The reason the prostate doesn’t get any respect has a little to do with the nature of the organ and its disease and a little to do with the mindset of the male. The “perfect storm” of a gland the male can’t see or feel and a cancer that doesn’t cause symptoms until it’s too late is responsible for the tragedy of over 25,000 deaths a year in the United States. Look at the following and consider whether they apply to a loved one, or maybe even yourself:
* Unlike a women’s breast, which gets all the attention an organ could ever want, the prostate lives a very isolated life. You can’t see or feel it, men don’t know what it does, and they sure as heck don’t want a stranger probing around to feel it. Many men feel unmanly at the very thought of a rectal exam and would just as soon not have the prostate checked. Men are told to self-examine their testicles in the shower as women do their breasts, but no one suggests that the male contort himself to examine his prostate. Its very location bespeaks of nature giving it no respect — why does it have to be located right there where other unpleasant things occur?
* The PSA blood test further complicates the prostate’s social life. Before the PSA, the only way to check on the prostate was a rectal exam. Now men and doctors often substitute this simple blood test for the exam. Doing so makes a doctor’s visit much more pleasant for both physician and patient. Everybody ends up happy except the dejected and unchecked prostate. Unfortunately, one can have prostate cancer despite a normal PSA.
* Even when the prostate asserts itself with prostate cancer, it gets little attention because of the prevailing beliefs that prostate cancer doesn’t kill and that the disease occurs primarily in older men. Articles in newspapers and on the Internet daily state that most men die with prostate cancer and not of it, despite over 200,000 cases diagnosed and 25,000 deaths a year. Society perceives breast cancer much differently, and more seriously, than prostate cancer.
* Many patients, but particularly men, will only go to the doctor if a symptom presents itself. Unlike chest pain, indicating a heart problem, or blood in the urine, indicating a kidney problem, prostate cancer often exhibits no symptoms until it’s too late to do something. Prostate cancers often originate away from the urethra, the tube men urinate through. As a result, urinary symptoms may not appear until the prostate cancer has become fairly extensive. Men can have prostate cancer for years without any symptoms.
* If the difficulty of checking for cancer isn’t enough deterrent to early detection, the idea of what can happen after treatment further complicates the prostate’s life. It is almost as if the prostate is mad about being ignored throughout its life. Any treatment for prostate cancer can affect, in varying degrees, how a male voids and his ability to get erections. The angry gland may exact its revenge in the form of leaking urine and sexual dysfunction. These two maladies strike right at the heart of the male ego.
Prostate cancer isn’t just an old man’s disease and has been diagnosed in patients in their 40s and early 50s who had no symptoms until it was too late for effective treatment. Lifestyle is irrelevant as a risk factor.
When men acknowledge the respect prostate cancer deserves, there will be a heightened awareness, early detection and treatment in a more curable phase of prostate cancer.
Dr. John McHugh, a urologist, is the author of “The Decision: Your prostate biopsy shows cancer. Now what?” His website is www.theprostatedecision.com.