Myths of prostate cancer presentation and diagnosis

Over the last few weeks I have been discussing prostate cancer and its associations. I have reiterated that we really do not know exactly what causes prostate cancer; we do know what factors contribute to initiation and progression. I have explored the contribution of age, sex, race, family history, testosterone, diet, vitamins and minerals, environment and sexually transmitted infections on prostate cancer.{{more}} In this article, I want to continue to debunk the myths surrounding prostate cancer presentation and diagnosis. These myths will be addressed in the form of questions. These are the questions that I get asked all the time. Firstly:

How can I know that I have prostate cancer? Or what are the signs of prostate cancer? The simple answer: prostate cancer has no specific signs or symptoms; in other words there is nothing specific for me to tell you to look out for. Men who experience urine problems usually have an enlarged swollen prostate that is not cancerous and those with pain and blood in the urine are usually suffering from an infection in their prostates or bladder. Very rarely, these symptoms are caused by prostate cancer, but this is rare. They are more commonly caused by a swollen, benign (non-cancerous) prostate. This means that men, who experience these, need not fear going to see their doctors. Prostate cancer really has no symptoms and the easiest way to detect it is to look for it; so we advise all black men over the age of 40 to get tested.

Doc, I heard that the best way to check for cancer is the finger test; is that true? This is true and false. In younger men, whose prostates are usually small and benign, the blood test is better than the finger test. If there is a cancer growing, the blood test usually picks it up before the finger test. It is only when the blood test is rising or becoming abnormal that the finger test helps us to get more information. In older men, i.e. over 50, the finger and blood tests are usually done together, as the incidence of cancer is higher and the blood test is often borderline from old or previous infection, so the finger test helps to differentiate infection from cancer.

Doc, I heard that the finger test is painful, is that true? Saying that the finger test is painful is like saying that the road is bumpy. It depends on what vehicle you are driving, who is driving and how fast you are driving. Clearly, if you are driving a luxury vehicle on a rough road, it will not feel like an average vehicle. Likewise, the finger test depends on who is doing it, how it is done and the patient himself. Tense, apprehensive men usually have more discomfort than the less apprehensive. I can count on my finger the number of men who say it’s painful over the last five years. Most of the men are apprehensive, but most leave the office very surprised and relieved that it was not painful and I’m sure that is the experience of most doctors. In other words, the belief does not live up to the experience. The examination usually takes about 5-10 seconds and a lot of men are not comfortable with sexuality, hence the apprehension.

We will continue this discussion next week.

For comments or question contact:
Dr Rohan Deshong
Tel: (784) 456-2785
email: deshong@vincysurf.com