Prostate cancer: the facts
• Prostate cancer is the second most common male cancer in Ireland.
• Many men with early prostate cancer have no symptoms at all.
• Because you may not have symptoms, if you are a man over the age of 50, it is important to talk to your doctor if you have any of the risk factors outlined, below.
• There has been a large increase in the numbers of men diagnosed in recent years due to the increasing use of the PSA blood test.
• Prostate cancer responds well to treatment and, if detected early, it can be treated successfully.
The prostate and prostate cancer
The prostate is a small gland found only in men and is part of the male reproductive system. It is the size of a walnut and surrounds the first part of the tube (urethra) which carries urine from the bladder to the penis. The prostate lies close to the rectum (back passage) through which it can be closely felt and examined for its size. The function of the prostate is to make some of the fluid used to carry sperm.
Risks and causes of prostate cancer
The cause of the majority of prostate cancers is unknown. However, the risk of developing prostate cancer may be slightly increased with the following:
• Increasing age – Prostate cancer is quite rare in men under 50.
• Family history – If your father or brother is diagnosed with prostate cancer you are two to three times more likely to get prostate cancer yourself. If they had it at a young age your risk is greater still.
• Diet – the “Western diet,” which is rich in fats and low in fibre, may increase risk.
• Race – African-American and African-Caribbean men are more at risk than other ethnic groups.
Click here for more information about risks factors and causes of prostate cancer.
Signs and symptoms of prostate cancer
Early prostate cancer is often present without any obvious symptoms. However, if you have any of the symptoms listed below, make an appointment with your doctor.
• Dysuria – difficulty and pain passing urine
• Urgency- difficult to postpone passing urine
• Frequency- going to the toilet more frequently than before
• Nocturia- getting up more than twice a night to pass urine
• Hesitancy- taking time to get going when passing urine
• Flow- has become weak or intermittent
• Incomplete emptying – feeling that the bladder has not emptied
• Blood-present in the urine
Less common symptoms include:
• Trouble having or keeping an erection
• Lower back pain or pain in hips or upper thighs.
It is important to note that the prostate enlarges with age. It wraps around the urethra and this enlargement (benign prostatic hyperplasia – BPH) can cause bladder outlet obstruction which can lead to the above symptoms. BPH is more common than prostate cancer but the conditions may exist together. BPH is not cancerous but can be troublesome.
Click here for more information about the symptoms of prostate cancer.
What to do
If you experience any of the listed symptoms:
• Please make an appointment with your GP. He or she will determine the severity of your symptoms and examine your prostate gland. Examination involves a digital rectal examination (DRE) where the prostate is examined and felt by the doctor by using a finger in the back passage. The examination itself will be quick and painless, and will assess the size, texture and consistency of the gland and look for any irregularities.
• If discovered early, prostate cancer can be treated successfully.
How prostate cancer is diagnosed
Tests and investigations to diagnose prostate cancer include digital rectal examination and blood tests (PSA) by your GP which will be repeated again if you are referred to a urologist (specialist doctor). A rectal scan (transrectal ultrasound) and a biopsy of the prostate may be necessary.
You can read more about the PSA test here.
You can read more about other tests for prostate cancer here.
The PSA blood test explained
PSA is prostate specific antigen, a substance produced by the prostate sometimes but not always in higher quantities in men with prostate cancer. Other causes of a raised PSA blood test include benign prostatic hyperplasia in men with a large prostate gland and infection or inflammation in the prostate (prostatits). A raised PSA blood test does not mean that you have prostate cancer but that you may have an increased risk of developing the disease. If the PSA is raised, your doctor will talk to you about your options. Men in Ireland are not routinely offered PSA tests to screen for prostate cancer. There are many reasons for this, the most relevant being that although the PSA is prostate specific, it is not cancer specific. In other words the PSA can be raised for reasons other than cancer.
You can read more about the PSA test here.
Treatment for prostate cancer
Prostate cancer treatment will depend on:
• The type of cancer cells found at the time of diagnosis.
• The test results.
• The age of the patient.
• General health of the patient.
Some of the treatment options include: active surveillance (doing regular PSA blood tests and digital rectal examinations), surgery, radiotherapy (external beam or brachytherapy), hormone therapy and chemotherapy. Your doctor will discuss your treatment options with you. Some of these treatments may be used alone or together to treat some prostate cancers. It is often useful to have a friend or relative with you when the treatment is explained. Some patients find it helps to write down a list of questions before going to the appointment.
You can read more about the factors that determine the treatment for prostate cancer here.
How can I reduce the risk of getting prostate cancer
You may help to reduce your risk and look after your health generally by:
• Maintaining a healthy weight by combining a balanced, low fat diet with regular physical activity.
• Doing regular exercise –Try to do at least 30 minutes of moderate physical activity five times or more a week. The more active you are, the more you can reduce the risk.
Coping with prostate cancer
You can read our section about coping with prostate cancer by clicking here.
Side effects of treatment
Treatment for prostate cancer can cause a variety of side effects which can affect your mind, your body and your relationships. All of this can impact your sex life, some more than others. You can read about sex and prostate cancer here.
Some men experience urinary problems after prostate cancer treatment, including leakage of urine (incontinence). You can read information about this here.