitously we can measure PSA in the blood to screen for cancers before they are big enough to do serious damage. There are five common causes of an elevated PSA, and only one is cancer, so interpreting the PSA results requires finesse and subtlety. What is a normal PSA? The range is quite variable (2 -10) so it is good to do a few PSA’s to establish your personal baseline before you get into your sixties and seventies when prostate cancer becomes quite prevalent.

Screening for prostate cancer should begin between the ages of forty or fifty depending on family history. A yearly PSA blood test and digital prostate exam can lower deaths from prostate cancer by 50%. Prostate cancer comes in many flavours; some need no treatment, some are curable by surgery, some by radiation and hormone drugs or chemo. Some kinds of prostate cancer are incurable, but temporary remissions can last for up to ten years. So guys, think seriously about prostate cancer – one way or another, you’re gonna have to take it like a man.