The trouble with men

The trouble with men is that many don’t look after themselves when it comes to their health. Yes, they’ll take their car to the garage regularly to get it serviced, and they are out polishing the bodywork every other weekend, but they’d never dream of taking themselves to the doctors to get a check up. And unfortunately, this means that many men die prematurely of illnesses such as heart disease and prostate cancer.

Every year in the UK, over 42,000 men are diagnosed with prostate cancer which affects the small doughnut-shaped gland that produces seminal fluid and encircles the urethra. Only 50 per cent or so will be alive in five years time, despite receiving treatment.

Every year in the UK, over 42,000 men are diagnosed with prostate cancer which affects the small  doughnut-shaped gland that produces seminal fluid and encircles the urethra.

Early diagnosis is crucial since up to 98 per cent of men who are diagnosed when the cancer is still contained within the gland itself will live for more than five years. That drops to around 30 per cent – if the cancer has spread to other parts of the body.

A national screening and awareness programme would help overcome the male reluctance to take themselves to the doctors on their own accord. It always helps if you receive an invitation to attend a surgery at a particular time and place.
At the moment, there is only a screening programme for colon cancer but not for prostate cancer. The reason given is that the PSA test, which measures levels of prostate specific antigen in the blood, is not accurate or cost effective enough.

At the moment, there is only a screening programme for colon cancer but not for prostate cancer. The reason given is that the PSA test, which measures levels of prostate specific antigen in the blood, is not accurate or cost effective enough.

It is true that the PSA test has a 75 per cent false positive rate, since it only signals when the prostate is enlarged and this happens to 50 per cent of men over the age of 65. Men with a raised PSA ideally need to undergo an expensive MRI test followed by a targeted biopsy to confirm a diagnosis of cancer if the MRI reveals an abnormality. This is not a perfect regime, but it is the best that we have until we develop a test which is a marker for prostate cancer rather than just an enlarged prostate.

Even without a national screening programme for prostate cancer, we should certainly be ensuring that we are testing those men who are greater risk of developing the disease, either because of family history, or because of their ethnicity. Black men will have a one in four life time risk, double that of white men.

We also need to get men talking about their lifestyle and help them improve their exercise regime and diet. Many more men are putting themselves at risk of a range of diseases because they are carrying too much extra fat around their middle. If we can encourage men to take advice and seek help in good time, these simple measures would greatly improve their quality of life and longevity.

Professor Roger Kirby will be talking at the Royal Society of Medicine’s Men’s Health Conference on Thursday 1st June in London. Registration starts at 9am. For further information go to www.rsm.ac.uk

Professor Roger Kirby

MA MD FRCS (Urol) FEBU

Professor of Urology, Medical Director of Prostate Centre, London, President Urology Foundation (TUF) Vice President Prostate Cancer UK and fundraiser for KEVII. Director and founder of The Prostate Centre.

“I have a “passion for the prostate” and founded The Prostate Centre in order to provide a better experience for patients. I am proud of the team we have assembled and the fact that everything we do is suffused with enthusiasm and commitment”

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