(July 2010) by Dr Warwick Palmer

At onset of midlife (that’s a broad one to define), our thoughts turn to prostate cancer, the almost universal scourge for old men. Yes, if we do live long enough, we should probably all develop prostate cancer eventually.

So what is really important to look out for, and what is worth checking?

For all men over 50, and some even in our late 40s, the prostate gland starts to enlarge. Situated at the base of the bladder, it concentrically enlarges around the bladder outlet and invariably takes its toll on urinary flow. “I’m no longer able to hit the wall doc”.

It is important to talk to your doctor about these changes. He or she will enquire about duration of symptoms, family history for prostate cancer, will likely examine your prostate through the back passage (“digital rectal examination”), and may order a blood test for PSA (prostate specific antigen), and kidney function.

Although there is a common impression that the PSA can confirm or deny prostate cancer, this is in fact not always the case. We can often get what we call both “false positives” or “false negatives”, so it is only a guide. Probably most important is:

  • what you tell us
  • any significant immediate family history (father or brothers)
  • physical examination findings.
  • Also, as with many medical conditions, the diagnosis of benign prostatic enlargement or prostate cancer may only declare itself over time with regular checks and monitoring.

    Finally, a word about the testicles. Check them yourself – the shower is a good place. The testes should be smooth and regular, the spermatic cord with vas deferens coming up from the back of the testes is a firm tube easily felt. Any extra lumps or bumps ... get them checked by a professional.