I’m a Urologist, here are 7 questions about prostate cancer, answered

As we head into Movember, men’s health issues including prostate cancer, testicular cancer, and men’s suicide become the focus. Mr Alan Doherty, a Consultant Urologist at Spire Parkway Hospital in Birmingham, has answered 7 questions about prostate cancer. 

The prostate is a walnut-sized gland in males that produces a thick, white fluid that gets mixed with sperm to create semen. It is located below the bladder, in front of the rectum and surrounds the tube that empties urine from the bladder (urethra). Prostate cancer refers to cancer that starts in the prostate and is the most common cancer in men in the UK, affecting around one in eight men in their lifetime.

What are the five warning signs of prostate cancer?

The main early signs of prostate cancer all revolve around urinating. You may find it difficult to urinate, need to urinate more often (often during the night), have a weak flow of urine and feel as if your bladder isn’t completely empty even after you’ve urinated. A painful or burning sensation during urination or ejaculation, as well as blood in semen and urine, could also indicate that a person has prostate cancer. When prostate cancer spreads, it often affects nearby bones, which can cause pain and tenderness in these bones. It is important to note that the signs of prostate cancer are also shared by many other, less-serious conditions of the prostate. For example, benign prostate enlargement, common in older men, can cause similar symptoms.

What is the prostate?

The prostate is a gland found in males that produces a thick, white fluid that gets mixed with sperm to create semen. It is about the size of a walnut and sits below the bladder, in front of the back passage (rectum) and surrounds the tube through which urine leaves the bladder (urethra).

Where is the prostate located?

The prostate sits below the bladder, in front of the rectum and surrounds the tube through which urine leaves the bladder (urethra). You can’t feel a prostate from the outside. However, it can be felt when inserting a finger into the rectum.

What causes prostate cancer?

The exact cause of prostate cancer is unknown. However, certain risk factors increase your likelihood of developing prostate cancer, including being aged over 50, being of Afro-Caribbean or African descent, having a family history of prostate cancer and being overweight or obese.

Some studies also suggest that following a high-calcium diet increases the risk of prostate cancer but there have also been studies that have found no link. Once you have prostate cancer, there is no evidence that excluding calcium-rich foods slows down the growth of the cancer or reduces the chances of the cancer coming back.

 Is prostate cancer curable?

Prostate cancer can be cured, however, the success of treatment depends on how early prostate cancer is detected. Treatment is more effective when prostate cancer is detected in its earlier stages. There is no cure for advanced prostate cancer, but it is often treatable for quite some time. Many people outlive their condition. Often the prostate cancer grows slowly, and there are now effective treatment options that extend life even further. Overall, in England and Wales, 78% of people with prostate cancer survive for 10 or more years.

How do you check for prostate cancer?

In the UK, there is no national screening programme for prostate cancer. However, if there are signs that you may have it, your doctor will perform several tests to check for prostate cancer. 

Your doctor will ask for a urine sample to rule out infection and a blood sample to check for levels of a protein called prostate-specific antigen (PSA), which is often raised by prostate cancer. They will also perform a physical examination called a prostate exam. This involves gently inserting a gloved, lubricated finger into your back passage (rectum) to feel for any changes in your prostate ie changes in shape, size and texture. Your doctor may also recommend an MRI scan of your prostate to help detect any abnormal growths.

However, none of these tests can provide a definitive diagnosis of prostate cancer – PSA levels are not raised in one out of seven men with prostate cancer and around three-quarters of men with raised PSA levels do not have prostate cancer.

Collection of a tissue sample (biopsy) from your prostate for analysis in a lab is the only way to confirm the presence of prostate cancer. However, if you have borderline elevated PSA levels and your MRI scan is normal, you may not need a biopsy to rule out prostate cancer.

How often should I have my prostate checked?

As there is no national screening programme in the UK for prostate cancer, it is your choice whether and how often you want to have your prostate checked.

On the NHS, you can ask your GP for a blood test to check for levels of prostate-specific antigen (PSA), which is often raised by prostate cancer, from age 50. If you have a family history of prostate cancer or are of Afro-Caribbean or African descent, you can ask your GP for a PSA test from age 45.

Privately, you can ask your doctor for a PSA test at any age. They will discuss the advantages and disadvantages with you so you can make an informed decision about whether to go ahead. If you are healthy and have no prostate symptoms, a PSA test may cause unnecessary worry as around three-quarters of men with raised PSA levels do not have prostate cancer.

However, if you have worrying prostate symptoms, you should see your GP as soon as possible to have a physical prostate exam, PSA test and urine test

Source:  Spire