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Preparing for a Prostate Exam!

Thanks to the incredible generosity of Bupa, the fear that has haunted me ever since finding out what a prostate exam entails, is about to become a reality! For those that don’t know about my charitable 90mile trek, where have you been :), Bupa have previously provided us with some top tips to get in shape and protect ourselves. They’ve clearly seen that I’m in no fit state to be doing the trek and have invited me down for the morning to have a full over assessment. The part of this Health Peak assessment I’m focusing on right now is the prostate exam bit! The thought of this is making me agitated because: a) I may have prostate cancer and find out probably while filming b) Internally, I’m allergic to latex haha OMG I hope they wear gloves, OMG what if it’s a woman! You can see the dilemma that I’m putting myself through. I only imagined this would happen at a later stage when I was so senile that I didn’t even know my own name and would happily let someone else wipe my backside after leisurely tarmacking the care home bathroom. Unfortunately I’m compos mentis, we’ll sort of if you ask my friends. This is going to be a rough, but smooth I hope ride!

I’ll let you decide wether I should Facebook Live this session 🙂 Here’s what’s going to be featured: https://www.bupa.co.uk/health/health-assessments/health-peak
I am honestly so grateful and will be booking in shortly. It’s great timing too to raise awareness of prostate cancer, a charity which Syd is supporting on our Walk and something which affects 1 in 8 men.

So with the help from Professor Hashim Ahmed, Consultant Urological Surgeon at the Bupa Cromwell Hospital, here’s a few honest questions and answers about the whole process:

Most importantly, do I have to have a rectal exam to check for prostate cancer? The first test a doctor usually carries out is a simple blood test called Prostate Specific Antigen (PSA).  A rectal exam can help identify obvious abnormalities on the surface of the prostate even if the PSA is normal. If you have a raised PSA, or the rectal exam shows a lump, your doctor may refer you for a MRI scan in a specialised unit, which is a much more effective way of detecting prostate cancer. It’s important to note that your PSA can be high if you have prostate cancer but it can also be higher than normal if there is an infection, inflammation or you have a large prostate. Recent sexual activity before the test or cycling due to the pressure from a saddle can also raise your PSA levels, so make sure your GP is aware of anything that could affect the test.   If I need to get a biopsy, does it have to be through the back passage and does it hurt? A biopsy to check for prostate cancer involves taking tissue samples from the prostate. Some expert centres now only biopsy the prostate if the MRI shows suspicious areas. One of the common ways to biopsy the prostate is through the back passage, called transrectal ultrasound biopsy or TRUS biopsy. This procedure takes about 20-30 minutes and your doctors can discuss the biopsy and the side effects Some urologists now biopsy the prostate using the transperineal approach (through the skin behind your scrotum). This is a cleaner approach that is more accurate but it requires sedation or general anaesthetic to carry out.   Will I still be able to be sexually active if I have prostate cancer or have just undergone treatment? It’s safe to be sexually active if you have prostate cancer or undergoing treatment, however, you may experience some erectile issues depending on the type of treatment you have. Talk to your doctor for advice.   Are the side effects of prostate cancer treatment, such as erectile dysfunction and issues when going to the bathroom worse than actually having prostate cancer? Some prostate cancers are low risk and are better managed with active surveillance. This means we monitor the cancer because the chance of it causing any problems is very low. This is a very safe approach. For men who have prostate cancer that is medium or high risk, and if left untreated, they may experience local urinary and erectile side effects. It can also spread outside the capsule of the prostate and cause a range of other complications   I have heard prostate cancer doesn’t need to be treated, so why should I bother seeing the doctor about it? You should absolutely see your doctor if you experience any signs of prostate cancer. Although prostate cancer is a slow moving cancer, it’s best to catch it early. The new approach we take at Bupa to diagnose prostate cancer is with an accurate MRI scan before the biopsy, which means that we are more likely to accurately identify cancers that definitely should be treated. MRI interestingly has a lower chance of finding the low risk small cancers that don’t normally grow or spread. This means that doing an MRI before biopsy and targeting only those men with a suspicious MRI leads to fewer men being diagnosed with the sorts of cancers that don’t need to be treated. Once you are diagnosed, doctors will look at the risk of cancer. Medium and high risk cancers in men who are likely to survive 5-10 years or longer should be treated as leaving the cancer alone will cause problems from the cancer growing and spreading. So, the strategy for diagnosing and treating prostate cancer is much more refined than it was in the past in specialist centres that are expert at delivering the new diagnostic tests and new treatments that have fewer side effects. This pathway is available to patients that don’t have Bupa insurance as well as those that do.   Can prostate cancer make me infertile? Your prostate is a walnut sized gland that sits underneath your bladder and surrounds the urethra – the tube you pee and ejaculate through. Its main job is to help make semen which is the fluid that carries sperm. Cancer in the prostate can affect its ability to make semen, which can result in infertility through the normal conception route. However, your testicles can still proceed sperm and can sometimes be retrieved for artificial methods of conception. Some of the new forms of treatment can lead to some men still being able to normally conceive. Your doctor can talk to you about this.  

So there you go, there’s no better time to have a check up so thanks for reading and I’ll see you all on the dark side!

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2 comments

  1. I recently has a over 40s MOT and was quite disappointed to discover it didn’t involve having a finger stuck up my rectum to check my prostate. Not, you understand, that I enjoy such activities but because I believe I should have had it checked.
    Interestingly, on my recent trip to Australia, I attended a presentation at the Movember HQ for Kirk Pengilley, guitarist from INXS. He’s gone very public with his own experiences of having prostate cancer and the after effects. It was very enlightening to hear him talking about and very persuasive in terms of making me think about prostate cancer.
    I will also admit that some years ago, while having a different health issue investigated, I had the procedure done. Yes, it was by a female doctor. Awkward, yes, not enjoyable but only mildly uncomfortable. Even so, real men get their prostates checked. Good luck Phil.

    Reply

    1. Cheers John, unfortunately it’s in there in black and white, so to speak.
      Read your post about movember hq, really eye opening.
      5 weeks to go till our event, Achilles pain and sore shoulder. Every little helps to get me prepared.
      Phill

      Reply

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