We continue to mark Men’s Health Month this June with “Cancer Facts for Men”. It’s a must-read for any man who is interested in staying informed and healthy.

According to the National Cancer Registry of South Africa, 1 in 5 men are affected by cancer. As such, it is important that men become more aware of their risks and begin taking active control of their health. This article will provide you with specific information and practical advice so that you can take action where necessary.


What are the Signs and Symptoms?

If the cancer is caught at its earliest stages, most men will not experience any symptoms. Some men, however, will experience symptoms that might indicate the presence of prostate cancer, including:

  • A need to urinate frequently, especially at night;
  • Difficulty starting urination or holding back urine;
  • Weak or interrupted flow of urine;
  • Painful or burning urination;
  • Difficulty in having an erection;
  • Painful ejaculation;
  • Blood in urine or semen; or
  • Frequent pain or stiffness in the lower back, hips, or upper thighs.

    Who is at risk?

    Prostate cancer is uncommon in men younger than 45 years of age, but becomes more common with advancing age. The average age at the time of diagnosis is 70 years. However, many men never know they have prostate cancer. According to autopsy studies done on Chinese, German, Israeli, Jamaican, Swedish and Ugandan men who died of other causes, it was found that 30% of men in their 50’s and 80% of men in their 70’s had prostate cancer. According to the National Cancer Registry (Maqoqi et al, 2004), 1 in 24 men were diagnosed with prostate cancer. Having one or more close relatives with prostate cancer increases a man’s risk of getting this disease, as does eating a diet high in animal fat.

    How is Prostate Cancer Detected?

    Prostate cancer can usually be detected in its early stages by having a prostate-specific antigen (PSA) blood test and a digital-rectal exam (DRE). A PSA and DRE should be performed every year starting when you are 50. If considered high risk (e.g., have a close relative who had prostate cancer) then you should start having these yearly tests at age 40. It is also easy for a man to conduct a prostate self-exam:

    • Insert your clean index finger into the rectum (ensure that your nails are short and clean and use lube for increased comfort);
    • Once inserted, move your finger towards the front of the body to behind the penis;
    • Feel with the tip of your finger for a walnut-sized organ at the base of your bladder;
    • Its texture and firmness should be similar to that of the flesh between your thumb and the rest of your hand when you make a tight fist.

    If you feel anything that is as firm as your knuckle then consult with your doctor as soon as possible.


    What are the Signs and Symptoms?

    Symptoms may include one or more of the following:

    • A lump in one testis or a hardening of one or both of the testicles.
    • Abnormal sensitivity e.g. numbness or pain.
    • Decrease in libido.
    • Sexual withdrawal.
    • Build-up of fluid in the scrotum
    • Dull ache in the lower abdomen or groin.
    • A significant increase or decrease in the size of one testis. A testicle with a tumour may be severely enlarged (as much as 3 times the original size). Simultaneously the other testicle may be shrunken in size due to the fact that the tumour is taking the majority of the blood supply.
    • Blood in semen.
    • Generally weak and tired (malaise).
    • A testicle mass can be palpated and may be an early sign. Because of the success rate of testicular cancer, early detection is vital.

    Who is at risk?

    Most testicular cancers occur in men between the ages of 15 and 40. White men appear to be at greater risk than other races. There is some evidence that men infected with HIV are also at greater risk. One risk factor for testicular cancer is undescended testicles (where one or both testicles remain in the abdominal cavity rather than descending into the scrotum). Other pre-existing conditions (such as fertility problems or a rare complication of mumps called orchitis – painful swelling of the testicles) have also been noted as possible risk factors. Having one or more close relatives with testicular cancer increases a man’s risk of getting this disease.

    How is Testicular Cancer Detected?

    Diagnostic and treatment delay may have an impact on overall survival. The best chance of decreasing mortality is early detection. About 90% of testicular cancer begins with a lump on a testicle that is often painless but can be uncomfortable. In most cases, men may notice testicular swelling or enlargement, or have a sensation of heaviness or aching in the lower abdomen or scrotum. Any of these signs should be investigated as soon as possible.

    Performing a monthly testicular self-examination is easy:

    • A testicular self-examination is best performed after a warm bath or shower;
    • Examine one testicle at a time. Use both hands to gently roll each testicle (with slight pressure) between your fingers. Place your thumbs over the top of your testicle, with the index and middle fingers of each hand behind the testicle, and then roll it between your fingers;
    • You may feel soft tube-like/rope-like structures which are slightly tender to pressure – this is normal. Remember that one testicle (usually the right one) is slightly larger than the other for most guys; and
    • Feel for any lumps or bumps along the front or sides. Lumps may be as small as a grain of rice or a pea.

    If you notice any swelling, lumps or changes in the size or colour of a testicle, or if you have any pain or achy areas in your groin, let your doctor know right away. Sometimes, lumps or swelling may not be cancer related, but it should be checked anyway. Testicular cancer is almost always curable if it is caught and treated early.


    What are the Signs and Symptoms?

    The symptoms of anal cancer are not unique and share symptoms with other conditions, such as haemorrhoids. Although anal cancer is relatively simple to diagnose, there is often a delay in diagnosis because of a misdiagnosis.

    Symptoms of anal cancer include:

    • Lumps or bumps located near the anus;
    • Anal bleeding or bleeding during bowel movements;
    • Anal discharge;
    • Pain in or around the anus;
    • Itchy sensation around or inside the anus; and
    • Change in bowel habits, such as constipation, diarrhea and the thinning of the stools

    Who is at Risk?

    Anal cancer appears to be increasing (especially among gay men), with most cases being associated with a pre-existing infection with the human papilloma virus (HPV). While HPV infection seems to be important in the development of anal cancer, the vast majority of people with HPV infections do not get anal cancer. Most people know that smoking is the main cause of lung cancer. But few realise that the cancer-causing chemicals in tobacco smoke can travel from the lungs to the rest of the body. Many studies have noted an increased rate of anal cancer in smokers, and the effect of smoking is especially important in people with other risk factors for anal cancer. Other associated risk factors include being over the age of 50, having a high number of lifetime sexual partners, pre-existing genital warts, pre-existing fistulas (an abnormal

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