Cancer
For many men, going to the doctor is something they put off until they have no other choice.
Work, family and everyday commitments often come first, while a check-up feels like something that can wait. Some men are also uncomfortable talking about personal issues, including urinary problems, sexual health or mental wellbeing. And sometimes, it’s simply the fear of finding out that something is wrong.
“A health check-up doesn’t have to be a big undertaking, and it’s certainly not something to be embarrassed about,” says Dr Reinholdt Kusche, a specialist urologist at Mediclinic Kloof. “It’s a chance to ask questions, raise concerns and get a better understanding of your health.”
Whether it’s discussing prostate screening, checking your blood pressure or talking about lifestyle changes, taking a little time now could help identify potential problems before they become more serious.
Prostate health: What every man should know
Your prostate might be small, but this walnut-sized gland can have a significant impact on urinary function and quality of life. Understanding how it changes with age can help men recognise when something may need attention.
“For many men, conversations about prostate health tend to happen only when something goes wrong,” says Dr Kusche. “A frequent need to urinate, difficulty starting a stream or waking several times during the night might be dismissed as a normal part of ageing. But while some prostate changes are common as men get older, persistent symptoms shouldn’t simply be ignored.”
The prostate sits beneath the bladder and surrounds part of the urethra, the tube that carries urine out of the body. Its primary function is to produce fluid that forms part of semen.
The prostate often grows as men age. While this is a natural process, an enlarged prostate can press against the urethra and affect the flow of urine.
When an enlarged prostate becomes a problem
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate that becomes increasingly common with age.
“Although BPH is not cancer and does not itself increase the risk of developing prostate cancer, it can cause uncomfortable urinary symptoms,” says Dr Kusche.
These may include:
- A weak or interrupted urine stream
- Difficulty starting to urinate
- A frequent or urgent need to urinate
- Waking several times at night to use the bathroom
- A feeling that the bladder has not emptied completely
- Dribbling after urination
“Urinary symptoms are not necessarily a sign of prostate cancer, but they should not be dismissed,” Dr Kusche adds. “An assessment can help identify the underlying cause and determine whether treatment is needed.”
Depending on the severity of symptoms, treatment may include lifestyle changes, medication or procedures to improve urine flow.
Prostate cancer: Know the risks
Prostate cancer is one of the most common cancers affecting men, with risk increasing with age. Importantly, early prostate cancer often causes no noticeable symptoms. Waiting until urinary problems develop may therefore mean missing an opportunity to identify the disease earlier.
When symptoms do occur, they can include difficulty urinating, blood in the urine or semen, or persistent pain in the back, hips or pelvis. However, these symptoms can have several causes and do not necessarily indicate cancer.
Risk factors include older age, a family history of prostate cancer and certain inherited genetic changes. Prostate cancer risk also varies between population groups.
Men with a father or brother who has had prostate cancer should discuss their individual risk with a healthcare professional.
Should you have a prostate screening test?
There is no single screening approach that is suitable for every man.
“Prostate-specific antigen (PSA) testing is a blood test that measures the level of PSA, a protein produced by the prostate,” Dr Kusche explains. “An elevated PSA level can be associated with prostate cancer, but it can also occur because of an enlarged prostate, inflammation or other non-cancerous conditions.”
A digital rectal examination (DRE) may also be recommended in certain circumstances.
“Understanding the potential benefits, limitations and implications of testing allows men to make decisions that are appropriate for their individual circumstances.”
The age at which screening discussions should begin depends on individual risk factors and clinical recommendations. Talk to your doctor about when testing may be appropriate for you.
Robotic surgery for prostate cancer
When treatment is needed, options may include surgery to remove the prostate or radiation therapy. For men with localised prostate cancer who require surgery, robotic-assisted radical prostatectomy may be an option.
The procedure involves removing the prostate and, in some cases, nearby tissues or lymph nodes. Despite its name, the robot does not perform the operation independently. The surgeon controls the robotic system throughout the procedure.
“One of the benefits of robotic-assisted surgery is that it allows us to operate through several small incisions rather than one larger incision,” says Dr Kusche. “The robotic system provides a magnified, three-dimensional view of the surgical area and allows the surgeon to make highly controlled movements in a confined space. This can be particularly useful when operating close to delicate structures involved in urinary control and sexual function.”
For suitable patients, minimally invasive robotic surgery may offer benefits such as smaller incisions, less blood loss and a shorter recovery compared with traditional open surgery.
Treatment for prostate cancer
For more advanced prostate cancer, hormone therapy, chemotherapy, targeted therapies or other specialised treatments may be used to slow the disease and manage symptoms.
Treatment can have side effects, including urinary incontinence and erectile dysfunction, making it important to discuss the potential benefits and risks with your healthcare team.
Supporting your prostate health
While there is no guaranteed way to prevent prostate problems, healthy lifestyle choices can support overall wellbeing.
Aim to maintain a healthy weight, exercise regularly, eat a balanced diet rich in vegetables and fibre, and avoid smoking. If urinary symptoms are affecting your sleep or daily activities, reducing caffeine and alcohol may help in some cases.
Most importantly, don’t ignore changes in urinary function. A check-up doesn’t have to be complicated – and getting concerns checked early can give you a clearer picture of your health.
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