Back behind the wheel: The uncomfortable truth about prostate cancer

by Dr. Christopher Singh

This month, I thought that it would be a good idea to talk a little bit about prostate cancer. I know, I know, most of us guys are very uncomfortable thinking about this topic let alone talking about it. However, it is extremely important to bring it out into the open as awareness about this topic will most definitely save lives. Recently, I went out for dinner with a few of my close friends and found out that my friend’s father, who is a medical doctor, was just diagnosed with severe prostate cancer. Even with all of his medical knowledge and training he still fell into the trap of denial when he first noticed the symptoms two years ago. Often, men are too afraid of what they will find out if they get the proper testing done, but it is this testing and subsequent treatment that will save their life.

Well, let’s get started with some anatomy. The prostate is a walnut-sized gland between the bladder and the penis and in front of the rectum. The urethra, the tube which carries urine from the bladder to the outside of the body, passes through the centre of the prostate. The prostate is not a vital organ, however, it is surrounded by many sensitive nerves and blood vessels that can be damaged as a result of the disease. Essentially, cancerous or malignant cells begin to replicate out of control most often in the outer part of the prostate. These cancerous cells begin to take the healthy cells forming a malignant tumor and in turn, increasing the size of the prostate. This increase in size often causes compression or invasion of the surrounding tissues which then leads to symptoms.

Although researchers still do not know the exact cause of prostate cancer, they have identified some risk factors which include the environment, genetics, family history and age. More than 70 per cent of all prostate cancers are diagnosed in men over 65 years of age. In addition, men who have a family history of prostate cancer have a two- to 11-fold increase in risk of developing it. Certain nationalities are also at greater risk for developing prostate cancer. According to the research, African-American men are twice as likely to develop prostate cancer as Caucasian men. As a result, earlier screening is recommended for African-American men. According to the American Cancer Society, men aged 50 and older, and those over the age of 45 who are in high risk groups should have a prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) once every year.

Now here comes the most important information to consider. Often, the early stages of prostate cancer do not cause any symptoms. However, as the tumour grows, it may spread from one part of the prostate to surrounding areas. Symptoms of prostate cancer may include:

* Frequent urination (especially at night)

* Weak urinary stream

* Inability to urinate

* Interruption of urinary stream (stopping and starting)

* Pain or burning on urination

* Blood in urine

* Difficulty in having an erection

* Pain in the lower back, pelvis or upper thighs

You should speak to your family doctor immediately if you have experience any of the above symptoms or if you are a man over the age of 50 who has not had a recent prostate cancer screening.

Determining whether you have prostate cancer generally involves a series of tests and exams. Before commencing the testing process you doctor will ask you questions about your medical and family history as well as the symptoms that you have been experiencing. After this, your doctor will likely refer you for one or more of the following tests.

Digital Rectal Exam (DRE)

Due to the fact that the prostate is situated in front of the rectum, your doctor can feel the prostate by inserting a gloved, lubricated finger into the rectum. This routine procedure is called a digital rectal examination. During the examination, your physician will be able to detect whether the prostate is enlarged or has lumps or other types of abnormal texture.

Prostate Specific Antigen (PSA) Test

The PSA test is most commonly used in conjunction with the DRE test to increase the likelihood of prostate cancer detection. PSA is a substance that is produced by the cells in prostate. In a healthy prostate, very little PSA escapes into the bloodstream. The two causes of high PSA levels are a condition causing a benign non-cancerous enlargement of the prostate called benign prostatic hyperplasia (BPH) and prostate cancer. PSA testing itself cannot confirm the presence of cancer as high levels of PSA only indicates the possibility of prostate cancer and the need for additional testing. To add to this, low levels of PSA do not rule out the possibility of prostate cancer.


During a biopsy, a physician will remove a sample of tissue from the prostate which is then examined under a microscope to check for cancerous changes. This is the only test that can definitely confirm the presence of cancer. If a diagnosis of prostate cancer is reached, the cancer is then categorized into stages based on the size and spread of the disease.

In terms of treatment, let me start by saying that early detection is the key to treating prostate cancer. Basically, the sooner you find it, the better your chances are for full remission. Over the years many different treatments for prostate cancer have been developed including surgery, radiation, hormone deprivation therapy, chemotherapy, dietary changes and the use of various herbal supplements. With this in mind, deciding which of these treatments to select is a difficult decision. Since there is no “once size fits all” treatment, each individual in conjunction with their physician must make his own decision as to which treatment is best for him. The best way to go about this is to collect as much information as possible before making a final decision. It is also advisable to seek out second and third opinions from other physicians as this will ensure that you are getting a complete assessment of your condition which in turn will allow you to make an informed decision about which treatment is best for you.

– Dr. Christopher Singh, B. Kin., D.C., runs Trans Canada Chiropractic at 230 Truck Stop in Woodstock, Ont. He can be reached at 888-252-7327, or email

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