Move over Prostate

Retirement? When I was younger, I always cringed when I heard the word –it sounded so… so age-heavy. To admit to retirement, I felt, would be akin to admitting to constipation, or maybe a gradual shift to lentils. Like a tattoo branded on a cheek for all to see, retirement would label the owner as a member of an overly-grey group of people with liver spots and hidden incontinence that usually sat together on bus tours exchanging memories of the last one they took.

Retirement, I figured,  was probably the time you discovered that you weren’t what you thought you’d be when the word first came up. Everything would groan or ache, and things that used to work like a new car, would have shiny seats with the soft and flabby patina of aging skin, and there’d be a speed governor on the few horses that remained. So many things would either have changed or deteriorated that one might be forgiven for thinking that to ‘retire’ was in fact to ‘re-tire’ – or more likely, re-patch, given that Time and Obsolescence would have inevitably ensured that they no longer made the only tires that fit by then.

But nothing lasts forever -sometimes you do get old. And it dawns on you that you may have to shed some of things you were attached to, or try to live with damaged stuff that creaks.

Take the prostate for example -the young man’s gift and the old man’s curse. It’s a scary organ when you get older; cancer of the prostate is the second most common cause of cancer deaths in US men –and its prevalence increases with age. A recent issue of the Urology Clinics of North American suggests that ‘Of all new prostate cancer cases, only 0.6% are diagnosed among men younger than 44 years of age, with most cases being diagnosed at ages 65 to 74’. The article goes on to say that ‘Prostate cancer is generally asymptomatic until it has reached an advanced stage, a strong incentive to the widespread use of prostate-specific antigen (PSA)-based screening for early detection within the window of curability.’

PSA is a readily available blood test and many studies suggest we old guys should probably all get one… Well, actually the Clinics article lists several caveats: ‘Although higher PSA levels are a strong predictor of prostate cancer risk, the total PSA measurement is not specific for prostate cancer [italics mine] and is influenced by other factors, such as benign prostatic hyperplasia, prostatitis, and other benign conditions.  Consequently, many men undergo unnecessary biopsies leading to the overdetection of some indolent tumors.’ In other words, unnecessary treatment of something that may not ever become a threat. And if the risk of dying of something else sooner, say stroke or heart disease, is higher than that of prostate cancer, there’s some debate as to whether it’s even beneficial to screen for it -screening wouldn’t likely change the prognosis but might heighten the anxiety.

I’m certainly not taking a for-or-against position on PSA –I think it’s probably a pretty good thing to have around; I’m just pointing out that there’s a price to pay for everything -there’s no free lunch, as they say… Or is there? Maybe there’s a light snack of hope –or at least an appetizer.

We’ve all heard how good exercise can be for our general health –it seems to have a good effect on mood, on memory, and certainly on muscle tone and bone metabolism. So how about the prostate? I have to say I would never have thought of the lonely little prostate as one of the beneficiaries of exercise –I mean, given that its stuck way down in the nethers, and everything. But scientists will study anything, anywhere. And the BBC will duly report it:

At the current stage, of course, this particular study is just a proof of concept -the trial is only for a year, and only on 50 men who already have prostate cancer. ‘Half of the men will have weekly supervised exercise sessions, while the other 25 will only be given information about the benefits of exercise for cancer patients.’

‘Study leader Dr Liam Bourke said: “It’s early days yet, but the data that we do have suggests that exercise may actually be beneficial in terms of helping regulate the way that cancer cells grow and repair DNA.’

But it’s not the only study to look at the effects of exercise on the prostate; there was an even more fascinating one reported in January 2014 in San Diego at the American Association for Cancer Research – Prostate Cancer Foundation Conference on Advances in Prostate Cancer Research (they probably had to have two signs to advertise the conference -or at least use very small letters):  A team funded by this foundation discovered that, ‘Men who regularly walked at a brisk pace of 3.5 mph or greater before any prostate cancer diagnosis, had more normally shaped blood vessels in their tumors once a cancer did develop. Malformed blood vessels in a prostate tumor have been associated with an increased risk of developing lethal cancers.’  This was no doubt building on a previous study published in the Journal of Clinical Oncology in 2011 also looking at physical activity and its effects on men with prostate cancer which found that: ‘Men who walked briskly for 90 minutes or more per week lower their risk of death from any cause by 46% compared to men who men who walked less quickly and less often. Men who exercised vigorously (e.g., biking, tennis, jogging, swimming) three or more hours per week had a 61% lower risk of death from prostate cancer compared to men who exercised vigorously less than one hour per week. Both non-vigorous and vigorous activity lowered men’s risk of death from any cause.’

And guess what exercise also does? It helps to combat obesity! And guess what effect that obesity can have on the prostate? In another study funded by the Prostate Cancer Foundation, Dr. Adam Dicker in Philadelphia found that ‘men who were either obese or overweight had a higher risk of local tumor invasiveness at the time of their surgery to remove a cancerous prostate.’

So there does seem to be accumulating evidence that exercise may well be able to breathe life into a stone. ‘Our remedies oft in ourselves do lie, which we ascribe to Heaven’ as Shakespeare observed.

All I’m saying is that retirement lends itself as much to exercise as it does to reading. In fact, as Mark Twain once cautioned, ‘Be careful about reading health books. You may die of a misprint’.

Okay… I suppose this means my retirement should include more than naps and lentils. Good -I don’t much like lentils.


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