Prostate Health: The Message Behind the Moustache

While Movember is a feel-good initiative full of slick ’staches, it carries a serious message about prostate cancer

Since its start in Melbourne over a decade ago, Movember has grown into a global movement in support of men’s health. For the month of November, men trade in their clean-shaven faces to proudly sport a “hairy ribbon” to raise funds for research and treatment of male diseases, most prominently prostate cancer. Beyond raising funds, Movember also aims to raise awareness – and there’s a lot to know. Although current screening methods have limitations – and even the experts can’t agree on what age to start getting examined – it’s important for men to educate themselves about prostate health. (Read one man’s first-hand account of his very first prostate exam here.)

Organizations like the Vancouver Whitecaps (represented here by Jordan Harvey) have thrown their support behind the Movember cause.

Quick Facts and Symptoms

• Prostate cancer is the most common cancer in Canadian men (excluding non-melanoma skin cancers, which affect both men and women and are rarely fatal) and the third leading cause of cancer deaths.
• About one in eight Canadian men is expected to develop prostate cancer during his lifetime and one in 28 will die from it.
• Simply aging increases the risk for prostate cancer, with the rates rising sharply after age 50. It is most frequently diagnosed in men aged 60-69 years.
• The five-year relative survival rate for prostate cancer in Canada is high (96 per cent).
• Men who are at higher risk for prostate cancer include those with a family history of prostate cancer in a father, brother or son, and those of African and Caribbean ancestry.

Source: Canadian Cancer Society

Symptoms

• Urgent need to urinate or difficulty doing so
• Frequency of urination especially at night
• Burning or pain when urinating
• Inability to urinate or trouble starting or stopping urine flow
• Painful ejaculation
• Blood in urine or semen

Testing

The Blood Test
The less intimidating part of the screening process involves a blood test to detect levels of a protein called the prostate specific antigen (PSA). The levels of this protein rise as the prostate gland gets larger with normal aging. While the blood test cannot diagnose prostate cancer, it can indicate that something is wrong.

So when should you get a PSA blood test? It depends on whom you ask.
In B.C., a PSA test is not recommended for mass screening and is not paid for by the Medical Plan unless a man has symptoms (see below). Prostate Cancer Canada suggests that average-risk males should get a PSA test in their 40s to establish their baseline level, earlier if they’re at higher risk. Meanwhile, the Canadian Urological Association recommends PSA testing among men age 50 and over.

The Prostate Exam

Ah yes, that test (see opposite page for a first-hand account). Technically called a digital rectal exam (DRE), this check-up involves a doctor manually inspecting the
prostate to evaluate its size as well as check for any bumps, hard spots or other abnormalities. The prostate gland should be about the size and shape of a walnut, and, as men age, the gland naturally grows larger.

A study in The Journal of Family Practice suggests that the accuracy of detecting prostate cancer is, overall, about 28 per cent while another published in the Annals of Internal Medicine estimates that an abnormal DRE screening doubles the odds of finding a clinically important cancer.

Read more about prostate testing in our first-hand account

Concerns and the Bottom Line

The Concerns

Screening for prostate cancer can come with risks – that’s because PSA testing is not perfect. An abnormal result may lead to unnecessary biopsies (which carry the risk of infection and bleeding) and over-diagnosis of cancers that may never have caused problems – but their treatment could cause permanent harms such as erectile dysfunction and incontinence.

The (Ahem) Bottom Line

Because the blood test and rectal exam provide different information, combining the DRE with the PSA blood test can increase the overall rate of cancer detection. While not
perfect, for men age 50+, it remains the best option to detect prostate cancer early.

Be Proactive

Every man should see his doctor for an assessment of his individual risk for prostate cancer, then an appropriate screening schedule can be made according to that risk and his beliefs.

How to Reduce Your Risk

While there is no proven way to prevent prostate cancer for men at average risk, research has found certain factors have been linked to a lowering your risk. For example:

Eat a Healthy Diet
We know that men who eat a low fibre, high fat diet are at increased risks for developing prostate cancer. Instead, fill up on fish, fruits and veggies. Drinking green tea and adding soy to your diet have also been found to lower the risk. Studies have found that men who ate the most dairy products such as milk, cheese and yogurt also had a higher risk of prostate cancer.

Maintain a Healthy Weight
Research shows that men who are obese have an increased risk for prostate cancer.

Exercise
While the jury is out on a direct link with prostate cancer, being physically active will help maintain your weight and boost your immune system.

Be Proactive
Start the conversation with your health-care professional about your risk for prostate cancer so that you can make an informed decision according to your age, life circumstances and personal beliefs as to whether you should be screened now or later for the disease.