Understanding Men's Cancers
Tuesday, September 1, 2015
Few among us have not been affected by cancer on some level. Did you know that half of all cancers can be prevented? September is Men’s Cancer Awareness Month – a time to understand cancers that are specific to men, recognize the warning signs, and be aware of the factors that put men at risk. Most importantly, know that early detection saves lives.
The most commonly-diagnosed male cancer, prostate cancer will affect 1 in 8 Canadian men in their lifetime. An estimated 4,100 Canadian men will die from the disease in 2015 alone.
Better news is the fact that prostate cancer deaths have been reduced by 40 percent over the past 20 years, due to improved testing and better treatment options. In most cases, screening and early detection are the key to successfully beating it.
What is prostate cancer?
The prostate is a part of the male reproductive system. It adds nutrients and fluid to sperm. Prostate cancer is a disease where the prostate cells have abnormal growth and division, and no longer function as healthy cells. A cancerous prostate cell can invade other parts of the body.
Because prostate cancer is slow growing, some men can live for many years without knowing they have the disease. That’s why regular screening is so important. If left untreated, prostate cancer may have serious consequences.
Who might be at risk?
Even though any man can develop prostate cancer, some are more at risk than others. You may be at risk if you:
- Are over 50: Your risk increases at age 50, and most cases are diagnosed in men over 65. Men should get tested to establish a baseline in their 40s. If you believe you are at risk for any of the reasons below, talk to your doctor before the age of 40.
- Have a history of prostate cancer in your family: If a father or brother has had prostate cancer, your risk is higher, and it increases with each first-degree relative who has the disease.
- Are African or Caribbean: Prostate cancer is more common among men who are African or Caribbean. (As a point of interest, men of Asian descent have lower risk.)
- Are overweight: Simply put, a healthy weight reduces your risk.
- Eat an unhealthy diet: A low-fibre, high-fat diet is more likely to encourage prostate cancer. Foods high in saturated fats may increase testosterone production and promote the growth of prostate cancer cells.
Signs and symptoms of prostate cancer
Symptoms may be hard to detect, especially in the early stages of prostate cancer. But you should watch for these common indicators:
- Difficulty urinating
- Urgent need to urinate
- Frequent urination, especially at night
- Burning or painful urination
- Inability to urinate or difficulty starting or stopping urine flow
- Painful ejaculation
- Blood in semen or urine
Testing for prostate cancer
There are several methods for testing for prostate cancer by a physician.
Physical examination: The first step is a physical examination, which allows the doctor to look for signs. During a physical examination, your doctor will do a digital rectal examination (DRE). With a gloved finger, the doctor examines the rectum to feel the prostate gland through the wall of the rectum. The doctor is looking for any lumps or changes in size, shape or consistency of the prostate.
Your doctor may also:
- Feel your bladder through the abdomen to see if it is enlarged or distended
- Check to see if your kidneys are tender or have lumps
- Check for sensitive or painful bones
Prostate-specific antigen (PSA) test: This simple blood test measures the level of PSA in the blood. PSA is a protein made by the prostate. The PSA level varies with age and tends to rise gradually in older men. A gradual increase over several years is normal, but if abnormal amounts are present in the blood, it could be an indication of the presence of prostate cancer.
Transrectal ultrasound (TRUS): An ultrasound probe placed in the rectum takes images of the prostate. It is used to measure the size of prostate, and look for abnormal or suspicious areas. It may also be used to direct the placement of biopsy needles to take samples of tissue.
Biopsy: A prostate biopsy may be performed if an abnormality was found during a DRE or transrectal ultrasound, or if the PSA level was high. During a biopsy, tissues or cells are removed from the body so they can be tested.
Bone scan: A bone scan will indicate if the prostate cancer has spread to the bones (the most common place where prostate cancer spreads). Your doctor will request this test if you have unexplained bone pain or tests indicate an increased alkaline phosphatase or calcium level.
Another common type of cancer in men is testicular cancer. In 2015, it is estimated that 1,050 Canadian men will be diagnosed with testicular cancer.
What is testicular cancer?
Testicular cancer is a malignant tumour that begins in the cells of a testicle. A malignant tumour can spread - or metastasize - to other parts of the body.
Part of a man’s reproductive system, the testicles are two egg-shaped organs that are covered by a sac of skin called the scrotum. The scrotum hangs between the legs. The testicles produce sperm as well as the male hormone testosterone.
Cells in a testicle can change and grow abnormally. Changes to cells in a testicle can create precancerous conditions, which means that the cells have a higher chance of becoming cancer.
Who is at risk?
One of the main risk factors for testicular cancer is an undescended testicle. This is a condition that means one or both testicles fail to move from the abdomen into the scrotum before birth. Males with this condition (called cryptorchidism) are several times more likely to get testicular cancer. For this reason, doctors will perform a surgical procedure known as orchiopexy to bring the testicle down into the scrotum, usually when the male child is younger.
Other risk factors include:
Family history: While having a father or brother with testicular cancer increases your risk, only a small number of testicular cancers occur in families. Most men with testicular cancer have no family history of the disease.
HIV infection: Men with the HIV virus, particularly those with AIDS, are at increased risk.
Testicular cancer in one testicle: About 3% or 4% of men who have had cancer in one testicle will eventually develop it in the other.
Ethnic origin: Caucasian men are up to five times more likely than black and Asian-American men to get testicular cancer. The risk is highest among men living in the United States and Europe, and lowest among men living in Africa or Asia.
Signs and symptoms of testicular cancer
Symptoms of testicular cancer usually start to become apparent once the tumour grows into surrounding tissues and structures. See your doctor immediately if you experience:
- A painless lump in the testicle
- Swelling that makes the testicle larger than usual
- Pain or dull ache in the testicle or scrotum
- “Heaviness” in the scrotum or abdomen
- Fluid buildup in the scrotum
- Enlarged lymph nodes in the neck
- Pain in the back or abdomen
- Trouble breathing or shortness of breath
- Cough, sometimes with the presence of blood
- Chest pain
- Trouble swallowing
- Swelling in the chest
- Fluid around the lungs
- Weight loss
- Breast soreness or growth
- Signs of puberty in boys at an earlier age such as the voice deepening, and growth of facial and body hair
Testing for testicular cancer
Most testicular cancers are first found by men themselves. It’s important to check your testicles regularly to learn what is normal for your own body. Report any changes to your doctor.
Physical exam: During a physical exam, your doctor may check the scrotum for lumps, swelling or tenderness, feel your abdomen and groin for enlarged lymph nodes, listen to your lungs and feel your abdomen for enlarged organs.
Ultrasound: The ultrasound is used to confirm that there is a tumour in the testicle and to check its size, shape, location and density. It can also help your doctor tell non-cancerous (benign) tumours from tumours that may be cancerous (malignant).
Blood tests: Blood tests indicate how well certain organs, like the liver and kidney, are functioning and can help find abnormalities. There are “tumour markers” in the blood that indicate the presence of testicular cancer.
Removal of the testicle: If a lump is determined to be cancerous, surgery that removes the testicle and spermatic cord is the first course of action. The tissue is sent to a lab for further diagnosis to assist with determining the appropriate next steps in treatment.
Penile cancer is a disease in which malignant cells form in the tissues of the penis. In 2010, 155 Canadian men were diagnosed with penile cancer. In 2011, 39 men died from the disease in Canada.
Who is at risk?
Men who were not circumcised at birth may have a higher risk of developing penile cancer. You may also be at risk if you:
- Are age 60 or older
- Have phimosis (A condition in which the foreskin cannot be pulled back over the head of the penis.)
- Have poor personal hygiene
- Have or had many sexual partners
- Are a smoker or use other tobacco products
Signs and symptoms
Check with your doctor if you have any of the following signs:
- Sores, discharge and bleeding from the penis
- Redness, irritation, or a sore on the penis
- A lump on the penis
Testing for penile cancer
Physical exam: Your doctor will perform an examination to check the penis for signs of disease, such as lumps or anything else that seems unusual. A history of your health habits and past illnesses and treatments will also be taken.
Biopsy: A biopsy will remove tissue or fluid, or part of a lump or the entire lump for testing to confirm the presence of cancer.
Cancer is a major health risk for men, but the good news is that it can be beaten. Pay attention to your body, and take steps to reduce the risk factors that you can change such as diet and exercise. If something doesn’t feel right, see your doctor. Remember that there is a strong chance that early detection could save your life!
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