Prostate concerns after sexual abuse

Ask anybody you know what they know about prostate issues and the chances are they will wriggle in their seat and change the subject. We don’t have a regular screening service in the UK and we don’t talk about this issue enough. When we do there is often a fear of intimate examinations and cancer. For those who have also experienced sexual violence or abuse this can cause extra issues. Worry that a person will not understand your experiences can act as a barrier to getting help or support.

The truth is there are many things that can cause prostate issues and different tests and treatments that can be used for all of these. But with around 1 in 8 men being diagnosed with prostate cancer in their lifetime and 12,000 dying from it each year in the UK alone, it is time to talk about this subject and look at the support available.

Who has a prostate?
Mainly we think of men as having prostates but this is not a single-gender issue. Although most information about prostates refers to men, anybody with a prostate can develop issues. The following people have a prostate:

• Cis men (men who identify as male and were assigned male at birth)
• Trans women/women who identify as female and were assigned male at birth
• Non-binary people who were assigned male at birth
• Some intersex people

Prostate Cancer UK has some really useful information for trans women for those who are worried about their prostate.

Where is the prostate and what can go wrong?
The prostate is a gland which sits underneath the bladder and surrounds the urethra. Its main job is to make semen – the fluid that carries sperm.

Whenever people talk about prostate issues, they are often fearful of cancer. The truth is there are several things that can cause prostate issues (and which may also have symptoms similar to cancer) which include enlarged prostate and prostatitis which can also be treated.

According to the NHS, prostate cancer can often have no symptoms, which is why knowing about risk factors is important.  However, symptoms can include:

• Needing to pee more frequently, often during the night
• Needing to rush to the toilet
• Difficulty in starting to pee
• Straining or taking a long time while peeing
• Weak flow
• Feeling that your bladder has not emptied fully
• Blood in urine (pee) or semen.

Other symptoms can include bone and back pain, loss of appetite, pain in the testicles (balls) and unexplained weight loss.

Knowing your risk
Because prostate cancer often has few symptoms Prostate Cancer UK asks men and those with prostates to be aware of risk factors:

• Age – prostate cancer usually affects those over the age of 50 (or people aged 45 and above with other risks)
• Having a close family history of prostate cancer or breast cancer
• Ethnicity – it is known that Black men or those with a mixed Black ethnicity are more likely to get prostate cancer than other men.

Prostate Cancer UK has some useful information for trans women who want to know more about their risk.

I’m worried – what should I do?
If you are at all concerned about your prostate or your level of risk, the best thing to do is to contact your GP or doctor. But we understand this is not always easy, especially for survivors of abuse. Thankfully there are services that can help and lots of things you can do to take control:

• Ask to be seen by a trusted doctor that you feel you have a good relationship with.
• Book an appointment just to talk about your concerns and any next steps.
• Take someone with you for emotional support.
• Plan what you are going to do after an appointment. You might not want to carry on with your day as normal or perhaps you need time to yourself first.

The Prostate Cancer UK website has a lot of useful information about prostate issues and the range of tests that can be done to diagnose a problem. It is important to remember that whilst a rectal exam is a possible test, there are others available including urine and blood tests. Nothing would be done without your consent and you are the person in control.

Prostate Cancer UK has a helpline staffed by specialist nurses who can answer any of your questions and help you to put aside any fears. You can call them on 0800 074 8383. They also have a useful form you can take with you to the doctors so you can write down your worries beforehand.

Here at Notts SVS Services we understand that the impact of a sexual assault can make dealing with this issue even more difficult. We are able to offer support to any survivors of sexual violence who are worried about their prostate. Our helpline can provide a space for you talk and be heard. We can look at ways to help you cope. We will not judge. Our ISVA and Survivors Support Services can offer more practical support which might help you through this time.

Whatever your experiences, if you are worried, there is support available and you do not have to do this on your own.