Six years ago, Anglican Bishop Laish Boyd said the best gift a person could give their family is health, after a routine annual health checkup detected he had elevated prostate specific antigen (PSA), which meant he had cancer in his prostate. It was in its very early stages, and he was successfully treated.
Meanwhile there are people like Valentine "Val" Maura, who has never been diagnosed with this life-threatening disease, but who fight daily to ensure their fellow men can receive an early diagnosis, treatment and give their family the precious gift of their health and life.
Prostate cancer is a life-threatening disease and a topic that most men 'sweep under the rug'. If they have it, they don't talk about it, and they don't bother to allow the doctor to perform the simple check to see if it's developing so that it can be caught in the early stages and be treated.
When it comes to prostate cancer, most men adopt a 'don't ask, don't tell' strategy. They see the disease, one of the most common types of cancer in men, as shameful and a threat to their manhood.
Prostate cancer occurs in the prostate, a small, walnut-shaped gland in men, which produces the seminal fluid that nourishes and transports sperm.
"For a long time, associated with prostate cancer has been erectile dysfunction, which means that the man either can't, or has problems, performing with his wife on an [intimate] basis," said Maura, a member of US Too, a prostate cancer education and support group. "Also, a lot of men don't get examined because they know they have to take a digital rectal exam (DRE), and when a doctor says you have to drop your pants, most men have all kinds of trepidation. Because of that examination, most men wait until it's kind of late."
It's recommended that men without familial history have the exam performed for the first time at age 40.
Maura, now in his 60s, is one of those men who did not have his first prostate examination until late in life. He had his first prostate exam at age 55.
"I wanted to know what my situation was and I was eager to find out what my condition was," Maura told The Nassau Guardian in an earlier interview.
But, he said, as soon as he got near the examination room, he became a little "chicken".
"I was real apprehensive when I found out what it entailed, but I said I had come that far and the only way I would find out my condition was to actually be examined."
Most men have no early symptoms of prostate cancer, but some have urinary symptoms and discomfort. Men of African descent are also considered to be at higher risk of prostate cancer.
Maura did the test and received a clean bill of health on his prostate. But along with relief, he said, came concerns as to whether the examination had been properly done and whether he was really safe. He has had his prostate checked every year since. He's not a survivor like Boyd and many other men, but he's willing to stand up and promote awareness of a life-threatening disease most men shy away from speaking about.
"I became interested in cancer some years ago, in the embryonic stage of the Cancer Society, some years ago. And I don't know if I have an inquiring mind, or a wavering mind, but if I get involved in something, I like to know about it as much as possible. I don't like to just be a member," he said.
Prostate Cancer Awareness Month is observed during September to bring recognition to the disease and the Us Too organization, where men can seek support.
More than a decade later, Maura said there has been a lot more openness about the disease and the test to check for prostate cancer, because men like himself and brave survivors have been talking about it. Despite the increased awareness, he said there needs to be even more talk among men. And he encourages them to discuss it the way breast cancer is so much more easily spoken about today than in years past.
The members of Us Too encourages that much-needed chat.
Over the years, prostate cancer screening statistics by Us Too have, for the most part, increased during prostate screening clinics staged by the organization, as awareness has also improved. In 2003, statistics showed a total of 313 persons were tested. In 2004, the number dropped to 231, then again in 2005 to 227. In 2006, a total of 481 persons were tested during the clinics, with 373 presenting in 2007. In 2008, a record 771 tests were performed, with 624 prostates checked in 2009; and last year, 687 men presented to have their prostates checked.
Statistics showed that most men reported that they took the test at the urging of their wives.
Maura says the information now suggests that men should have their prostates checked as early as 35, especially if they have a family history. He says prostate cancer is a disease that can be treated and men don't have to die from it if it's caught early enough.
"Men are worried about their manhood, but aren't doing much, or waiting too late to take the requisite steps to protect the very thing that could destroy their manhood," said Maura.
In an earlier interview with The Nassau Guardian, Boyd said the experience was one of the most frightening of his life, but he was glad he took action for himself and those who would be affected by his choices. He advised other people, especially men to take precautions and to take their health seriously.
"Your health is a gift you give your loved ones, so if you can preserve it, you should do all you can," said Boyd.
With several tests to detect prostate cancer the DRE is an early test to screen for the disease when it is most treatable. Maura said Us Too touts the DRE as it measures the degree of enlargement that a prostate has undergone and medical professionals are able to detect textural changes. A PSA blood test can be done in conjunction to the DRE.
"The PSA test alone won't be able to tell you what condition the prostate is in, because it has no way of measuring the degree of enlargement the prostate has undergone. There have been studies done that show that the PSA itself has no way of measuring what is happening to the prostate, so you could be falsely feeling safe or you could be way off the mark," said Maura. "The DRE measures the degree of enlargement the prostate has undergone and it has a certain texture that it develops because of the enlargement, and so therefore you need both to tell you the true picture, because you can have an elevated PSA count, but it cannot tell you what is actually happening with the prostate itself."
Maura says checking your prostate is an overall health concern, and younger men who don't take care of their prostates now will suffer from it later.
"A lot of people think when you get prostate cancer it automatically progresses to stage four and you die, but that's not the case. There's a process where it becomes an embarrassment; it becomes painful; it becomes everything before you eventually die. Men tend to want to protect their manhood, but they're dealing with the very source of their manhood," he said.
While there are no warning signs or symptoms of early prostate cancer, once a malignant tumor causes the prostate gland to swell significantly, or cancer spreads beyond the prostate, men may have a frequent need to urinate, especially at night. Other symptoms include difficulty starting or stopping a stream of urine; a weak or interrupted urinary stream; inability to urinate standing up; painful or burning sensation during urination or ejaculation or blood in their urine or semen. These are not symptoms of the cancer itself, but symptoms of the blockage from the cancer growth within the prostate and surrounding tissues.
Symptoms of advanced prostate cancer include dull, incessant deep pain or stiffness in the pelvis, lower back, ribs or upper thighs, and arthritic pain in the bones of those areas. Other symptoms include loss of weight and appetite, fatigue nausea or vomiting, swelling of the lower extremities and weakness or paralysis in the lower limbs.
Maura says he knows of people who are undergoing prostate cancer treatment who have finally come to the realization that they are not going to die and that the disease is not necessarily fatal.
"They now find that because they're undergoing the treatment, they're looking at it much better. They still haven't been brave enough to speak about it in a public forum, but they have at least come to grips with the fact that they don't have to die," said Maura. "Some are recovering from the surgery. Some only have one or two more regimens of chemotherapy and radiation and are realizing it's a whole different ball game than the death knell they thought it was when they first found out."

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