Myths, facts about prostate diseases

BY: Dr Samuel Amanamah

There are lots of myths surrounding prostate diseases. Get the facts with the Urologist Consultant, Dr Samuel Amanamah.

Myth :I do prostate-specific antigen (PSA) test yearly as part of my medical examination. It has always been within the normal range. I am sure I’m far from prostate cancer.

Fact :It is yes and no. You can have prostate cancer though your PSA is normal. PSA alone is not used to assess if one has prostate cancer or not. Your urologist must do a physical examination on your prostate by a procedure called digital rectal examination (DRE) and based on what he finds, coupled with your PSA results that a determination is made on whether cancer is suspected or not.

Combination

A combination of the PSA and DRE is what is used to ascertain the health of the prostate.

Myth: I know I have prostate cancer because my PSA is always high.

Fact: A high PSA does not necessarily mean one has prostate cancer. All the prostate disease give to a rise in the PSA level(inflammation, enlargement, cancer). Manipulation of the prostate like rectal examination can transiently raise the PSA level. So PSA is not a prostate cancer marker.

Myth:I went for free medical check up, and had a scan done. I was told my prostate at my age is large, so I was advised to take medication to reduce the size.

Fact: Prostate is like grey hair, we will all have grey hair with age. In the same way as we age our prostate naturally increases in size. It's only when it presses on the urethra which will invariably cause changes in our urine pattern that intervention is needed. This intervention is needed so that our bladder and subsequently our kidney does not get compromised. So without any urinary symptoms large prostate alone is not an indication for medical or surgical intervention.

Womanising

Myths: Having catheter passed to relieve you of urine retention is a sure sign you are or were a womaniser.

Fact: It's not the case at all. Any one can have a catheter passed on him. Even women can be catheterised. So far as at a point in your urine refuses to come you will need catheterisation to relieve it. Womanising is not a cause for retention of urine leading to catheterisation . Issues of nerve supply to the bladder can cause that. Prostate disease can be the cause etc. In women uterine fibroid can cause that.

Myth: I don't want to hear anything about prostate. A good friend of mine who was physically well died just six months after starting prostate treatment.

Fact: There are different diseases of the prostate (Inflammation, enlargement, cancer) . Also there are different stages of the disease that people present. Inflammation of the prostate is easily treatable but when it can lead to urosepsis when it presents late. Urosepsis can lead to death Enlargement of the prostate is treatable, and in the initial stages would need just oral medication. When it presents late, the bladder and the kidney can get compromised. Some coming for the first time already with a kidney failure.If a patient presents with a cancer at a stage when the cancer has spread to major organs. He may look good on the outside but inside may not be that good. No matter how good the Urologist is he can't cure this patient. The best he can do is to try to suppress the growth of the cancer to avoid debilitating consequences. This will however not improve his life expectancy. Early reporting is very critical in the outcome of all diseases, including prostate diseases.

Death sentence

Myth: Prostate cancer is a death sentence. It will kill you if you get it.

Fact: There are aggressive types of prostate cancer which can kill if not well managed and if it presents late. But there are others which are not aggressive. If you have the none aggressive type your Urologist may choose not to even treat and may offer what we call watchful waiting. Meaning he will watch till the time he feels the cancer is getting aggressive before he intervenes.Out of this came the saying that some people die with their prostate cancers not from thier prostate cancer. Meaning some who have prostate cancer will die from other diseases never knowing they even had prostate cancer.

Plenty sex

Myth: I hear lots of sex can cause prostate cancer.

Fact: It's rather the opposite. The risk of prostate cancer decreases with the number of ejaculation per month.

Myth: Treatment for prostate cancer will lead to erectile dysfunction.(impotence)

Some treatment options cause erectile dysfunction, though not all men undergoing such treatment will have erectile dysfunction. There are other forms of treatment which does not cause erectile dysfunction. In case you have problem with your erection after treatment discuss with your Urologist.

Myth: I know of a herbal treatment which cures your prostate issues.

Fact: We know as a matter of fact that most medications are extract from herbs.The first question is, what will that herb be treating. Inflammation? Enlargement? Or Cancer? Are we saying causes of the three prostate diseases are the same, so one herb preparation can treat all? Most of the time we hear these herbs are not for cancer treatment. But the question is how will you know the patient being offered the herbs does not have cancer since there is no one specific symptom to tell you one has prostate cancer. Good treatment always starts with a good diagnosis.

The writer is a Consultant Urologist at the Kumasi South Hospital