The organ it affects is minuscule but prostate cancer looms large on the male health agenda.

The disease, which targets a male gland about the size of a walnut found below the bladder, is the most commonly occurring cancer in Australian men, according to an Australian Institute of Health and Welfare report released in August.

Currently, about 10,000 cases of prostate cancer are reported in Australia each year, and diagnoses are expected to reach 15,000 by 2011.

Do gay men need to be particularly concerned?

The disease mainly affects older men and there is no evidence the gay community in general is more at risk, according to Dr Robert Finlayson, director of Taylor Square Private Clinic.

But gay -“ and straight -“ men who take anabolic steroids or the anti-hair loss drug finasteride should consider more regular testing.

If you have any cancerous cells, there is evidence that the cancer will be more aggressive and grow faster in the presence of anabolic steroids or hair loss treatment, Finlayson said.

You’ve only got to look around at a gay dance party and you can see evidence of anabolic steroid use.

And because we use anabolic steroids to prevent weight loss or maintain weight in HIV-positive men, they should be looked at at an earlier age.

The general recommendation is that men over 50 should test for prostate cancer every couple of years, and annually after the age of 60.

Screening should involve a blood test and a digital examination of the prostate by a doctor. If prostate cancer is detected, treatment can vary from hormone therapy to radiotherapy or surgery.

If caught early, most prostate cancer responds well. This is why it’s important to be screened and examined -“ so that these things can be found early, Finlayson said.

In a small number of cases, men experience impotence after prostate cancer treatment. Retrograde ejaculation -“ when semen goes backwards into the bladder rather than out of the penis -“ is also a side effect on rare occasions, although this doesn’t affect orgasm.

Men with a family history of prostate cancer could face an increased risk, but diet and lifestyle appear to have little bearing. Nor does receptive anal sex.

Certainly there’s no evidence that being screwed regularly or irregularly has any effect on prostate cancer [developing], Finlayson said.

Nevertheless, gay men who have anal intercourse should have a rectal examination every two to three years anyway, to screen for any abnormalities or inflammation. This will also help detect prostate cancer.

While the doctor is doing that, he or she should routinely be examining the prostate, Finlayson said.

For more information visit the Prostate Cancer Foundation of Australia website.

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