Dear Doc | My father has prostate cancer, am I at risk?

Q Dear Doc, I am in a predicament. I am 37 years old and five years ago, my father was diagnosed with prostate cancer. I was told then that I should start screening because there is a good chance I could get it too, but I don't want anybody putting their finger in my you know where (butt). I have not done the screening or seen a doctor for that reason, despite my other family members who keep asking if I have as yet. Is there some way around this?

A A very good question, as this concern is very common among men in our culture; a concern which has caused many their lives. Your family members are right. You are at increased risk of getting prostate cancer! Men who have a first-degree relative; that is a father or brother - with prostate cancer, are more likely to develop the disease. Men of African decent (black) are also more likely to develop prostate cancer than white and Hispanic men. African men are additionally also more likely to die of prostate cancer than white or Hispanic men.

Prostate cancer screening is aimed at finding cancer at an early stage. The good thing about prostate cancer is that it grows slowly, so the earlier it is detected, the less drastic your treatment will have to be.

Now here's where I allay your fears.

Prostate cancer screening involves a blood test that measures a protein produced by the prostate that is called prostate-specific antigen (PSA).

The PSA test measures the amount of PSA in a sample of blood. Many men with prostate cancer have an elevated PSA value; however, a high level does not necessarily mean there is cancer.

There are other causes for an elevated PSA, the most common being benign prostatic hyperplasia; a non-cancerous enlargement of the prostate. Other causes include prostatitis (a prostate infection), trauma (e.g., from riding a bicycle), and sexual activity.

For this reason, you should avoid ejaculating or riding a bike for at least 48 hours before having a PSA test.

The dreaded 'finger in your you know where' is called a rectal examination.

A rectal examination is sometimes recommended to screen for prostate cancer, when there is an increased PSA value. However, studies have shown that a rectal examination is not an effective screening test for prostate cancer.

This doesn't, however, mean that an increased value should not be ignored.

The first step in evaluating an elevated PSA is to repeat the test. Your doctor may decide to treat you for a prostate infection before repeating the test. Once again, you should avoid ejaculating and riding a bicycle for at least 48 hours before repeating the test.

If the PSA remains elevated, further testing is usually recommended, and maybe a prostate biopsy if cancer is suspected.

Prostate cancer is not commonly found in men younger than 50 years old. For that reason, screening should usually begin at that age for men at average risk for developing prostate cancer. However, for men with risk factors for prostate cancer such as yourself, it is recommended to begin screening at age 40.

So you have a few years before you start screening; however, I do suggest you start the discussion with your doctor.

 

Annoying bump on eyelid

 

Q Dear Doc, I have a bump on my eyelid and I don't like it. It started small then got to the size it is now. It is not getting any bigger, but it's not getting any smaller, either. It's not hurting, but it looks very ugly and annoying. People tell me it is a 'hog sty', and that it will go away, but it's two weeks now and it is still there. Do I need to see a doctor?

A What you have been told that you have is called a stye, or 'hog stye' colloquially.

Old-time people used to say you get one when you give somebody something and then take it back.

However, what you seem to have is a chalazion - a painless lump in the eyelid.

It is caused by a blockage in a gland that makes tears.

It is different from a 'stye', which also causes a lump on the eyelid, but is caused by an infection and is painful.

A chalazion also lasts longer than a stye does.

Do not squeeze or pop your chalazion.

To help resolve it a bit quicker, you can put warm compresses on the chalazion. To do this, wet a clean rag with warm water and put it on your chalazion. When the rag cools, reheat it with warm water and put it back on the chalazion. Do this for 15 minutes, four times a day.

In most cases, a chalazion goes away with the warm compresses within a few weeks, and sometimes even goes away on its own. If it does not go away, you may need to visit an eye doctor, who may do a procedure in their office to remove the chalazion or inject a medicine into it to reduce the swelling.

deardoc@gleanerjm.com