My doctor has told me that I have cancer of the prostate, but doesn’t seem too worried about it, but I am! How serious is this? Can it be cured?
The prostate gland sits inside the body at the base of the penis, and secretes a fluid that lubricates the urine tube from the bladder through the penis, and supplies part of the man’s ejaculate during sex. Cancer can develop in this organ, but it occurs normally in old men and early signs include difficulty in passing urine, pain and bloody urine.
The seriousness of this (and most other cancers) depends on how far advanced it is when the diagnosis is made and treatment started. Doctors consider a five year survival after diagnosis to be equivalent to cure, and with cancer of the prostate, 70% of all patients survive for five years. If the diagnosis is made early, the survival rate exceeds 90%.
Treatments will involve one or more of several different medications, surgery to remove all or part of the prostate, radiotherapy (high intensity x-rays), removal of the testes (to stop the male hormone being produced that encourages the cancer to grow) and female hormone tablets.
It is possible that your cancer was diagnosed during an operation to clear a blocked urethra (urine tube). This operation, carried out by passing an instrument up from the end of the urethra, is the most common way in which this type of cancer is found, and if only a small number of cancer cells were detected, the operation you have already had may have cured the cancer.

I had a prostate operation ten years ago, and no problems since until recently. Now I pass a few drops of blood before the urine with my first trip to the toilet in the morning. As I don’t have a regular doctor, would appreciate your opinion.
The best thing you could do would be find a GP whom you like and trust. Ask friends and neighbours who they go to, then visit that GP for a routine matter. If satisfied, return to discuss your intimate problem, and let the doctor know that you intend to be a regular patient.
If you are not satisfied, keep trying until you find a doctor with whom you are compatible.
As far as your current problem is concerned, you do need to be thoroughly assessed, and in particular, your prostate requires further checking, both by blood and urine tests, and probably by a specialist urologist. It is likely that your prostate is causing the bloody discharge, but the bladder, sperm storage sac or even the testicles could be responsible.
Investigation and treatment as soon as possible would be appropriate.

I am 72 and I can’t pee very well any more. I have to stand for ages, and then go back again after half an hour. What can I do to speed things up?
The tube from the bladder to the outside in men runs through a golf ball sized gland called the prostate before passing along the penis. The prostate gland is responsible for secreting part of the semen a man ejaculates during sex. There is no female equivalent.
As a man ages, the prostate slowly enlarges, putting pressure on the urethra (the urine carrying tube) so that it is narrowed, and the urine has difficulty in passing. When you go to the toilet, the bladder is usually not emptied completely because of inadequate pressure to keep the narrowed tube open. Therefore the urge to pass urine comes on again after only a short period of time.
The enlargement of the prostate gland is normally benign in older men, but it can be due to a cancer. For this reason it is essential for any man with a poor urinary stream to be checked by a doctor. If a benign enlargement is the cause, a simple operation will set the problem right, and you will rejoin the jet set!

My prostate has been giving trouble, and my surgeon says he is going to remove it—through my penis! How on earth can he do that?
Impossible as it may seem, most (but not all) of the prostate can be removed through the penis.
The prostate secretes a fluid that lubricates the urethra (the tube that carries urine from the bladder to the outside) and nurtures sperm. It sits at the base of the penis behind the pubic bone. The gland is the size and shape of a small egg, but in older men it can enlarge to be two or three times this size. There is no cancer or other disease necessarily present when this enlargement occurs, but because of its position around the opening of the urethra from the bladder, it can constrict the outflow of urine from the bladder when it is enlarged (see diagram).
If the flaccid penis is held straight, it is quite easy (under an anaesthetic) for an instrument to be passed down the urethra to the prostate. This instrument has a sharp edged cup at the end, which is used to scrape away layer after layer of the prostate to remove any blockage that is present. The scrapings are then washed out of the bladder and urethra. In this way, a quite large internal gland can be removed through a very small rube.