Statistically, prostate cancer has been proven by the Jamaica Cancer Registry to be the most common form of cancer among men in Jamaica. It is also the leading cause of male-related cancer deaths in Kingston and St. Andrew. However, another ailment - prostatitis - also affects men.

Dr. Robert Wan, urologist at Medical Associates Hospital, explains the difference between the two. He told Flair that prostate cancer is a malignant tumour of the gland. It is an abnormal growth of tissue or a body part. The tumours are benign and usually slow growing and non-lethal. He pointed out that malignant tumours have the potential to grow out of control and spread to nearby or distant areas and can cause death.

On the other hand, prostatitis is an inflammation of the prostate gland. It may be acute bacterial (caused by an infection) or chronic bacterial. Most cases are, however, chronic and non-bacterial in aetiology.

Acute bacterial prostatitis is the least common of the four types, but also the easiest to diagnose and treat effectively. Men with this disease often have chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night, burning or painful urination, body aches, and a demonstrable infection of the urinary tract as evidenced by white blood cells and bacteria in the urine. The treatment is an appropriate antibiotic.

Chronic bacterial prostatitis, also relatively uncommon, is acute prostatitis associated with an underlying defect in the prostate, which becomes a focal point for bacterial persistence in the urinary tract. Effective treatment usually requires identifying and removing the defect and then treating the infection with antibiotics. However, antibiotics often do not cure this condition.

No Similarity

There is no similarity between prostate cancer and prostatitis, except that some cases of prostatitis may affect the PSA (prostate specific antigen), that is, a test for prostate cancer.

Dr. Wan said that men with acute prostatitis usually complain of fever, feeling unwell, a burning sensation and difficulty urinating. Those with chronic prostatitis usually complain of mild burning on urination; pain in the lower abdomen, testes and penis; pain in the lower back and frequency of urination.

Screening

However, men suffering from prostate cancer are usually discovered through screening. Dr. Wan said that the screening is similar to how breast and cervical cancer screening are done routinely in women. He added that screening involves seeking out the disease before it causes symptoms and is, therefore, more likely to be at an early stage, and thus curable. Screening for prostate cancer is done with two tests.

A rectal exam (DRE) to feel for abnormal areas of the prostate.

A blood test called the prostate specific antigen (PSA) that can often detect a cancer long before a lump can be felt.

If either of these two tests is abnormal, the patient should then undergo a prostate biopsy which is done with ultrasound guidance. In most cases, some men have an enlarged prostate due to benign prostatic hyperplasia. This a non-cancerous growth and may cause some difficulty in urination such as frequent voiding both night and day; the inability to suppress the urge to void, poor urinary stream and in severe cases, 'stoppage of water'.

These patients, Dr. Wan says, are usually evaluated with PSE and DRE to exclude prostate cancer since an enlarged gland may be benign or cancerous. He added that frequently, prostate cancer is not detected at an early stage because symptoms do not appear until the cancer is in an advanced stage. These symptoms are usually stoppage of water, weight loss, bone pain due to spread of tumour and even paralysis because of spinal cord compression.

- K.S.-B.

(Next week: Men battling prostate cancer and treatment of prostatitis and prostate cancer).