prostate
cancer
What is the prostate?
The prostate is a male sex gland which produces a thick fluid that
forms part of the semen. It is about the size of a walnut and is
located below the bladder and in front of the rectum.
Prostate cancer: the facts
Today one man in 20 is diagnosed with prostate cancer, around
30,000 every year, and it has now become the most common cancer
in men - overtaking lung cancer. This is largely due to a likely
increase in the number of cases diagnosed, through the greater use
of PSA tests, and the influence of an ageing population.
About 10,000 men a year die from prostate cancer in the UK, which
makes it currently the second most common cause of cancer mortality in men
after lung cancer.
The majority of men with prostate cancer are aged over 60 years,
with an average age at the time of diagnosis of 75 years. Although
this cancer can also occur in younger individuals, it is very rare
under the age of 50.
Little is known about the genes and molecular mechanisms which
cause prostate cancer.
Prostate cancer can run in families. Men with a brother or father
who developed prostate cancer have a 3-5 fold increased risk. Two
prostate cancer genes have been reported, and may be responsible
for around 10% of familial cases. Further genes remain to be discovered.
The Institute of Cancer Research co-ordinates the largest UK study
in this area with teams working in 200 centres across Britain. The
Institute has also set up an international collaboration with six
other countries (Canada, USA, Australia, Norway, Italy and Austria).
Studies of Asian immigrants to the US show that whilst those brought
up in Asia have a low incidence of prostate cancer, Asians raised
to adulthood in the US acquire that country's higher risk. This
observation suggests that environmental and dietary factors that
are different between the two countries may influence the incidence
of prostate cancer. Diets high in animal fats and milk products
may be associated with a higher risk, and diets high in green vegetables
may be protective.
It has also been suggested that Lycopene (the compound that gives
the tomato its appealing red colour), selenium and vitamin E in
the diet may protect against prostate cancer.
What are the symptoms?
In its early stages, prostate cancer often does not cause symptoms.
But when they do occur, they may include any of the following problems:
-
- Difficulty in urinating
- Delays in urinating
- Stopping and starting urinating
- A weak stream of urine
- Urinating more often than usual
- Blood in the urine
- Pain and stiffness in the lower back and hips
It is vital that you do go and see your doctor as soon as possible
if you are suffering from any of these symptoms so that the cause
can be diagnosed and any relevant treatment administered.
Screening and testing
The PSA test (Prostate Specific Antigen) can be used to screen for
early prostate cancer. A raised result does not necessarily mean
that cancer is present. A positive biopsy is needed to confirm cancer,
which will occur in about one man out of every five.
If prostate cancer is diagnosed, it is not necessarily life threatening
and curative treatment many not be required - as most men diagnosed
with early prostate cancer following a positive PSA test would be
expected to have slowly growing cancer which should not cause any
problems during their natural lifespan.
There is controversy over whether PSA testing should be used in
routine screening for prostate cancer. Many medical professionals
feel it would be wrong to introduce national screening in this country
because the effectiveness of screening is unproven and the side
effects of treatment can be significant. As a result there is no
NHS PSA testing programme because it has not been demonstrated that
it leads to an improvement in mortality. However every man over
50 has a right to a PSA test if they request it and in the US many
men have regular PSA tests from the age of 50.
Men are advised to visit their doctor if they experience any of
the symptoms of early prostate cancer described above.
Treatments
The method most commonly used to treat prostate cancer varies in
different countries. In the US prostatectomy - removal of the prostate
- is common. In the UK where advanced disease is diagnosed more
frequently, radiotherapy is preferred. However, cases that are being
diagnosed earlier are making up an increasing number of the total
and prostatectomy is becoming more widely used in the UK. An alternative
is active monitoring or surveillance ensuring that the prostate
cancer situation is being carefully managed.
Conformal radiotherapy, a new treatment in trial at The Institute
of Cancer Research and The Royal Marsden NHS Trust leads to major
reduction in side effects, and therefore the possibility of giving
higher doses leading to an increased cure rate.
Both radiotherapy and surgery can result in impotence although
this is more common with surgery (50-80% of patients). Surgery may
cause incontinence whereas conventional radiotherapy may cause bowel
side effects.
Where can I get more information?
- Look at our further help page for links
to some useful cancer support organisations.
-
a copy of our male cancer information leaflet.
(This leaflet contains versions of the prostate and testicular
fact sheets).
Please click on to the following to have some of your main concerns
about prostate and testicular cancer answered by one of our male
cancer experts at The Institute of Cancer Research:
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