As part of Movember, we’re talking about Men’s Health issues. We’ve covered the low-hanging fruit, but now, very specifically, we’re talking prostate. Hands up those who know where it is and what it does? Hmmm. Not so good. As expected, most men know we have one, but not necessarily what the damn thing does. By the way, we will be frank and use common terms, so get over it.
It is a bit-bigger-than-a-walnut sized gland below your bladder and North-North-West of your asshole. About an inch inside your body, more or less, straight up from the middle of your taint. (Taint, or chode, or gooch depending on where you’re from – perineum for those of a medical mind, or that space between Yay and Nay)
It’s a fascinating little gland and here’s what it does: Your prostate secretes a slightly alkaline fluid that is about 25 to 30 percent of your semen. Not the sperm themselves, as that’s a nut job, pun intended, but the seminal vesicles pass up from the nuts via the vas deferens to the prostate and mix together to pass down your penis when you pop your cookies from watching “The Golden Girls” in reruns. (That Rue McClanahan…what a minx! Oh crap, that was out loud wasn’t it?)
The reason the prostatic fluid is slightly alkaline is to give your sperm a fighting chance in the Great Swim of Life. The vagina is acidic, so a bit of alkali lets the lads live longer, leading to fertilization, “was it good for you?” right up to “Yes Dad, it’s a really nice Home and we’ll come to visit you every weekend; we promise.”
The Creator did great, nay, fabulous work when He built Woman, but Jeeze Louise, male parts were not His best work: The design is merely functional, like reproductive organs designed by Ikea. It’s part of a system, but the illustrations are cartoon sketches and the instructions were written in Swedish, translated to Belgian, then Farsi, into Xhosa and finally English.
There are enough maladies that can befall the prostate that entire medical careers are built on it. It’s a very poor design, almost as bad as the knee, but at least the knee will stop working or swell up if you injure it. The prostate just sits there like a walnut, asking itself “Am I Coming or am I Going?” By the time a prostate is unwell enough to have symptoms, you could be in trouble.
There are two ways to check the prostate: The first, we’ll cover in this post. It is called a Prostate Specific Antigen test, or PSA Test. The PSA is a blood test, taken from blood from your arm. The lab folks look for an increased level of Prostate antigen, a chemical that indicates a fine, healthy, happy, prostate or an unhappy prostate depending on the change between tests.
Around the age of 40 to 45, men should have a PSA test yearly. Some docs say 50, other say 40, but what you want to do is start early enough that you know what your PSA level is over a few years. Mine’s normal, around 0.01 which indicates no issues with increased antigen production. If the numbers change from test to test, see your doctor. A change in the PSA is an early warning that something is not right and needs further investigation. A PSA test is not a diagnosis.
There are issues with the PSA test, both false positives and false negatives. There are also issues with, in the female department, PAP (Papanicolaou) tests, again false positives and false negatives. The usual protocol (be it PSA or PAP) is to repeat the test if the results are wonky, which is only sensible.
Up until 2009, you had to pay separately for a PSA test when you had your blood work done: It was usually $15. Now most health care covers it, so ask for it when you go to the doctor. Have the discussion. Your doc might not consider it important at your age, or, your doc might offer it. We’ll vote for asking for it as having a baseline result over a couple of years is a good thing. A PSA test hurts as much as having your blood taken hurts. Instead of four vials, they’ll take five vials. It is not a big thing.
Having a known PSA baseline is part of early detection. And we will repeat: A PSA Test isn’t a diagnosis, it just flags something for more investigation.
The second test we’ll cover in excruciating detail next week.
RoadDave 