Practice Dialogue: Enlarged Prostate

The Diploma in Public Service Interpreting (DPSI) exam in Health is right around the corner, and so is Father’s Day! So I guess it’s the perfect time to set a question about a patient with an enlarged prostate. If you are taking the DPSI Health in June 2024, this dialogue should help you prepare for consecutive portion of Unit 1, the interpreting part of the test. But if you aren't taking the test this summer, this dialogue will probably be good practice!

Context: A patient’s daughter has come to talk about her father’s symptoms of an enlarged prostate. The GP gives information about the disorder, its causes and what may help the patient.

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Doctor: Hello, my name is Doctor Thompson, and I’m one of the GP’s here. How can I help?

Patient’s Daughter: I’ve come in today to talk about some of the symptoms my father is having. He’s 55 years old and he’s never had any problems like this before. I’m very concerned for him.

Doctor: Can you describe those symptoms for me?

Patient’s Daughter: Well, he needs to pee frequently. He says it can be difficult to start to pee, and that it is difficult to empty his bladder fully.

Doctor: I see. How long has he had these symptoms?

Patient’s Daughter: He said it’s been four weeks.

Doctor: Does he ever experience leaking?

Patient’s Daughter: I’m sorry, I’m not sure what you mean.

Doctor: Leaking is when a small amount of urine dribbles into your underwear. This might happen just after peeing. Or it can happen when you strain, for example after coughing or lifting a heavy object.

Patient’s Daughter: I don’t know if he is leaking or not, I’m sorry.

Doctor: OK, that’s fine. Does he get up to use the toilet in the night?

Patient’s Daughter: Yes, he says he frequently has to use the toilet in the middle of the night. He says he has not had a full night’s sleep for weeks now.

Doctor: Right. Let me bring up his medical record. Just a moment.

Patient’s Daughter: OK.

Doctor: Given what you’ve told me, it sounds like your father may have an enlarged prostate.

Patient’s Daughter: I’ve never heard of that before. Is it cancer?

Doctor: An enlarged prostate is also called benign prostate enlargement, or BPE. It’s a condition that can affect how you pee, but it’s not a cancer.

Patient’s Daughter: It sounds so frightening!

Doctor: Usually it is not a serious threat to health, so it’s not something to be too concerned about.

Patient’s Daughter: But does this prostate problem mean that he might get prostate cancer?

Doctor: The risk of prostate cancer is no greater for men with an enlarged prostate than it is for men without an enlarged prostate. So the risk is the same for any man of his age.

Patient’s Daughter: But why does my father have an enlarged prostate? He does not smoke and he has been trying to eat healthy foods lately.

Doctor: Actually, the cause of prostate enlargement is not known, but studies suggest that it is linked to hormonal changes. Men tend to experience hormonal changes when they get older.

Patient’s Daughter: Ah, so both men and women experience hormonal changes when they get older!

Doctor: That’s right. In the case of men, it tends to be increased levels of estrogen and increased levels of a type of testosterone called dihydrotestosterone.

Patient’s Daughter: I see.

Doctor: Some studies suggest that there is also a link between benign enlarged prostate and insulin resistance. Does your father have diabetes?

Patient’s Daughter: No.

Doctor: OK, that’s fine.

Patient’s Daughter: So what should my father do?

Doctor: You mentioned that he is trying to eat healthy foods. He should try to eat more vegetables, especially brassicas. Brassicas include broccoli, kale and cabbage.

Patient’s Daughter: OK. What about exercise?

Doctor: Yes, more frequent exercise is the next thing I was going to suggest. Ideally, he should exercise 30 minutes a day, three or four times a week.

Patient’s Daughter: He used to play tennis, but now he has bad knees so he does not like to play on hard courts anymore. He says he needs to find another activity that he enjoys.

Doctor: Perhaps he can take up cycling or swimming. That can avoid pressure on the knees. He should also avoid highly processed foods.

Patient’s Daughter: What are highly processed foods?

Doctor: They are foods that contain a lot of additives. Some examples include breakfast cereals, cheese, tinned vegetables, crisps and sausage rolls.

Patient’s Daughter: I understand. We will need to clear out the cupboards at home! I’ll make sure he does that.

Doctor: Finally, he should drink less alcohol. Does he drink regularly?

Patient’s Daughter: A little bit. I think sometimes when he is feeling bored, he will get a beer and just watch something on the television.

Doctor: Right. Well, it can make a difference if he can cut out the alcohol. Please encourage him to do that.

Patient’s Daughter: I will.

Doctor: Do you have any questions for me?

Patient’s Daughter: No, I don’t think so. I’ll speak to my father and let you know if he has other things he wants to ask you.

Doctor: OK. If his symptoms worsen, you can make another appointment for him.

Patient’s Daughter: OK, thank you very much!

Doctor: OK, bye.

Michelle Deeter (NRPSI, DPSI Law) is a Chinese-English interpreter based in Manchester. She teaches translation and public services interpreting at Newcastle University. She has over 450 hours of experience interpreting for medical and legal assignments. If you have questions about translation, interpreting or taking the DPSI, you can contact her at www.michelledeeter.com