Prostate and colon cancer screening:
Going where the sun don't shine can save your life

by Hal Brown, LICSW


Women in the United States live on average 7.2 years longer than men. Men working in high stress jobs like farming, where they are subject not only to farm stress but to maintaining a veneer of self-reliance come hell or high water, die on average even sooner. If you take to heart what I'm about to write, it is more likely to save your life than all the self-defense tactics you've ever learned.

In a few hours I will find out if I have prostate cancer. This seems like a good time to start an article I probably should have written a long time ago. You can't pick up the paper these days without reading about a male celebrity, like New York Yankee manager Joe Torre (age 58) fighting prostate cancer, or Darrell Strawberry battling colon cancer. These are among the top three killers of men, and probably the top two among nonsmokers. They are also the most curable if discovered early.

If my urologist tell me the results of the biopsy I had last week is positive, but that the cancer is most surely localized (due to a low PSA test this is my hope if indeed it is cancer), then I will most assuredly opt for surgery to remove, and cure, the cancer. I'll survive because I stared having prostate exams and PSA tests when I turned fifty, five years ago.

If you are over fifty, and have not had a digital rectal exam to test for prostate enlargement or asymmetry, a PSA (Prostate Specific Antigen) test; and fecal tests and a scope of your colon for colon cancer, you are literally taking your life into your own hands. You might as well crash through the door of a drug house without a bullet proof vest.

But many male farmers would rather stand in a cold rain wearing leaky waders in knee deep water cleaning ditches for eight hours than have their nether regions probed. Is it manly to have a doctor's finger in your rectum? That should be a non-issue! Let me tell you, the doctor isn't having any more fun than you are. He (or she!) is intensely focused on exactly what your prostate feels like. The lucky, and life saving,  anatomical fact is that the side of the prostate that tumors most frequently develop on is the side next to the rectum. An experienced physician can feel abnormalities which could be tumors. Further tests become more invasive: a painless transrectal ultrasound may show a suspicious area and if so, a needle biopsy can sometimes be painful. All of these tests mean, to put it delicately, being probed where the sun don't shine.

None, however, are in the same ball park as dying of prostate cancer when it comes to pain. Colon cancer diagnosis is along the same lines, although the diagnosis made with a colonoscopy (the "Gold Standard") generally includes actually snipping out suspicious growths and is often curative if they are malignant and found early.

Mister Tough Guy

If you're a repeat reader of Cranberry Stressline, you know that I try to encourage self-awareness, and being more open with your feelings. I also know, as a farm stress therapist, that it is always better for  farmers to admit to themselves when they are afraid. These aren't exactly the traditional characteristics of the stereotypical rugged farmer, especially those in their twenties and early thirties. As middle age approaches I find many  become more philosophical about themselves and their jobs. If they don't, they often succumb to farm stress, they become cynical and angry. And they sometimes wall themselves off from their emotions, distance themselves from their families, and stop caring about their own physical and mental health. Indeed, it is like a slow suicide, often made worse with alcohol.

If this happens to you, what is the sense of seeing a doctor for an annual physical? You've really given up caring whether you live or die. If you're like this, hear me out: you might be killing yourself.

Personal Note

While biopsy is one of the more frightening words in the English language, one of the sweetest of all to hear from your doctor is the word "benign". To tell the truth everybody but me was convinced that my results would be negative. I'm the one who read extensively on the Web about what would be in store for me if the results were positive. That is what prompted me to write this article, which I hope will help others. There was a heart-stopping moment when the doctor looked at the report from the lab and said "give me a few minutes, I just want to give the head pathologist a call and speak to him". Those few minutes dragged on. But he came back smiling and said "good news".

The fact of the matter is that the odds were in my favor. But had the biopsy shown a localized cancer, there is little doubt that early detection would have saved my life. Just as it would for you.


Links

Prostate Health | Colon Cancer Links | Mayo Clinic Men's Health Center

American Family Physician Men's Health

Johns Hopkins Intelihealth

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