My name is Chris Bell, I'm an engineer, I live in Wales and I have prostate cancer. It's the most common male cancer and it kills 30 men every day in the UK. All men are at risk of getting it, but how many people know its symptoms? Here's a selection of stuff which I think everyone should know...
© Prostate Cancer UK
Only men have a prostate. It lies just beneath the bladder and its main job is to make semen, the fluid which carries sperm during sex.
The prostate is a sexual organ. But unlike breasts and cervixes, most people remain too embarrassed to talk about prostates - maybe because they're connected with ejaculation, a subject which remains taboo, even in today's enlightened society.
The 3 most common prostate problems are:
The rest of this website is concerned with prostate cancer...
© Haynes Manuals
If you notice any sexual or toilet changes, go to see your doctor (physician or GP) without delay. There's a good chance that they're caused by something else but, if it's cancer, then early detection will give you the best chance of a cure.
However, prostate cancer is often 'silent', with no symptoms for months or even years. There isn't a screening program so, if you're a man who's over 45 (black) or 50 (white), you should ask your doctor for an annual PSA test yourself (see below).
Download a fact sheet listing Prostate Cancer Symptoms.
These can give the earliest indication of a problem. But they aren't often discussed, probably due to embarrassment, and some doctors aren't even aware of them. You are more likely to notice these symptoms during masturbation than intercourse, but DON'T BE EMBARRASSED (your doctor won't be!)
It was devastating to be told 'you've got cancer' and it took me a while to overcome the initial shock. But once I'd come to terms with it, I've been living life to the full. There really hasn't been any time to waste!
I'd noticed, but had ignored, sexual changes 2 years earlier, but I went to my doctor as soon as I started needing to wee a lot. My diagnosis was delivered to me in November 2004 after several months of tests.
The cancer had already spread outside my prostate, limiting my treatment options and reducing my longterm outlook. Inevitably this made me feel miserable, not helped by the fact that the cancer itself made me feel progressively weaker each day. I wouldn't have coped nearly so well without the love and care of my wife who, of course, had her own difficult emotions to come to terms with.
I underwent 4 weeks of 'radical radiotherapy' in 2005 - strong x-rays to zap my prostate and the surrounding area. And whoopee - this successfully knocked the cancer back to the point where it became undetectable for nearly 2 years.
I also started receiving 3-monthly implants of female hormones. These have continued to this day and cause a few interesting side-effects (see below).
Thankfully I remained fit and well for the next 5 years. I had regular check-ups, both in hospital and with my own doctor. These showed my cancer slowly returning, as I knew it would, but this didn't cause me any problems. Those were some of the best years of my life - every day was a bonus, petty things didn't matter any more, friendships became deeper, and I made sure that I made the most of every day.
I began suffering back and leg pains in the autumn of 2010, shortly after cycling 4000km across Europe to raise money for prostate cancer research. It turned out that my cancer had spread to my spine and I'd reached the next stage of the disease. I underwent 7 months of chemotherapy - strong chemicals delivered into a vein in my arm. This was unpleasant but it successfully checked the progression of my cancer again, although I now had to take strong painkillers every few hours to overcome serious leg pains. In 2012, after a further short course of radiotherapy, I was well enough to undertake another trip, this time cycling 5000km through eastern Europe to Istanbul to raise money for children with cancer.
Things started to go wrong again in the autumn of 2014 while I was on another fundraising trip, this time to Gibraltar for 'Médecins Sans Frontières'. I could feel myself getting weaker as I crossed Spain and, by the end of the trip, had to push my bike up every little hill, however gentle its slope. Back home, further diagnosis revealed another large tumour at the base of my spine, this one squashing nerves from my bladder and bowel, making me doubly incontinent.
Radiotherapy and a new drug helped me to recover sufficiently for another 2500km cycle ride in 2015 but my longterm outlook isn't good. As I write this (December 2015), the side-effects of new courses of chemotherapy and radiotherapy are making me feel grim but, once again, there's a possibility that I might regain sufficient strength to continue enjoying a quality lifestyle for a little while longer - who knows?
Only one more treatment option remains, so my clock is ticking - but, hey, isn't it ticking for all of us anyway? My advice is to make the most of this wonderful life while we can!
There's no UK screening program for prostate cancer (yet) but all men can ask their doctors for an annual PSA blood test:
PSA is a protein in the blood that can give an early indication of prostate problems. This simple test determines how much PSA you have. IT MUST BE REPEATED EVERY YEAR since a single result is not as significant as the rate at which PSA rises over a period of time, something that can only be judged by having regular tests.
Ask your doctor for your PSA scores and keep a record of them - it's not enough to be simply told that 'the result is normal - there's nothing to worry about'. Your PSA will increase slowly as you get older, but a sharp rise indicates a problem that needs to be investigated immediately.
Some doctors are reluctant to provide PSA tests but all men have the right to be tested and a recent British NHS 'Risk Management Program' advises doctors how to interpret the results. INSIST THAT YOUR DOCTOR GIVES YOU AN ANNUAL TEST!
Download a copy of the West Wales Prostate Cancer Support Group's fact sheet about the PSA test.
(The routine screening of all men is long overdue. Women are screened for breast and cervical cancer, so why aren't men treated equally? Perhaps a case could be brought against the UK Government under its own Sex Discrimination Act! PSA tests aren't perfect but they're the best we've got at the moment, so please put pressure on your MPs, AMs, MSPs and MEPs for a national screening program.)
© Haynes Manuals
Another test which can be done by your doctor is called a 'Digital Rectum Examination' or DRE. Your doctor will wear a rubber glove and feel your prostate with a finger up your bottom. Don't be shy about this - it's quick, doesn't hurt and is something your doctor is used to doing.
If he/she feels any lumps, or if your PSA has risen too much, you'll be sent for further tests in a hospital. There you'll probably be given a urine flow test (when you will be asked to pee into a special bucket behind a screen), an ultrasound examination and an MRI scan. If these tests are inconclusive will you be given a prostate biopsy to see if any cancer cells are present (this is the only unpleasant test).
Fortunately only a minority of men receive the bad news that they have cancer and, even when this is the case, it may not be serious enough to warrant treatment. If your cancer is mild and slow-growing, you'll simply be told to return for annual tests - they'll keep a watchful eye on you from then onwards and you'll be able to continue living a long and active life!
Some men's cancer will require treatment but, as long as it's been caught early, there's a good chance that it can be completely cured. An unfortunate few, like me, will have 'locally advanced prostate cancer' which is not curable but, even so, there's still a good chance that it can be kept at bay for many years - as mine has been.
Prostate cancer can be cured if it's caught early and, if you are otherwise fit, you should be given a choice of 'radical' treatments. Your PSA should then drop to a very low level. You will then probably be offered 3-monthly hormone injections to reduce your testosterone level, because prostate cancer needs testosterone to grow. These have a few unfortunate side-effects (see below) but these are preferable to the cancer itself. Your doctor will also monitor your PSA at regular intervals.
Currently available treatments include...
These are all described in the West Wales Prostate Cancer Support Group's fact sheet about Prostate Cancer Treatment.
Once you've been diagnosed with prostate cancer, YOU must take the driving seat. Don't accept delays and read all you can about your condition, both as it is now and how it might develop in the future.
Don't let things slip until it's too late - in my own experience, this can happen all too easily. NHS treatment in the UK is second to none and the doctors and nurses are some of the kindest people you're ever likely to meet. But NHS management and administration leave a lot to be desired and, remarkable for such a common disease, many health workers remain ignorant of some of the warning-signs connected with prostate cancer and its progression. Your own knowledge and polite assertiveness might even save your life!
I've found it helpful to keep a graphic record of my cancer journey since initial diagnosis in 2004. It clearly shows how different treatments have affected my PSA level (and, consequently, how well my cancer is being controlled) over the years. In my opinion, it is easier to understand than some of the hand-written notes that my doctors and consultants keep - some of them have even said so themselves!
(Click on the graph to enlarge it)
As long as your PSA remains low, then you can rest assured that your cancer has either been cured or remains inactive. A rising PSA, however, could indicate the return of the disease and there's a danger that it will eventually metastasise to other parts of your body, especially your bones. This can't be cured, unfortunately, but it can still be controlled - possibly for several more years.
It's very important, therefore, that you monitor your PSA level and, if it starts rising significantly, that you are aware of any symptoms that require action. In particular, any unexplained pain, tingling, numbness or pins and needles in your back, legs, buttocks, chest, tummy or arms, and problems going to the toilet, should be investigated immediately because if they indicate 'Metastatic Spinal Cord Compression' then palliative treatment should start within 24 hours.
Whichever treatment you undergo, you will have to cope with side effects. Some of these are more serious than others, but all of them are preferable to having prostate cancer itself. There's not enough space to list all the possibilities, so I'll tell you what I've experienced myself...
The main side-effect is that I'M STILL ALIVE and have have already enjoyed 10 extra years of quality life!
(April 2005 onwards)
'Menopausal' symptoms such as hot flushes, night sweats, weight gain and hightened emotions - fortunately the intensities of all of these have reduced with the passage of time.
My sexual department shut down as soon as treatment started and I've been impotent ever since - I no longer get aroused, either physically (no erections) or psychologically (no sexual thoughts).
4 weeks of
Bowel urgency (very little warning when I need to poo)
7 months of
3-weekly drug infusions
Hair and nail loss
Tingling fingers and peeling skin
Loss of appetite - everything tasted awful
Serious arm pain caused by accidental drug leakage
Arm numbness due to the accidental drug leakage
4 further courses of
(2011, 2012, 2014, 2015)
Gut ache (4 months)
Flatulence (4 months)
(Dec 2014 - Oct 2015)
There are many other things which you can do to help control your cancer and there's no shortage of advice if you care to search the Web. Some people reject medical intervention altogether, preferring to put their faith in something alternative, while others (including me) feel that it's sensible to accept what modern medicine can offer and help it to do its job by using carefully-chosen complementary therapies. Here's a selection, although I haven't, personally, tried most of them...
It's not known why some men get prostate cancer and others don't. Age and a family history of prostate cancer are known risk factors, but you can't do anything about these. However it seems likely that diet in general, and milk and dairy products in particular, also plays a role - and that's something you CAN control.
Professor Jane Plant is one of Britain's most distinguished scientists who has won many scientific honours. She was struck by breast cancer at the age of 42 but refused to give in to it and devoted her many scientific skills to researching and beating it - which she did.
Jane's research showed that milk and dairy products can trigger both breast and prostate cancer. Milk from cows, humans or other animals, is a medium which encourages cell-division and growth. This is needed by babies but not by adults in whom cancer is caused by uncontrolled cell-division. Milk is a great food for babies but nature didn't intend it for the rest of us!
Jane's suspicions were raised when she noticed that breast and prostate cancers are rare in China, where milk and dairy products aren't normally consumed. Yet they ARE suffered by Chinese people who adopt a Western diet which, of course, is rich in dairy products such as milk, butter, cheese, yogurt and cream.
She also recommends avoiding red meat which, in most 'developed' countries, comes from animals which have been given hormones and other growth-factors to stimulate rapid growth. These poisons find their way into meat and can cause cancer in humans.
Her recommended diet is mainly vegan (fresh fruit and vegetables), plus free-range poultry and oily ocean fish (like mackerel). And, strange as it may sound, men should drink a glass of pomegranate juice every day!
As a result of her research, Jane has written several carefully-researched books, including:
Click here to read Jane's story in her own words.
The British charity that helps prostate cancer sufferers and their families, by providing information and advice, is Prostate Cancer UK. If you want to talk to a nurse who specialises in prostate problems, phone Prostate Cancer UK's Confidential Helpline:
Prostate cancer sufferers and their partners usually value the support of others in the same situation as themselves, and support groups exist all over the UK. Use the Tackle website to find your local group.
© Chris Bell