Happy Movember! Or, "Happy that Movember is Almost Over" for some. Since Movember exploded out of Australia about a decade ago, this month has become synonymous with an excuse for men to grow bad facial hair (in some cases) in support of Prostate Cancer Awareness. But regardless of their varying levels of success - in my opinion, anything that gets men talking about their health is awesome.
Prostate cancer is the most common cancer in men in Canada - 26,000 new cases are diagnosed each year, and 4,000 men will die of prostate cancer this year. (However, lung cancer still has the highest mortality - killing more Canadians than breast, prostate and colo-rectal cancers combined). Symptoms of prostate cancer include changes in urination (increased frequency/urgency, weak/intermittent flow, difficulty starting/stopping flow), blood in urine/semen, or pain with ejaculation.
Screening methods include the infamous rectal exam and having PSA (prostate specific antigen) levels checked. Last month, a special task force to Health Canada recommended eliminating PSA as a standard screening tool, stating that test results were too often resulting in unnecessary diagnosis and treatment of cancer.
PSA levels can be raised for several reasons - prostatitis, BPH (benign prostatic hypertrophy) and prostate cancer are the most common. (Even ejaculation can transiently raise PSA levels for 6-24 hours). And symptoms of all of these conditions can have significant overlap. But a good doctor should take PSA levels for what they are - simply a reason to look further to see what's going on.
Further investigation will likely mean repeating the PSA at intervals to follow any rising trend. A urine test, ultrasound, xray or scope are all possibilities before the biopsy, the gold standard of cancer diagnosis. And even if it turns out to be cancerous (which is only 25% of biopsies ordered because of an elevated PSA), many tumours are so slow-growing that they don't even warrant aggressive treatment.
On the other hand, you can get a false negative as well - PSA in the normal range even though cancer is present.
Bottom line - should you get your PSA checked? I say yes (if you're 50+, have any of the symptoms listed above, or have a family history of prostate cancer). It's simple, cheap, non-invasive, and can be a useful screening tool if used properly. But remember - don't get worked up the first time your PSA levels are raised. And as much as you might want to - don't skip the digital rectal exam. It'll only take a minute, and it might save your life.
Reuben Dinsmore is a naturopathic physician in Vancouver, BC interested in opening up the lines of dialogue around health.