THE greeting is addressed to members of the human male aged 45 years and above. If there is any cancer, males are scared of, aside from lung cancer, malignant growth of the prostate gland comes a very close second.

Urologists all over the world are one in proclaiming that indeed, prostate cancer is the most common form of cancer in men.

Our two previous articles on liver cancer may have stirred the hornet's nest, so to speak because, all of a sudden, your columnist was getting more text and even frantic calls from men, this time asking about prostate cancer. As we all know by now, the prostate ( not prostrate ) is a small gland just underneath the urinary bladder; it encircles the first part of the urethra or the small tube that drains urine from the bladder as well as passageway of seminal fluid, the volume of which is also contributed by secretions from the prostate.

Typically, prostate cancer grows slowly although a few may grow fast. For the most past, prostate cancer persists for years without producing any symptoms so much so that many men die of other causes rather than an existing malignant growth in their prostate. Many epidemiologists explain that the geometric rise in prostate cancer registry is due to increasing use of screening procedures and lab test that now detect the cancer in its early stage. Usually, symptoms include frequent, painful urination with difficulty in initiating the urine flow. Others complain of weak or interrupted urine flow, or worse, painful ejaculation.

In med school, we were taught that there are two screening tests for prostate cancer. DRE or digital rectal exam is not the most pleasant physical exam procedure. With a gloved finger adequately lubricated, , the forefinger is inserted into the anal opening and up into the rectum, thus evaluate the hardness of the prostate- soft, firm to stony-hard.), the harder, the more probability that the prostate may be malignant.

PSA testing is a blood test that measures prostate specific antigen, a protein secreted by the prostate gland; that is, a high PSA may mean prostate cancer. However an elevated PSA is NOT diagnostic of prostate cancer because many other conditions may give rise to it. Now, even urologist admits that only 25% of males who have elevated PSA actually have cancer. The most common non-malignant condition that may give rise to high PSA is BPH-benign prostatic hyperplasia- just an enlarged prostate but whose biopsy yields non-cancerous findings. Prostatitis which is infection of the prostate gland- whether part and parcel of a complicated urinary tract infection or due to sexually transmitted illness like gonorrhea, may also increase PSA levels. And mind you for some men, the PSA level does not go up even if they have actual prostate cancer.

The take-home message is, aware of your advancing age, plus a more frequent visit to the bathroom especially at night, a weak slow stream of urine, on and off pain at the base of the penis, especially when it is erect or when the bladder is full plus a grainy feel along the first part of the urethra when urinating- it is wise to go see your family physician for a more thorough examination. In cancer prevention and detection, timing is essential!