What does this future look like? Half as many men are dying from prostate and testicular cancer. Half as many men are suffering from serious side effects as a result of their treatment. A quarter fewer men are dying from suicide. These are realities that often do not make it to public discourse. It has, in fact, become a human phenomenon that issues around men’s wellbeing, besides the contents in their wallets, are often shelved never to be discussed.
When it comes to their health, too many men do not talk, do not take action, and die too young. In fact, it is less of a priority. As long as they wake up, feel no pain, then all is well. The month of October was decorated with pink ribbons, as a way of raising awareness about both breast and cervical cancer. So now that November is here, it is equally time to pull those who never minded about their health along to raise awareness on prostate cancer.
During Movember, men are challenged to grow a moustache and be physically active and move or host a fundraising event.
Knowledge is power. Thus, the more you know about the normal development and function of the prostate, where it is located, and what it is attached to, the better you can understand how prostate cancer develops and impacts a man’s life over time.
The prostate is a gland located immediately below the bladder, in front of the bowels. It produces fluid that protects and enriches sperm.
Prostate cancer occurs when some of the cells in the prostate reproduce far more rapidly than normal, resulting in a tumour. If left untreated, prostate cancer cells may eventually spread from the prostate and invade distant parts of the body, particularly the lymph nodes and bones, producing secondary tumours in a process known as metastasis.
One of the most worrying aspects of the disease is that most prostate cancers develop without men experiencing any symptoms in the early stages. This can be a huge concern knowing how ignorant men can be when it comes to their health.
Below is a breakdown of the how it all happens.
The normal prostate is a small, squishy Gland about the size of a walnut. It sits under the bladder and in front of the Rectum. The Urethra – the narrow tube that runs the length of the penis and carries both urine and semen out of the body – runs directly through the prostate. The rectum, or lower end of the bowel, sits just behind the prostate and the bladder.
Sitting just above the prostate are the seminal vesicles – two little glands that secrete about 60% of the substances that make up semen. Running alongside and attached to the sides of the prostate are the nerves that control erectile function.
The prostate is not essential for life, but it is important for reproduction. It seems to supply substances that facilitate fertilisation and sperm transit and survival. Enzymes like are actually used to loosen up semen to help sperm reach the egg during intercourse. (Sperm is not made in the prostate, but rather the testes.)
Other substances made by the seminal vesicles and prostate such as zinc, citrate, and fructose, give sperm energy to make this journey. Substances like antibodies may protect the urinary tract and sperm from bacteria and other pathogens.
Thus, the prostate typically grows during adolescence under the control of the male Hormone Testosterone and its by-product DHT, or dihydrotestosterone.
The prostate is divided into several anatomic regions, or zones. Most prostate cancer develops from the peripheral zone near the rectum. That’s why a digital rectal exam (DRE) is a useful Screening test.
Lower urinary tract symptoms due to Benign Prostatic Hyperplasia (BPH), which is a non-cancerous prostate condition, typically develops from the transition zone that surrounds the urethra, or urinary tube. This is why BPH may cause more difficulty with urination than prostate cancer typically does.
Because the prostate is close to several vital structures, prostate cancer and its treatment strategies can disrupt normal urinary, bowel, and sexual functioning.
Urinary function: Under normal circumstances, the urinary sphincters (bands of muscle at the base of the bladder and at the base of the prostate) remain tightly shut, preventing urine that’s stored in the bladder from leaking out. During urination, the sphincters are relaxed and the urine flows from the bladder through the urethra and out of the body.
During Prostatectomy: the surgical removal of the prostate – the bladder is pulled downward and connected to the urethra at the point where the prostate once sat. If the sphincter at the base of the bladder is damaged during this process, if it’s damaged during radiation therapy, or if scarring develops that prevents the sphincter from closing, some degree of urinary Incontinence or leakage may occur.
Bowel function: Solid waste that is filtered out of the body moves slowly down the intestines, and, under normal circumstances, the resultant stool is excreted through the anus following conscious relaxation of the anal sphincter. Damage to the rectum caused by radiation, or more rarely, by surgery, can result in bowel problems, including rectal bleeding, diarrhoea, or urgency.
Sexual function: If the erectile nerves are damaged during prostatectomy, the ability to achieve erection is lost, though sexual desire is not affected. Erectile dysfunction can also result from damage to these nerves by radiation therapy, though this process usually occurs more slowly over time.
Fertility: As part of the removal of the prostate, the seminal vesicles and part of the vas deferens are removed, disrupting the connection to the testes. Orgasm may still occur, however ejaculation will be dry and natural conception will not be possible.
“I actually took time and read up on prostate cancer and I feel there are so many unproductive things we pay attention to but little do we even consider going to get tested. Cancer is real. In fact, I have lost a friend to cancer. But what was puzzling was that before he died, we were all just happy souls. The next moment, he was diagnosed but it was unfortunately too late. And before we could even make peace with his sickness, we lost him. Now this is a lesson. While we grow our moustache this month, let us also take time to go out there and make sure that our inside looks just as clean as out outside. Let us also take this time to support our brothers out there. I think the message for this month should be to just be healthy. And it should go beyond the 30 days of November. We have lost too many lives already due to our ignorance of the importance of our health,” said Jackson Ndinoshili, a young activist.
*Additional information from: www.pcf.org