Prostate Facts for Gay and Bisexual Men 2 Prostate Facts for Gay and Bisexual Men
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Prostate facts for gay and bisexual men 2 Prostate facts for gay and bisexual men About this booklet This booklet is for gay and bisexual men, and men who have sex with men. In many ways, prostate cancer and other prostate problems are the same for men whatever their sexuality – gay, bisexual or heterosexual. But if you’re gay, bisexual or a man who has sex with men, you might have some specific questions or concerns. We’ve included information about prostate problems and prostate cancer that may be more relevant to you as a gay or bisexual man, or a man who has sex with men. There’s also information about the support available to you. You can read our more general information on prostate cancer and other prostate problems in our other fact sheets and booklets. Ask your doctor or nurse for more details about your care and the support available to you. You can also speak to our Specialist Nurses, in confidence, on 0800 074 8383 or chat to them online. The following symbols appear throughout the booklet: Our Specialist Nurses Our publications Watch men tell their own stories in our online videos: prostatecanceruk.org Specialist Nurses 0800 074 8383 prostatecanceruk.org 3 Contents What is the prostate? ........................................................................................................ 4 What can go wrong? .......................................................................................................... 6 What is my risk of prostate cancer? .................................................................. 6 Testing for prostate cancer ......................................................................................... 9 Treatment for prostate cancer ............................................................................... 12 Side effects of prostate cancer treatment ................................................ 13 HIV and prostate cancer ............................................................................................. 20 Speaking to health professionals ...................................................................... 20 Getting more support ..................................................................................................... 22 More information from us ........................................................................................... 25 Other useful organisations ........................................................................................ 26 About Prostate Cancer UK ....................................................................................... 29 4 Prostate facts for gay and bisexual men What is the prostate? Only men have a prostate gland. The prostate is usually the size and shape of a walnut and grows bigger as you get older. It sits underneath the bladder and surrounds the urethra, which is the tube that men urinate and ejaculate through. Its main job is to help make semen – the fluid that carries sperm. bladder urethra penis prostate gland testicles Specialist Nurses 0800 074 8383 prostatecanceruk.org 5 6 Prostate facts for gay and bisexual men What can go wrong? The three most common prostate problems are: • an enlarged prostate – this is the most common prostate problem • prostatitis – an inflammation or infection of the prostate • prostate cancer. What changes should I look out for? If you notice any changes when you urinate or have trouble controlling your bladder (urinary problems), this could be a sign of a problem in your prostate. Urinary problems are common in older men and are not always a sign of a prostate problem. They can be caused by a urine infection or another health problem, such as diabetes, or by some medicines. If you have symptoms, get them checked out by your doctor. Specialist Nurses 0800 074 8383 prostatecanceruk.org 7 What is my risk of prostate cancer? Prostate cancer is the most common cancer in men in the UK. It develops when cells in the prostate start to grow in an uncontrolled way. About 1 in 8 men will get prostate cancer at some point in their lives. There’s no evidence that gay or bisexual men are more likely to get prostate cancer. Transgender women, who were born male, still have a prostate and they can also get prostate cancer. You may be more likely to get prostate cancer if: • you are aged 50 or over, or • you are Black, or • your father or brother has had it. If you are more at risk of prostate cancer, or if you have symptoms such as problems urinating, it’s a good idea to visit your GP. Or you can talk to our Specialist Nurses. Read more about prostate problems, symptoms and your risk of prostate cancer in our booklet, Know your prostate: A guide to common prostate problems. 8 Prostate facts for gay and bisexual men Specialist Nurses 0800 074 8383 prostatecanceruk.org 9 Testing for prostate cancer There is no single test to diagnose prostate cancer, but there are a number of tests that can be used to see if you have a prostate problem. These include a PSA test (see below), a digital rectal examination and a prostate biopsy (see page 10). Read more about tests for prostate cancer in our fact sheet, How prostate cancer is diagnosed. The PSA test This is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. PSA is a protein produced by normal cells in your prostate and also by prostate cancer cells. It’s normal to have a small amount of PSA in your blood, and the amount rises as you get older. A raised PSA level may suggest you have a problem with your prostate, but not necessarily cancer. However lots of things can affect your PSA level – not just a prostate problem. This includes being the receptive partner (bottom) during anal sex or having your prostate stimulated during sex. It might be worth avoiding this for a week before having a PSA test. You can have a PSA test at your GP surgery. You’ll need to discuss it with your GP first. At some GP surgeries, you can talk it through with the practice nurse, and they can do a test if you decide you want one. Read more about the PSA test, including things that can affect your PSA level, in our booklet, Understanding the PSA test: A guide for men concerned about prostate problems. 10 Prostate facts for gay and bisexual men Digital rectal examination (DRE) This is where your GP or practice nurse feels your prostate through the wall of the back passage (rectum). It’s a useful test to help diagnose a prostate problem. During a DRE, the doctor or nurse will ask you to lie on your side on an examination table, with your knees brought up towards your chest. The doctor or nurse will slide a finger gently into your back passage. They’ll wear gloves and put some gel on their finger to make it more comfortable. You may find the DRE slightly uncomfortable or embarrassing, but the test isn’t usually painful and it doesn’t take long. The doctor or nurse will feel your prostate for any hard or lumpy areas and to get an idea of its size. If your prostate is larger than expected for your age, this could be a sign of an enlarged prostate. If it is hard and lumpy, this could be a sign of prostate cancer. Read more about the DRE test in our fact sheet, How prostate cancer is diagnosed. Prostate biopsy If your test results suggest you may have a problem with your prostate, your GP will refer you to a hospital specialist for more tests, such as a biopsy. This involves using thin needles to take small pieces of tissue from the prostate. The tissue is then looked at under a microscope to check for cancer. This is usually done through the back passage. An ultrasound scan will be done at the same time to help guide the biopsy needles. You will have a local anaesthetic injection to numb the area around Specialist Nurses 0800 074 8383 prostatecanceruk.org 11 your prostate and reduce any discomfort. Some men find the biopsy painful, but others have only slight discomfort. A biopsy can cause some short-term side effects. It’s normal to see a small amount of blood in your urine or bowel movements for about two weeks. You may also notice blood in your semen for a couple of months – it might look red or dark brown. This is normal and should get better by itself. You can still masturbate and have sex. You might prefer to use a condom until the bleeding stops. If it takes longer to clear up, or gets worse, you should see a doctor straight away. If you are the partner receiving anal sex, wait until any side effects from your biopsy have settled before having sex. Ask your doctor or nurse at the hospital for further advice. You can read more about speaking with health professionals on page 20. After your biopsy, the samples will be looked at under a microscope to check for cancer cells. Your doctor will be sent a report, called a pathology report, with the results. This will show: • whether any cancer was found • how many biopsy samples contained cancer • how much cancer was present in each sample. If you are diagnosed with prostate cancer, you might need more tests to find out whether the cancer has spread outside the prostate. The results can show if the cancer is likely to cause any problems or symptoms or shorten your life. This will help you and your doctor decide if you need treatment and which treatments might be suitable for you. Read more about having a biopsy and getting your results in our fact sheet, How prostate cancer is diagnosed. 12 Prostate facts for gay and bisexual men Treatment for prostate cancer There are several treatments available for prostate cancer. Some treatments aim to get rid of the cancer completely, others to control the cancer. The stage of your cancer (how far it has spread), how quickly it might grow and your personal preference will all affect which treatment you have. You may have a choice of treatments. Your doctor or nurse will explain all your treatment options, and help you choose the treatment that’s right for you. Each treatment has its own advantages and disadvantages.