Ask Your Pharmacist

November 5, 2020
Q:

I’m a 45-year-old man in good health. Is there specific testing I should ask my doctor about to prevent prostate cancer?

A:

This is a timely question because Movember (https://ca.movember.com/) occurs during the month of November. Movember is a campaign to raise necessary funds and awareness for men’s health with a specific focus on prostate and testicular cancer prevention (as well as suicide prevention).

Pharmacists are often the first point of contact to the health care system, and as such, we often get general health questions in addition to specific questions about medication. Pharmacists are happy to provide advice and point you to another healthcare provider if necessary. To provide some background to answer your question, I am including some information I found on from the Canadian Cancer Society website (www.prostatecancer.ca/Prostate-Cancer). Prostate cancer is the most common cancer among Canadian men (excluding non-melanoma skin cancers). It is the third leading cause of death from cancer in men in Canada. On average, 64 Canadian men will be diagnosed with prostate cancer every day and 11 Canadian men will die from prostate cancer every day.

The prostate is a walnut-shaped gland and is a part of the male reproductive system. The prostate is located in front of the rectum just below the bladder. The prostate provides nutrients and fluid to sperm. Prostate cancer often does not cause any signs or symptoms in its early stages. Signs and symptoms often appear as the cancer grows and causes changes in bladder habits or other problems. If you experience new, unusual, or bothersome urinary symptoms, contact your physician or nurse practitioner for assessment. 

The prostate-specific antigen (PSA) test is a blood test used to detect prostate cancer early.  Along with a digital rectal examination, a PSA is the best way to detect prostate cancer at an early stage when there are more treatment choices and when survival is the highest. When detected early the five-year survival rate for prostate cancer is almost 100 per cent.

Thank you to Dr Scott Bagnell, urologist with Horizon Health Network, for his interprofessional collaboration on the diagnostic content of this article (even though my Movember moustache is better than his). In general, it is reasonable to have a PSA level measured and a digital rectal exam performed by your doctor or nurse practitioner, starting at age 50. If your father or brother was diagnosed with prostate cancer before age 75, it is reasonable to have a PSA level measured and a digital rectal exam at age 45. See your physician or nurse practitioner if you have any signs or symptoms that you are concerned about.   

If you are experiencing new or bothersome urinary symptoms, talk to your pharmacist. It can be embarrassing for a man to talk about “his privates”. Trust me though when I say, you need not be embarrassed, pharmacists have likely heard a similar story before. The information you share with us is your private health information, and we take the privilege of your trust in us seriously. If you are anxious about having a digital rectal exam done, your pharmacist can provide you information about the procedure so that you can go to your appointment knowing what to expect. I have had a prostate exam in my recent medical history. I think it’s fair to say, it did not deserve the amount of worrying I did over it. Your pharmacist is there to answer those awkward and uncomfortable questions that you are sometimes too embarrassed to ask.  Sometimes the pharmacy is busy and crowded. Cue the pharmacist that your question is private, by saying, “Do you have a minute”? It’s that simple. The patient counselling area is available for this reason.

I challenge the men of New Brunswick this Movember to talk to your pharmacist about what you can do to prevent prostate cancer. Make the appointment you have been putting off with your doctor or nurse practitioner for prostate cancer screening. New Brunswick men, let’s do this.

Dr. Kevin Duplisea (PharmD BSc. Pharm, BSc. ACPR) is a pharmacist at Sharp’s Corner Drugstore in Sussex, New Brunswick. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.