Movember is here! Please donate to my effort to raise money for prostate cancer research and patient support
This November, a.k.a. Movember, I have dared myself to raise funds to
fight prostate cancer. HOW? By trying to write and post 30 articles
about prostate cancer on this blog, while coping
with my ongoing cancer treatment.
Wish me luck, and please share this post.
And if you to donate: THANK YOU!
For this, the first of my 30 prostate cancer awareness raising blog posts, I'm going to start with the basics, like what is the prostate and what does it do? Hopefully, you won't be insulted by this, but in my five years of living with prostate cancer I have encountered a surprising number of people who didn't understand what this crucial male gland does, or even where it is. So let's get started with a helpful diagram:
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| Diagram showing the location of the prostate (adapted from public domain image) |
The prostate is a small gland that resides between the bladder and the rectum. Present in most people who are assigned male at birth, the prostate is about the size or a walnut or ping-pong ball. The main function of the prostate is to produce seminal fluid, the liquid that mixes with sperm to form semen. That puts the prostate at the heart of multiple critical bodily functions. And that makes treating cancer in the prostate very tricky, not to mention scary.
Basically, and I feel this is not acknowledged enough in conversations about prostate cancer, this cancer puts at risk the patient's ability to have sex, specifically erection and ejaculation. Why? During ejaculation, the prostate contracts to help propel semen through the urethra and out of the penis. Furthermore, the prostate is closely surrounded by nerves and blood vessels that control erections, and these can be damaged by prostate cancer treatment, potentially causing erectile dysfunction.
Because the penis also handles output from the bladder, the urethra passes through the prostate, as you can see from the diagram above. That's why an enlarged prostate impacts urination, and why one of the other risks associated with prostate cancer and its treatment is damage to "water management," meaning the ability to start peeing, stop peeing, and fully empty the bladder.
To be clear, it's not the presence of cancer in the prostate that affects sexual function so much as the treatment to remove the cancer. This is true of both surgery to remove the prostate and the use of radiotherapy and hormone therapy to kill off the cancer cells. I will be talking about this in more detail in future articles.
Given all this, you might be wondering: if the treatment comes with risks like that, why not just leave the cancer alone? A closely related question, one that my mum asked me, is: does prostate cancer hurt? In my case, the answer is "not so far," and that is the same for most men whose cancer, like mine, is confined to the prostate. However, some men do experience pain with "confined" or "contained" prostate cancer, and not all men experience pain when the cancer spreads — metastasises — to other parts of the body.
All of which makes things complicated to say the least. Having prostate cancer is not a death sentence, although it can be fatal, and in some cases extremely painful, but treatment can be painful too. This complex reality helps to explain why some men chose not to get tested for prostate cancer, and some who have it decline to get it treated. I hope to explore these aspects of prostate cancer in future articles.
Hopefully, this article has been helpful. If there is one important takeaway it's this: bear in mind that every case of prostate cancer is different, unique to each patient. This means that making assumptions about people based solely on "he's got prostate cancer" is a fool's errand. The effect of the cancer and the treatment of it varies from man to man. What is common to all cases of prostate cases is their capacity to induce fear, anxiety, and a sense of mortality that can sometimes be hard to handle.
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