What you need to know about prostate cancer

Prostate cancer is the most common cancer in men in the UK. It usually affects older men, with the risk increasing with age. Nearly eight in 10 men who get it will recover and live for at least another ten years after diagnosis.

The prostate is a gland found in a man’s pelvis, just underneath the bladder. It’s about the size of a walnut and helps produce semen.

In most cases, prostate cancer is slow-growing and therefore, in much older men it may be monitored but not actively treated — this is because it is unlikely to cause significant problems in their lifetime.

However, there are some types of prostate cancer that are more aggressive, develop faster and need treatment.

What are the risk factors?

Aside from age, other risk factors include family history and ethnicity.

You’re more likely to develop prostate cancer if a close relative (such as a father or brother) has had it. Statistics also show that it affects black men more.

Being obese can also increase your chances of developing it.

What are the symptoms?

In its early stages, prostate cancer usually has no symptoms. As it progresses you might experience urinary and sexual problems.

Urinary problems can include a low urine flow, needing to urinate more often or blood in your urine. Sexual problems can include being unable to maintain an erection (erectile dysfunction) or blood in your semen.

If prostate cancer spreads, it can often spread to your bones. This can cause pain in your pelvis, chest or back.

Common symptoms of prostate cancer can also be caused by other conditions, so if you have any of these symptoms, it does not necessarily mean that you have cancer. If you do develop any of these symptoms, you should see your doctor to find out if any further action is needed.

Diagnosis

There are a number of tools that can be used to determine if you have prostate cancer or not.

• A PCA3 test
• CT scan
• Digital rectal exam (DRE)
• MRI scan
• Prostate-specific antigen (PSA) test
• Transrectal ultrasound

The first step is often a prostate-specific antigen (PSA) test. This is a type of blood test that assesses how much PSA you have in your bloodstream. Prostate cancer can cause higher levels of PSA in your blood, though having a high level doesn’t always mean you’ve got cancer. It can be caused by a number of other things too, such as an inflamed or enlarged prostate. A PSA test is used as a first step to decide whether more investigations are needed.

Your doctor may also perform a digital rectal exam (DRE). This involves carefully inserting a gloved finger inside your rectum to feel for any lumps or hard or soft spots on your prostate gland. It can feel uncomfortable but lasts less than a minute.

Both the PSA test and the DRE can help detect potential signs of prostate cancer, but abnormalities that get picked up can also be caused by other conditions. To know for sure whether you have prostate cancer or not, you’ll need to have a biopsy, where a sample of tissue is taken for analysis.

A PCA3 test looks for the PCA3 gene, which is found in higher levels in prostate cancer cells. It involves taking a sample of urine and examining the prostate gland.

Scans that can produce images of the prostate are also useful. These include an MRI scan, a CT scan and a transrectal ultrasound scan.

Treatments

If you are diagnosed with prostate cancer, your treatment will depend on your age, how far your cancer has advanced and your overall health.

If your cancer isn’t aggressive, your doctor may advise keeping it under close surveillance, but not treating it straight away. In this situation, you will have regular check-ups and exams to monitor how fast the cancer is progressing, including MRI scans and biopsies.

If your cancer is aggressive, then treatment may be needed.

Depending on the stage of your cancer, the treatment may aim to cure it, control it and stop it spreading, or ease symptoms and prolong your life.

Often a combination of two treatments is used. These can include surgery, radiotherapy, hormone treatment and chemotherapy. 

Both radiotherapy and chemotherapy involve killing cancer cells or stopping them from multiplying. With radiotherapy, radiation is used to attack the cells. With chemotherapy, drugs are used.

Surgery is the main treatment for early-stage malignant tumours where the cancer hasn’t spread beyond your prostate. It involves removing all or part of your prostate gland. 

Hormone treatment reduces the level of testosterone in your body, which will shrink the tumour caused by your prostate cancer.

Reducing your risk

The main risk factors for prostate cancer are outside of your control, such as age, ethnicity and family history. But there are some steps you can take to reduce your chances of getting it.

Obesity is a risk factor, so eating a healthy diet and making sure you maintain a healthy weight will help. Exercise will help you keep excess weight off. The Government recommends adults do at least 150 minutes of moderate exercise every week, or 75 minutes of vigorous exercise.

When it comes to your diet, try to control your portion sizes and avoid too much sugar and fat. Eat a diet that consists of 50% fruit and vegetables, 25% wholegrain carbohydrates and 25% protein from a healthy source, such as fish, beans or eggs.

Some studies suggest that eating tomatoes and making sure you get enough vitamin D can lower your chances of developing prostate cancer.

Smoking is known to cause several types of cancer because it releases harmful chemicals into your bloodstream. If you smoke, stopping is the number one thing you can do to improve your health.