Dr. Dan SperlingAs a woman, you don’t have a prostate gland. However, the men you love—your dad, brother, partner, close guy friend—have been equipped by nature with this small but important gland. The prostate gland has an essential role in reproduction. It manufactures the seminal fluid that carries sperm out of the body during orgasm. Since it’s so important, nature has safely tucked it in below the bladder where it is well protected in a man’s pelvic bed. It’s not easy to harm it from the outside.
Inside, however, is another matter. Under certain conditions, normal prostate cells can mutate and become cancerous. It is estimated that 1 out of 8 men will develop prostate cancer (PCa) in their lifetime. Some men are more at risk than others, due to factors such as family history, aging, occupational exposure to toxic substances, racial/ethnic background, and unhealthy lifestyle (poor diet, lack of exercise, etc.)
No one wants to hear, “I’m sorry to tell you that you have cancer.” Any cancer diagnosis can be scary not only for the patient but also for those who care about him/her. However, in most cases of PCa, there is no need to panic. For couples, the woman plays an essential role in joining doctor visits, being a second pair of listening ears, and helping gather information and research to the extent the patient is comfortable. Here are 5 general things every woman should know if the man she loves is diagnosed with PCa.
- Early detection is key. When prostate cancer begins, it has no symptoms. Yet, finding it early offers the best chance for 100% treatment success. Luckily, there is a simple blood test to screen for PSA. It is called the Prostate Specific Antigen test, or PSA test for short. All prostate cells have surface proteins, or antigens, that are shed into the bloodstream where the amount can be measured. When prostate cells are stimulated, more PSA is shed. The American Cancer Society recommends that at age 50, men start talking with their doctors about an annual PSA test to monitor.
- Making the PSA test more accurate. The PSA test is good, but it’s not specific; it’s just for PCa. Other conditions can cause more antigen shedding, such as infection, bike riding or sex before the blood draw, and noncancerous ageing-related prostate enlargement. Thus, a suspicious PSA test should not cause alarm. Doctors recommend 2 next steps before having a needle biopsy: a) wait several weeks and do a repeat blood draw to rule out lab error (hint: don’t ride a bike or have sex before the test). Then, if the result is still suspicious, move on to b) a special prostate scan called multiparametric MRI (mpMRI). mpMRI can determine if a biopsy is necessary.
- MRI-targeted biopsy for diagnosis. If the mpMRI identifies a suspicious area, the only sure way to diagnose if it is cancer is a biopsy or taking needle samples. This is like breast cancer, which requires a biopsy after a suspicious mammogram. Today, doctors and patients prefer precise MRIs targeting the suspicious area instead of taking random ultrasound-guided samples throughout the gland. Ultrasound can’t tell the subtle differences between normal prostate tissue and PCa. MRI-targeted biopsy, especially when done in real-time within the MRI equipment, uses a small number of needles placed accurately into the core area most likely to contain any dangerous PCa cells. This type of biopsy also has the least risk of side effects because of the minimal number of needles.
- Match the treatment to the disease. In most cases, when PCa is detected and diagnosed early, the cancer cells will be low-risk. This means they are slow-growing and not likely to become life-threatening. However, roughly 15% of cases will be more aggressive (intermediate-to-high risk). Experts agree that low-risk cancer need not be “over treated”, but higher-risk cancer should not be “under-treated.” It’s important to know that treating aggressive PCa involves removing or destroying the entire prostate. Given the gland location, there’s a chance of urinary, sexual or bowel side effects depending on the type of treatment. On the other hand, patients with low-risk PCa have other options such as Active Surveillance, or a focal treatment that destroys the cancer but spares nearby healthy structures—though some patients will still prefer aggressive treatment. The doctor, patient, and patient’s partner should have honest discussions about the patient’s disease, the treatment choices, their possible side effects, and lifestyle considerations. The best principle is, to match the treatment to the disease and the patient’s lifestyle.
- Treatment side effects. What if the patient is treated and ends up with temporary or longer-lasting incontinence, erectile dysfunction (ED) or bowel problems? Again, honest discussion with the patient’s doctor is the best policy. First and foremost, don’t give up hope—most side effects will resolve over time, so be patient and think positively. Also, there are great treatments to help a man return to his natural functions. Here’s where a woman’s understanding, empathy and support are so important. Studies show that when both members of a couple are good listeners and willing to experiment or adapt, there are happy endings.
Perhaps most important of all, if the man you love is diagnosed with PCa, it’s reasonable to expect that he will be in shock. He may need some space and time to absorb the news. Meanwhile, assure him of your love, then ask, “How can I help?” Yes, you have much to offer, but some patients may experience you taking the initiative as intruding. Take your cues from him and rely on the strengths of your relationship. Prostate cancer is a couple’s journey, and together you can come through it.
NOTE: This content is solely for information purposes and does not substitute for diagnostic or medical advice. Talk to your doctor if you have health concerns or questions of a personal medical nature.
