Men and the challenge of prostate cancer.

Abstract

Most men over the age of 50 have an extra health consideration to take into account with regard to the possibility of prostate cancer. A worrying trend is occurring: in the 1990s, bowel and lung cancer were more common in men than prostate cancer. However, by the end of 1998, prostate cancer was the most common cancer in men in the UK, accounting for 25% of all new cases (Office for National Statistics (ONS), 2011). This cancer is most common in men over 65, although current thinking (Cancer Research UK, 2011) suggests that its development begins at a much earlier age than that. This is why it is important to consider having checks around the age of 50 years. According to Ben-Shlomo et al (2008), men of African decent tend to be diagnosed at much younger ages and their prostate cancer grows faster than in men of other races. The fact that early-stage prostate cancer tends to be symptomless (silent) means that men may not always give it priority and get it checked by their GPs. Compared with many other cancers, prostate cancer grows slowly. This means that it can take 10–30 years before a prostate tumour gets big enough to cause symptoms or for doctors to find it (National Cancer Institute, 2014). It is therefore important that health professionals prompt men to be aware of this disease and consult their doctor for a chat or test. Community nurses are in a privileged position as they visit men in their own homes to initiate this discussion, and this may take several visits as some men may take longer to act on the advice. The anatomy and physiology of the prostate is given in Figure 1. The prostate is a small gland the size and shape of a walnut that helps to make semen, which carries sperm from the testicles through to the penis during ejaculation. The prostate lies low in the pelvis, below the bladder and in front of the rectum and surrounds part of the man’s urethra.