a polite old English phase meaning to Urinate
Q: What is a rectal examination ?
A: A rectal examination also known as a digital rectal examination (DRE) is a type of physical examination during which a doctor or nurse inserts a finger into your rectum (back passage) to feel for abnormalities. Naturally the doctor or nurse wears a surgical clove and your rectum is thoroughly lubricated.
The doctor carrying out the examination will be able to feel any changes in the prostate, such as swelling and hardening. The prostate gland often becomes larger in older men.
Prostate cancer can cause the surface of the prostate gland to become hard and bumpy, while prostate enlargement doesn't usually affect the surface.
This examination by itself is not particularly accurate.
Q: My doctor now says he will do a blood test. What is that about ?
A: The blood test is to look for a Prostate Specific Antigen (PSA) a chemical discovered by Professor Richard J. Ablin in 1970 and produced normally by prostate cells. It is a type of chemical known as an enzyme, and it is believed to have a role in liquefying semen after ejaculation (which may help in sperm motility).
PSA is only produced by prostate cells (it is prostate specific), but is produced by both cancerous and non-cancerous prostate cells (it is not cancer specific). Although PSA is the best example we have of a marker for prostate cancer this non-specificity for cancer means that there are reservations about the interpretation of raised values.
Essentially, one of the following scenarios may commonly occur:
A man with prostate cancer may not have a raised PSA test (this is known as a false-negative result)
A man with a raised PSA may not have prostate cancer (this is known as false-positive result)
Recent introduction of age-specific ranges for normal PSA values was an attempt to make the PSA test a better one. Rather than use the absolute limit of more than 4 ng/ml most urologists now use the following values:
The amount of PSA in your blood is measured in nanograms of PSA per millilitre of blood (ng/ml). PSA levels can range from less than 1ng/ml to hundreds of ng/ml.
Age (Years) Reference Range (ng/ml)
40-49 <2.5
50-59 <3.5
60-69 <4.5
70-79 <6.5
The use of a PSA test by itself is not particularly accurate; you can read what Professor Richard J. Ablin has to say about it! The Great Prostate Hoax: How Big Medicine Hijacked the PSA Test and Caused a Public Health Disaster.
Q: The Oncologist has scheduled a MRI scan. How long does it take ?
The M.R.I. or Magnetic Resonance Imaging developed in the 1970s by an Englishman, Sir Peter Mansfield and an American Paul Lauterbur. This enables an image to be made of the prostate or any other part of the body.
Magnetic Resonance Imaging is a procedure as a number of scans are taken which can take some 30 minutes or more.
Two issues concerned Professor Mansfield. Firstly, the noise of the machine caused by rapid pulses of electricity and claustrophobia (fear of being in a closed space). You are given earplugs or ear protection and can even listen to music and as the prostate is located in the pelvic area you should go feet first. If not, ask to go feet first to reduce any claustrophobic feelings, and (tip) close your eyes.
M.R.I. scans and the images they produce are very important. 'A picture paints a thousand words' YOU MUST DO THIS!
Q: What is Hormone Therapy ?
Hormone Therapy, (tablets, injections or implants) works by stopping testosterone from reaching the cancer cells in the prostate and elsewhere in the body.
Testosterone is a hormone that controls the development and growth of the sexual organs, including the prostate gland. It also controls other male characteristics, such as erections and muscle strength. Most of the testosterone in your body is produced by the testicles, but a small amount comes from the adrenal glands which sit above your kidneys.
Testosterone doesn't usually cause problems, but if you have prostate cancer it can make the cancer cells grow faster by feeding the cancer cells. If you eliminate testosterone the prostate cancer cells shrink, wherever they are in the body.