I AM
JACK’S
P R O S TAT E
GLAND.
72 MEN’S HEALTH
I sit around his urethra, just below
his bladder. If I’m in good shape, I’ll be
a little bigger than a walnut. I produce
an alkaline fluid that is about a third
of what makes up his semen, and my
muscles help him to ejaculate. One
day, if Jack lives long enough, I will
get cancer. And it could kill us both.But will it? Let’s examine the facts.
Prostate cancer is the most common form
of cancer for men in the UK, but it does
discriminate. Our risk is higher if our
father or brother has had it. Black men
are more at risk than white men, with a
one-in-four chance compared to one in
eight, and Asian men have the lowest risk,
at one in 13. Obesity can put you in further
danger. Whether or not a man develops
prostate cancer also depends on how
long he lives. There’s plenty of other stuff
that can kill us first – heart disease, for
example. We’re also not at much risk until
our fifties, though it can strike sooner.
Here’s the good news. For those who
do develop prostate cancer, it’s no longer
an automatic death sentence. Far from
it. More than 85% of those diagnosed will
survive it (or, to phrase it somewhat less
positively, be killed by something else
first). In the 1970s, only a quarter of men
diagnosed lived beyond 10 years.
Now, with increased screening, men
are being diagnosed younger and with
less severe symptoms. Not too long ago, if
you were over the age of 70, you wouldn’t
necessarily be treated at all, because
another ailment was likely to get to you
first – but this has changed, too. A fit manRobo-surgery is
still a fairly niche
specialism but,
with more funding,
that could be about
to change. “The
Da Vinci robot ‘miniaturises’ a
surgeon’s movements for accuracy
you could never achieve with the
naked eye and human hand,” says
Kumar, who has been a consultant
at the Royal Marsden since 2012.
Sitting in the operating theatre,GAME CHANGER # 1
THE SUPER
SURGEON
Mr Pardeep Kumar,
urological surgeon02
Kumar works the controls while
watching the procedure on a screen
as his actions are translated to the
robot in real time. “It also magnifies
things 20 times: something the
size of a peanut looks the size of
a tennis ball.” This helps surgeons
not only to remove the cancer in
its entirety, but to preserve the
structures around the prostate,
too. For example, it can negate the
need for urinary catheters, which
can be painful or embarrassing for
some patients. “We’re starting to
remove things that make people
fearful of surgery,” says Kumar.
“We can now reliably tell people
they’ll be back working on their
laptops within a day of their op.”of 70 today has a fair
chance of living another 15
years, and someone with
a nasty cancer at 75 can do
just as well as a 65-year-old
with the same condition.
Still, prostate cancer is
frightening. Its discovery
and treatment can erode
a man’s sense of self. It
can be undignified and
complicated. And it’s still
the third biggest cause
of death from cancer in
the UK, though it’s not
a case of kill or cure: in
some instances, you can
live with it. In between
the black and white of
diagnosis and treatment
is a morass of grey. So,
what do you need to know?UNDER THE SKIN
An enlarged prostate isn’t necessarily
a cancerous prostate. Its symptoms may
be uncomfortable – having to pee more
often, or a reduced flow – but an enlarged
prostate and its tightening grip on your
urethra are common by-products of
getting older. It’s these fairly non-specific,
irritating symptoms that generally
send men to their GPs. They’ll then be
examined. A typical exam will combine
a digital rectal exam (DRE), in which
the doctor feels for any abnormalities,
and a blood test to measure the levels of
prostate-specific antigen (PSA) in the