What is prostate cancer?
Prostate cancer is the most common cancer affecting men in the UK, with approximately 40,000 cases a year. It is a cancer of the cells in the prostate gland (the walnut-sized gland sitting behind the bladder) and is most commonly found in those over 65 years old.
It is different from many cancers as it can often only affect small areas of the prostate, causing very few symptoms and not reducing life expectancy. There are, however, some forms that are more aggressive and may require more extensive treatment.
There is no one clear cause of prostate cancer; it is likely to be linked to lots of different factors that increase its risk of developing, including:
- Family history
- Ethnicity – more common in Afro-Caribbean men
- Being overweight – also, a diet with high amounts of fat and low amounts of fruit and veg can increase the risk
Because prostate cancer is often slow-growing, there may not be many symptoms. As it grows, it may eventually press on the urethra (the tube carrying your urine) and cause partial blockage to urine flow. If this happens, it may cause symptoms such as:
- Increased frequency to urinate – you may need to pass urine more often than usual
- Poor stream – it takes longer to empty your bladder, and the flow isn’t as strong
- Incomplete emptying – you have a feeling of not quite getting rid of all the urine. You may get a bit of urine dribbling out after you’ve finished as well
- Hesitancy – you feel like you’re waiting at the toilet for longer than usual before the urine starts to flow
It is important to note that a lot of these symptoms can occur in older men, and they are more commonly caused by a non-cancerous growth of the prostate. There are some symptoms that don’t occur with non-cancerous enlargement, including:
- Passing blood in the urine
- Pain in the base of the penis
How is prostate cancer investigated?
If your doctor suspects prostate cancer, they can examine you and send you for some initial tests.
The examination is done by inserting a gloved finger into the back passage (anus) to feel the prostate.
A blood test can also be done to test for prostate-specific antigen (PSA), a chemical produced by cells of the prostate. If the levels are raised, there is a higher chance the prostate is enlarged. However, this test is NOT always accurate, as there are other conditions that cause the PSA test to be high.
If needed, doctors may perform a biopsy. Here, a fine needle takes a small piece of the prostate, which is then examined under the microscope. This is done with the help of a special scanner. In many cases, a biopsy is not necessary and an MRI scan can be done instead.
Screening of prostate cancer
Screening for prostate cancer is controversial. It is done using the PSA test, but this test may not be accurate.
There is no national screening program at present like there is for breast cancer for example, but you can discuss with your GP if you would like a PSA test.
Stages of prostate cancer
If prostate cancer is confirmed, other tests may be needed to see if it has spread. These include CT scan, bone scans or abdominal scans. Using all this information, the stage of prostate cancer can be determined and graded using a tool called the Gleason score. A score of 2 to 6 is low grade, and will most likely grow very slowly. A score of 7 is intermediate, and 8 to 10 is high grade, which could spread more quickly.
Prostate cancer treatment
The treatment options for prostate cancer vary a great deal and depend on each person’s specific cancer. Some of the strategies include:
- Active surveillance – watching and waiting
- Hormone treatment
- Drugs like goserelin and triptorelin stop your pituitary gland from producing hormones that stimulate the prostate
- Flutamide and cyproterone are medicines that block testosterone
Some treatment will just help symptoms, like painkillers and nutritional supplements.
There are some research and clinical trials about prostate cancer, with some new treatments being tested, but these are not available in all hospitals.
Prostate cancer outlook (prognosis)
The prognosis of prostate cancer is very variable; some don’t affect life expectancy at all, while others that have spread have a poorer outlook. Each person’s response to treatment is different as well.
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. myHealthSpecialist makes no representations as to the accuracy or completeness of any of the information in this article or found by following any link from this article. Please consult a doctor or other healthcare professional for medical advice.
5th year medical student