It’s a sad fact that most men are into their seventies before prostate cancer is diagnosed, by which time the disease is often well advanced and beyond a cure. This is particularly sad because many men begin to experience enlarged prostate symptoms in their forties and fifties and simply choose to ignore them.
In many cases of course an enlarged prostate is not a problem and, if it does become a problem, then it can be treated without presenting any real threat. In addition, an enlarged prostate is often simply something of an inconvenience which many men feel that they can live with quite happily, so why bother the doctor. The problem of course is that, although not connected, cancer can develop alongside an enlarging prostate and, as a normally very slow growing cancer, it can be easily masked by enlarged prostate symptoms.
One answer, although somewhat controversial, would be to make screening for prostate cancer a routine procedure for men in their forties, or certainly in their fifties.
Prostate screening comes in a variety of different forms but the first line of screening is normally a digital rectal examination, or DRE. This is a simple examination in which the doctor inserts a gloved and lubricated finger into the rectum and feels the prostate gland to gauge its size and to identify any irregularities.
Another less invasive test is the prostate specific antigen, or PSA, test. This is a simple blood test to look for the presence of antigens in the blood which are specific to the prostate. This test will not in itself indicate the presence of cancer but monitoring PSA levels over time will indicate whether or not there is a likelihood of cancer developing and thus whether or not further more specific testing should be undertaken.
To provide a definitive diagnosis of prostate cancer a doctor may typically order a cytoscopy and transrectal ultrasonography in the first instant. A cytoscopy allows the doctor to view the urinary tract as it passes through the prostate gland, by using a thin camera inserted through the penis. A transrectal ultrasonography is carried out by inserting a probe into the rectum and creating a picture of the prostate gland using sound waves.
As a final test, and really the only test to definitely confirm the presence of cancer, the doctor may order a biopsy. A typical biopsy will be carried out through the rectum with a number of needles being inserted into different parts of the prostate gland to remove small pieces of tissue for microscopic examination.
There is considerably controversy surrounding the whole subject of prostate screening, much of it political (or economic) rather than medical, but prostate cancer is a serious condition which kills millions of men every year and an early and definitive diagnosis could certainly reduce the annual death rate very considerably.
