Men don’t like to talk about prostate cancer, which is a shame because a lot of us are going to get it. Ask a man to locate his gland and he will struggle, although he will be aware that diagnosis will involve a digital rectal examination (DRE). And to paraphrase the hip-hop classic, most men would rather forget about DRE.
In reality prostate cancer is an umbrella term for a number of different diseases. But you can break them down into two: wolves and dogs. A wolf cancer is the sort that killed my uncle: it quickly metastizised and spread through his body in a little more than six months. A dog cancer on the other hand grows slowly and coexists with its host. It’s said that 80% of men over 80 have some sign of the disease. But the crucial thing is that they are more likely to die with it, than of it.
All of which makes a new study by Oxford University intriguing reading. It followed prostate cancer patients for 10 years and found no difference in survival rates between those who opted to have their cancer treated aggressively with surgery and radiotherapy (often with unpleasant side effects), and those who opted for active surveillance, where the progress of the cancer was merely monitored. Anywhere science can replace the scalpel is welcome, but early detection is still key. And that begins with a conversation in practice, that many patients will struggle to initiate. In this battle the nurse’s ability to break the ice trumps the skill of the surgeon.
Mike Shallcross, acting editor, Independent Nurse