King Charles, the prostate, and your health

King Charles III does not have prostate cancer. That is about the only thing we know about the royal cancer patient’s condition right now.

But the news has gone worldwide this week, and that may be a boon for health, doctors say.

The Atlanta Journal-Constitution talked to a couple of cancer doctors at Emory’s Winship Center and at Piedmont Healthcare. Both emphasized they have no connection to King Charles’ care and any guesses would be pure speculation. But for patients in general, the case brought to mind some facts and tips.

For men who have signs of prostate trouble, the doctors said their top advice is to stop trying to power through the irritation and go get a checkup.

“Some men will not bring the problem forward to their doctor,” said Dr. Martin Sanda, chair of the Department of Urology at Emory University’s Winship Cancer Institute. “The key is getting on top of the problem early on.”

Some questions and answers about prostate health:

Q: What’s a prostate?

A: The prostate is a male organ in the pelvis that helps with the creation of semen. The tube that carries fluid from the bladder to the penis, the urethra, also runs through the prostate.

Q: Buckingham Palace reported that King Charles III had an enlarged prostate, but that he did not have prostate cancer. What’s the difference?

A: The prostate in men often grows bigger normally as men age. This benign enlarged prostate generally has an orderly growth, unlike cancer. Simply because it’s expanding, the enlarged prostate may start to press the urethra and make it difficult to urinate.

In contrast, when the prostate gets cancer, those growing cells can grow in ways that disrupt the natural organization of the organ, and may hurt or stop its function.

Whether a man has an enlarged prostate or prostate cancer, difficulty with urination may be a symptom of either.

Q: Urine trouble? Why not tough it out?

A: Enlarged prostate is common and can be successfully treated.

“When (enlarged prostate) becomes problematic there are two types of medications and several surgical procedures that can assist them,” said Dr. Walter Curran, chief of Piedmont Oncology at Piedmont Healthcare. “And it sounds like at a certain point, King Charles opted for a surgical procedure,” Curran speculated. “And most of those are quite effective.”

The most important reason to get any difficulty with urination checked, is that it could be a sign of prostate cancer. If it is, catching it early is a big help. In either case — whether benign or cancerous — a trip to the doctor can set a patient on the path to sort that out and make their life better.

Q: How is a guy supposed to know which expert to see?

A: When confronting urinary problems, start with the basics, Sanda said. “It’s really the primary care doctor who is the first point of contact.” They’ll assess the situation and may start with a medication or testing. If that doesn’t work, they may recommend the patient see a urologist.

Q: Wait. King Charles has cancer. But he doesn’t have prostate cancer. But he went in because of his prostate. Huh?

A: Buckingham Palace said Monday that “During The King’s recent hospital procedure for benign prostate enlargement, a separate issue of concern was noted.” It was diagnosed in “subsequent tests” as some form of cancer.

But that doesn’t mean it was noted by the pathologists sifting through his prostate tissue in the lab. Maybe it noted because King Charles mentioned that some completely different part of his body hurt. Nobody’s saying.

However, there are cancers that accidentally get noticed in the lab following surgery on an enlarged prostate, after the patient has already gone home and scientists are examining cells in the specimen. Such cancers may include different forms of bladder cancer, which may be quite fixable.

Q: Why is prostate cancer such a common cancer?

A: Sanda likened the phenomenon to breast cancer. “One could ask the question more broadly: You know, ‘Why is it that these secondary reproductive organs are so prone to cancer?’” Sanda said. “We don’t really know the answer to that.”

Q: Any other advice to lower the odds of prostate cancer?

A: Don’t smoke tobacco. Do eat a healthy diet.