I am worried about testicular cancer- how do I know if I’ve got it?
Testicular cancer tends to affect men between the ages of 20 and 45, although it can occur at any age. Overall however it is relatively rare. Men who have a family history of testicular cancer, and those who have had an undescended testicle in the past are at higher risk. The good news is that it’s one of the most treatable forms of cancer, especially if it’s caught early.
Testicular cancer tends to present as a painless lump within the testicle itself. It generally feels hard compared to the rest of the testicle. Occasionally pain may be a feature. It’s important that men know what their testicles feel like and the best way to do this is to examine yourself regularly, so if there are any changes they will be picked up. A good time to do this is in the bath when the scrotum is more relaxed and the testicles are easier to feel. If you do notice anything out of the ordinary, go and get it checked by a doctor. Remember, the earlier testicular tumours are picked up, the easier they are to treat.
I’ve heard about a blood test for prostate cancer - can you tell me about it?
There’s a blood test called PSA (prostate specific antigen) which tests for a protein which occurs normally in the blood stream which is produced by the prostate, and found in all men. Certain conditions cause a raised PSA level in the blood stream. These are benign enlargement of the prostate, which occurs naturally as men age, infection within the prostate or urine, and finally prostate cancer. The higher the PSA is, the more likely that there may be a prostate cancer .
The test is not perfect as many men with a slightly raised PSA don’t have prostate cancer. We also know that some men with prostate cancer have a normal PSA level. It’s important therefore that men having a PSA test also undergo an examination of the prostate as it’s the combination of the examination and PSA level that predicts the likelihood of prostate cancer. Your own doctor should be able to discuss this test with you, and if the PSA is raised, then a discussion with a urologist may be needed.
My dad’s just been diagnosed with prostate cancer - should I be worried?
Prostate cancer is more common in men with a family history of the disease. A significant family history is when a first degree relative (a father or brother) has been diagnosed. If your father has been diagnosed then your risks of developing prostate cancer are increased to roughly twice that of men without a family history of prostate cancer. If there is more than one man in your family who’s had prostate cancer, then the risks are a little higher.
We know that prostate cancer is very common in elderly men, and in many of these men the cancer grows very slowly. The age at which your father was diagnosed, and the aggressiveness of that cancer may also be important, and if your father was diagnosed at a young age with a more aggressive form of the disease, then this may be significant.
Men who have a strong family history of prostate cancer may benefit from having their PSA level checked regularly. PSA is a protein which can be detected in the blood and may be raised in cases of prostate cancer. A series of PSA tests may be more useful than a single one off test, as PSA levels tend to increase more rapidly in cases of prostate cancer. Many urologists would recommend having a PSA test every three years from the age of 45 in men who have a strong family history of prostate cancer.
My waterworks aren’t quite what they used to be - do I need treatment?
It’s very common to notice a change in your waterworks as you get older. This may be due to a number of reasons. The prostate tends to enlarge slowly from the age of 40 and this benign enlargement can obstruct the water-pipe and slow the urinary stream down a little. However, not all waterworks symptoms in men are due to an enlarged prostate, and changes in the bladder, drugs and fluid intake can also affect the waterworks.
It’s important to ensure that you maintain a reasonable fluid intake. Most of us need at least two to two and a half litres of fluid a day. The best way to judge if you are drinking enough is to look at the colour of your pee - it should be straw coloured and you should pass a reasonable volume when you urinate. Caffeinated drinks (tea and coffee) can also irritate the bladder.
Symptoms to watch out for are blood in your urine, which always needs investigating by a specialist, and infections and pain, which certainly need investigating in men. Also, if you have suddenly noticed that you are having to rush to get to the toilet and you are going a lot more often, then medical attention is required.
If symptoms are worrisome or bothersome then go and see your doctor. Many urinary complaints in men can be managed by changing drinking habits or simple medication. When symptoms don’t respond to medication and remain bothersome, then surgery may be indicated, and this is generally successful.
My erections aren’t what they used to be but I am too embarrassed to go to the doctor. What can I do?
There are now many successful and relatively simple treatments for erectile dysfunction (ED). In the past, before we had these treatments, men would have to accept ED as an inevitable consequence of getting older but the availability of these newer treatments has changed all this. ED can be caused by many things including diabetes, high blood pressure, medication, low testosterone levels, and previous cancer treatments.
Most GPs are very used to dealing with this common problem and talking to men with ED and as a consequence of this men are much more open about seeing their GP and willing to get help.
Viagra is a tablet which has transformed the lives of men with ED. There are now similar types of tablet that do a similar job to Viagra (Cialis and Levitra), but Viagra is now off patent which means it’s much more affordable. If tablets don’t work there are many other options including gels, suppositories, injections and pumps. Most gentlemen with ED will have their potency restored by one of these treatments.
If you do have ED, another reason to see your doctor is just to get a general check-up. One of the common reasons for men to develop ED is a furring up of the arteries as you age. This same process can affect other arteries in the body, including those that supply the heart, and we know that ED may be a marker for heart problems later on in life. Your GP can check your blood pressure and cholesterol levels to see if you do have any risk factors for heart problems and can also provide some lifestyle advice.