Let’s talk about Men’s Health

From time to time men are brought up with ideas like not to cry, not to complain and always show they are strong. This could also be the reason as to why a lot of men have a lazy attitude towards their health. Even amongst general talk, the most conversations lean towards women’s health and issues, how much do we really talk or know about men’s health?

A recently conducted survey revealed that men would rather talk about sports, current affairs, their jobs, kids etc. and not about health. [1] Women are always advised to get regular screenings and tests done in order to make sure they are healthy, but don’t men need to follow the same?

There is a need to create awareness among men about the various health conditions that could affect them in order to urge them to visit a healthcare professional regularly in order to get tested and treated. Urological conditions are rather common in men, they affect a variety of diseases affecting the urinary tract or the reproductive organs. Below listed are 5 of the most common urological conditions in men, their causes, symptoms and treatment options:

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Prostate Cancer – Diagnosis & Tests

Prostate cancer is the cancer of the prostate gland, and one of the most common cancers that affects older, adult men. Although this disease has been found in adult men of various ages, the risk of getting it increases considerably once men reach the age of 50. Which is why hospitals and doctors recommend getting checked for the risk of prostate cancer at least once, as early as the age of 40.  The standout feature of prostate cancer is that unlike other forms of cancer, it does not manifest itself in the form of any physical symptoms until it becomes too late. However, the argument for screenings for men is made of the fact that statistics show that those men that get diagnosed with prostate cancer early, have a nearly 90% survival rate. So what exactly do the tests for diagnosing prostate cancer entail?

Prostate cancer screening tests are two distinct types:

  • Digital Rectal Exam (DRE): Is a physical exam where the doctor inserts a gloved, lubricated finger into the patient’s rectum in order to examine the prostate gland. This test is carried out in order to find and identify any abnormalities in the shape, size or texture of the prostate gland.
  • Prostate Specific Antigen (PSA) test: In this test, a blood sample is drawn and analysed for the substance, PSA which is naturally produced in the body by the prostate gland. High levels of PSA in the bloodstream may be an indicator of prostate infection, inflammation, enlargement or cancer.

If the DRE and PSA tests lead to the detection of an abnormality, your doctor might recommend getting an MRI or a biopsy done. Both these additional tests are used to determine whether the initial abnormalities that were discovered are because of cancer or some other prostate disorder such as a prostate infection or prostatitis.

Once the presence of prostate cancer has been determined, it now becomes imperative to go forward and analyse the cancer cells for their degree of aggressiveness and their degree of spread during the time of diagnosis. In order to determine the degree of aggressiveness of the cancer cells, they are sent to be examined by a pathologist. Once examined, the cancer cells are then given a Gleason score. These scores range from 2 to 10 and indicate how likely it is that a tumour will spread. A low Gleason score indicates that the cancer cells are similar to normal prostate cells and are less likely to spread (less aggressive). Conversely, a high Gleason score indicates that the cancer cells are very different from the normal prostate cells and are more likely to spread (more aggressive).

Once a prostate cancer diagnosis has been made, your doctor works to determine the extent (stage) of cancer. If your doctor suspects your cancer may have spread beyond your prostate, imaging tests such as bone scan, CT scan, MRI, and PET scan might be recommended. Once the testing phase is complete, and the diagnosis and level of aggressiveness of cancer have been determined, the doctor then assigns cancer a stage. The stage at which cancer has reached is the most important factor in determining treatment options. The stages of prostate cancer are:

  • Stage 1 – This stage signifies very early cancer that’s confined to a small area of the prostate. When viewed under a microscope, the cancer cells aren’t considered aggressive.
  • Stage 2 – Cancer at this stage may still be small but may be considered aggressive when cancer cells are viewed under the microscope. Or cancer that is stage II may be larger and may have grown to involve both sides of the prostate gland.
  • Stage 3 – Cancer has spread beyond the prostate to the seminal vesicles or other nearby tissues.
  • Stage 4 – Cancer has grown to invade nearby organs, such as the bladder, or spread to lymph nodes, bones, lungs or other organs.

Knowing the type and stage of cancer helps the doctor decide what treatment option would be best suited for a particular situation.

Dr.Rahul Bhatt 

Specialist Urologist 

Aster Clinic, Bur Dubai (AJMC) 

Dr.-Rahul-Bhatt

 

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Prostate Cancer – It’s Causes and Symptoms.

The prostate gland is part of the male reproductive system and is located below the bladder and in front of the rectum. The size of the gland changes with age, being smaller in young men and larger in older men. Being a part of the male reproductive system, the prostate gland functions to produce and release a fluid that forms part of the semen.

Cancer is a condition in which the cells in a particular part of the body start growing uncontrollably and crowd out the normal cells. Cells in any part of the body can become cancer cells and spread to the other parts of the body. Prostate cancer begins when cells in the prostate gland, in men, start to multiply uncontrollably. Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland itself, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly. Unlike other forms of cancer, however, if detected early, prostate cancer has a very high rate of survival attached to it.

Despite the high rate of diagnosis for prostate cancer in older men, doctors have not been able to pinpoint one or more exact causes as to why prostate cancer presents itself in some men. What doctors do know is how the process of prostate cancer begins and spreads. Cancer begins when cells in the prostate become abnormal. Mutations present in the DNA of the cells cause them to grow and multiply more rapidly than normal cells would. These mutated cells continue surviving while the normal cells around them perish. The accumulating mutated cells form a tumour that can grow to invade the nearby tissue. These abnormal cells can also break off (metastasize) and spread to other parts of the body.

Although doctors have not identified a direct cause for the advent of prostate cancer in men, they have been able to identify risk factors that increase the chances of getting prostate cancer. These risk factors include:

  • Age: Statistics show that the older a person is, the more likely they are to be diagnosed with prostate cancer. The rate of diagnosis for men under 40 is 1 in 10,000. However, this rate shoots up considerably as the age bracket increases. The rate of diagnosis for men between the ages of 40 and 59 is 1 in 38, while the rate of diagnosis for men above the age of 60 is 1 in 14.
  • Family history/ Genetics: Another risk factor is the presence of prostate cancer in the family. If men in a family have a history of prostate cancer, then it is likely to be passed down onto the successive generations. Furthermore, if the women have a family history of containing the gene that increases the risk for breast cancer (BRCA 1 or BRCA2), then to the risk of prostate cancer increases for the offspring.
  • Obesity: Although there is no direct linkage between a high BMI and the risk of getting prostate cancer, it has been observed that obese men that have been diagnosed with prostate cancer usually suffer from the aggressive form of the disease.

One of the standout features of prostate cancer is also the reason why doctors strongly suggest that men over 40 get regularly screened for the disease, namely, that has no overt symptoms. Since prostate cancer starts in a relatively small gland, located in a relatively obscure position in the body, the disease stays silent for many years. In some cases, it has been seen in autopsies in patients that have died from other causes that they were suffering from prostate cancer as well, without having shown any physical symptoms for the same. However, in more aggressive forms of the disease, there are certain physical discomforts that can arise, these include:

  • A need to urinate frequently, especially at night; sometimes urgently
  • Difficulty starting or holding back urination
  • Weak, dribbling, or interrupted flow of urine
  • Painful or burning urination
  • A decrease in the amount of fluid ejaculated
  • Blood in the urine or semen
  • Pain or stiffness in the lower back, hips, pelvis, or thighs

However, these symptoms may also be indicative of the presence of other diseases such as Benign Prostatic Hyperplasia (BPH) or prostatitis.

Almost all forms of prostate cancer are adenocarcinomas, and they might vary between gestating slowly and gestating rapidly. Due to the lack of symptoms, until very late into the disease, physicians and doctors are usually adamant about their male patients above 40 getting checked for prostate cancer. Despite the widespread nature of the disease, there is still a lot of misinformation about it and a general lack of knowledge about it, amongst the general public. In the UAE itself, 20% of all cancer cases were those of the prostate kind. As men get older it is imperative that they get themselves checked for any signs of prostate cancer, because as mentioned earlier, early detection of the disease can go a long way in eliminating it from the body completely.

Dr.Nazeer Ahamed

Specialist Urologist 

Aster Clinic, Bur Dubai (AJMC)

Dr.-Nazeer-Ahamed

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