Prostate Cancer
How common is prostate cancer?
95% of all prostate cancer patients are aged between 45 and 80. About
30,000 men in the UK are diagnosed with prostate cancer each year. It
has become the most common cancer in men overtaking lung cancer. With
PSA testing on the increase and an ageing population, incidence is predicted
to rise ahead of breast cancer over the next decade.
What causes prostate cancer? Is there anything I can do to reduce
the risk of developing it?
Little is known about the genes and molecular mechanism of prostate cancer.
Men with a brother or father with prostate cancer have a 3-5 fold increased
risk. It has few symptoms in its early stages. When symptoms occur they
may include difficulties in urinating or pain and/or stiffness in the
lower back and hips. However these symptoms are more commonly caused by
other conditions, such as benign (non-cancerous) enlargement of the prostate
or arthritis. If you have concerns, you should consult with your doctor.
How is prostate cancer diagnosed?
Early diagnosis of prostate cancer is important for successful treatment.
Diagnosis methods include the PSA Blood Test, which tests the level of
‘Prostate Specific Antigen’ in the blood; digital rectal examinations
to feel the size of the prostate gland and biopsies which take tiny samples
of tissue from the prostate. The PSA test is not specific for cancer and
‘raised’ levels can occur due to benign enlargement or inflammation
of the prostate gland. Microscopic examination of the biopsy is required
to confirm the presence of cancer.
How is prostate cancer treated?
Some prostate cancers grow so slowly that no treatment is needed. Instead,
an active surveillance policy is employed to monitor the condition. When
more active treatment is required surgery, radiotherapy, hormone therapy
or a combination of these treatments are used. Surgery, the removal of
the prostate gland, is known as a ‘prostatectomy’ and is commonly
used in the US. Both radiotherapy and prostatectomy are used in
the UK.
Will any treatment affect my sex drive and will I still be able to
father children?
Different treatments for prostate cancer can cause impotence, reduced
ejaculation, a lowered sex drive, urinary incontinence, bowel problems,
hot flushes and sweats and tiredness. Surgery, radiotherapy and hormone
therapy all have different side effects which need to be considered in
any decisions about treatment.
Will I lose my masculinity?
Treatment for prostate cancer is likely to cause infertility. This should
be discussed with your doctor before you start treatment.
Is the chance of developing prostate cancer influenced by dietary
or environmental factors?
Eating a diet high in animal fat and low in fresh fruit, vegetables and
fish and being exposed to cadmium (a heavy metal) or 'radiation' have
been identified as possible risk factors which may be associated with
prostate cancer. However research is still continuing in this area. Some
preliminary research suggests that Lycopene (the compound that gives the
tomato its appealing red colour), selenium and vitamin E in the diet could
play a preventative role in the development of prostate cancer.
I have heard about PSA screening. Is it necessary for all men over
a certain age to be screened?
The PSA test (Prostate Specific Antigen) can be used to screen for early
prostate cancer. A raised result does not necessarily mean you have cancer,
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
whether PSA testing should be used in routine screening for prostate cancer.
Many medical professionals feel it will 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.
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