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Embarrassing Bodies, 2:05am Tuesday 7th February 2012 on Channel 4. Catch up for free on 4oD »

Video

Dr Pixie:
Not many men know much about the prostate, yet prostate cancer is the most common cancer seen in men and kills over 9,000 people every year in England and Wales.

So what is it? Well, it’s a small gland between the penis and the bladder that surrounds the urethra—that’s the tube through which urine flows. It helps make the fluid that carries sperm out of the body during ejaculation.

As a man grows older, his risks of prostate problems increase significantly, especially after the age of 65. There are 3 main issues that can occur:

- Prostatitis is inflammation of the prostate gland and might include symptoms such as pain in the pelvis, discomfort when urinating and ejaculating. It can affect men of any age, and in its various forms, around 1 in 5 men in the UK will suffer from it. Fortunately it’s usually easy to treat with a dose of antibiotics, though chronic cases can require more invasive treatments, such as prostate massage.

- Another common prostate problem is what is known as benign prostate enlargement. The prostate continues to grow as men get older, so it can squeeze the urethra and slow or stop the flow of urine from the bladder. Treatment options for this condition range from medications to reduce the prostate growth, through to surgical solutions that remove portions of the gland. If you are a sufferer, there are also lifestyle changes that can be made to reduce the impact of the symptoms, such as avoiding drinking liquids before going to bed and reducing your caffeine intake.

- Thirdly, the most serious condition that can affect the prostate is a cancerous growth.

The underlying causes are not totally understood, but there are some risk factors that we know play a part. Age is important, as 70% of all cancer cases occur in men over 65. A family history of the disease also heightens risk, as does ethnicity, with men of African descent more susceptible. Diet plays a role as well, with men eating a western diet seemingly at a higher risk.

If you are displaying any symptoms I’ve been talking about, you should really talk to your GP about a prostate check-up. Many men are put off by this, perhaps due to the fact that the prostate is checked using a digital rectal examination, where a doctor inserts their finger into the rectum and touches the surface of the gland. If it’s hard and bumpy, it may be a sign of prostate cancer, while if it’s smooth and firm, it’s more likely to be a benign enlargement.

There are several options for treating prostate cancer, and what’s right for one man may not be best for another.

For some, the best treatment can be no treatment at all. If there’s not a significant risk that the cancer will spread, some choose not to undergo treatment as the side effects can include a loss of sexual desire, the inability to have an erection and sometimes urinary incontinence. In these circumstances, regular monitoring of the prostate is carried out to check for any worsening of the cancer.

If treatment is required, then the options include radiation therapy–-often utilising embeddable pellets—or hormone therapy, to restrict the male hormone that the cancer cells need to grow.

The most invasive treatment method involves a partial or total removal of the prostate, but in around 40% of cases, the cancer can spread to the surrounding tissue. In these circumstances, chemotherapy must be utilised as well.

Prostate cancer can’t be prevented, but you can take measures to significantly reduce your risks or possibly slow the disease’s development.

Diet is important, so eat plenty of fruit and vegetables and whole fibres. These all contain antioxidants that prevent cells from being damaged. The most important of these is called lycopene and it’s found in tomatoes, grapefruit and watermelon.

Avoid eating large amounts of red meat and dairy products and remember that exercise is also really important, as it strengthens your immune system and helps reduce the risk of cancer occurring.

So when should you get checked? Well, currently in the UK there’s no screening programme for prostate cancer as it’s not been proven that early diagnosis of the disease will significantly reduce deaths from it. Instead, if you start displaying any symptoms such as pain in your pelvis, weakened flow when urinating, pain when ejaculating or difficulty in emptying your bladder, then go and see your GP for a check-up.

Many prostate problems are benign, and numerous treatment options are available. Even in the most serious cases of prostate cancer, treatment is much more effective when caught early.

Read the video transcript

Dr Pixie presents a special video looking at the prostate and the various problems that can develop with it. The prostate is one of the few parts of the body that continues to grow as a man gets older, and this can lead to a number of problems that range from the benign, to the life-threatening. This video guide explains the process of getting your prostate checked, explains the various problems that can occur, and also provides advice on lifestyle changes that can be made.

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Comments and Questions

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i'm 56 years old and over the past few years when I ejaculate the sperm is very low ( sometimes nothing appears although i do have the same sense as normal) does this relate to protate cancer?





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when i urinate sometimes it crosses over like a spiral and then goes straight. can anybody tell me if this is normal please thank you.





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FOR A NUMBER OF YEARS I HAVE BEEN A PROSTATE TABLET(TAMLUSAN.IV SUFFERERD WITH A WEIGHT PROBLEM,DIGESTIVE PROBLEMS,AND LATLEY I HAVE HAD A CERTAIN AMOUNT OF ERRECTION PROBLEMS,WHERE I HAVE LOST INTEREST IN SEX.I HAVE NOTICED WHEN I GO FOR A WEE, SOMETIMS ITS VERY SLOW AND OTHER TIMES IT SEEMS A LITTLE FASTER I OFTEN GET CAUGHT OUT WHEN IM OUT WHERE I GET THE URGE TO GO AND WHEN I GET TO THE LOO ITS VERY SLOW IN COMEING.WHEN I GET THE URGE I VERY RARLY GET STIFF LIKE I USED TO IT JUST STAYS SMALL.





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eek i had that once !!

i have blood in my seamen for months now i was told it will leave by itself





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I WAS TOLD BY THE GP THAT I MIGHT HAVE THORASIC NERVE PROBLEMS. CAN THIS EFFECT THE PROSTRATE?





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i am currentley suffering form this problem it really hurts wen i got to av a pee please help me !





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I just saw the video and your comment and I need to tell you I HAD prostate cancer and I was treated with an alternative prostate cancer treatment called Hyperthermia, in combination with low-dose-radiation. Since no surgery, chemotherapy or high dose radiation are used, the side effects were none. I do not have erectile dysfunction, incontinence, and i have no loss of sexual desire. Actually my libido increased after the Hyperthermia treatment.

i had prostatitus,and was treated with a series of alpha blockers,i had a psa of 8.4 at one point which had me worried however i was reassured i was ok and the alpha blockers did start to have some success unfortunatly i was involved in a vehicle accident and the trauma caused my prostate to close completely nothing worked to shrink it again and i had a catheter for 3months eventually i had a procedure called turp to remove 40% of my enlarged prostate,my prostate is fine and the E.D i had as gone unfortunatly i am left incontinent with a bladder problem which is taking time to cure.but for guys liveing with a prostate problem that wont go away a turp procedure will help a lot and take away the constant feeling of needing to go 20 or 30 times a day...





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I have been suffering from prostate problems from last six years.on four occactions I discussed with my GP, Twiced I been in Hospital (Once with bad infection when I could not pass any water)My last appt.with my GP was on Nov.7 and I insisted he should do some thing about it otherwise I go to India and have a second opinion.Dr.agreed to do the PSA. I am still waiting for the result. In the mean time I went to India and seen two seperate consultants,both with different opionions. The results in India are,Enlarged in sige showing homogenous echtexture.Significant enlargement of median lobe seen bulging into blader lumen.Size of prostate=51X58X47mms Volume of prostate=50cc Volume of medion lobe=15cc Grade III prostrate enlargement with 30cc I came back to London even more confused and not knowing what is going to happen ? Please help.





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I have been diagnosed with prostate cancer and was told that it is "moderate." I was then told that I would be monitored with no treatment. I am 79 years of age and fairly fit, walking 15-20 miles a week. I was interested in the the new keyhole surgery to remove tha prostate completely and wondered if I could insist on having this procedure.





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I just read your comment and I highly recommend you to to the Hyperthermia combined with low radiation dose treatment. I had prostate cancer and this non invasive alternative prostate cancer treatment not only saved my prostate, but I was saved from the terrible sexual side effects that conventional therapies have: loss of sexual desire, no more erections (erectile dysfunction), diarrhea, and incontinence. You can find Hyperthermia clinics in Europe and USA

I have had radiation treatment for prostate cancer [locally advanced], and cryotherapy. I am 68. The pathology of the prostate in your patient described the cancer as " multi-focal : prostate unstable : small volume of cancer : the best kind of prostate cancer : no cancer spread". By giving the PSA and Gleason the informed viewer would be able to judge how reliable was the doctor's prediction of total success. 25% of people sexually active over 65 was stated in your programme. It was not stated if the keyhole surgery preserved the nerves which control erection. Keyhole and robotic surgery have greater ability to spare nerves. I am shocked that British surgeons give so little consideration to preserving sexual activity after prostatectomies. Impotence was a major fear for me, and following cryotherapy it is 100%. Research has shown that screening would save lives. In this country we do not even have an awareness programme. As you doctor observed the patient was lucky to prostatitis which resulted in his having a PSA test. A PSA test in my fifties could have saved my life. I have had years of treatment with side effects and emotional stress. It is unlikely that I will survive to my normal life span, so I can look forward to an unpleasant and painful death.





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It looks like no one else has asked this question, so please fill in the rest of your details below.





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