Prostate cancer is cancer of the prostate gland, it may develop slowly so there may be no symptoms for many months or years.
Prostate cancer is the most common cancer in men and 1 in 8 men will be diagnosed with prostate cancer in their lifetime.
What is the prostate?
The prostate is a small gland in men in the pelvic area. It is at the base of the bladder and surrounds part of the urethra.
This gland can grow and be a normal part of ageing. The prostate surrounds the urethra, therefore prostate enlargement can cause difficulty in passing urine.
Risk factors for the prostate cancer
1. Age: Increasing age is a risk factor. Prostate cancer mainly affects men over 50. The average age of men being diagnosed with prostate cancer is between 65-69 years.
2. Ethnicity: Men from Afro-Caribbean origin have higher risk of developing prostate cancer.
3. Family history: Men with a first degree relative (father or brother) who had prostate cancer have a higher risk of developing prostate cancer, especially if the relative was diagnosed before the age of 60.
4. BRCA gene: The risk of prostate cancer increases in men with BRCA 1/BRCA 2 gene mutation. BRCA gene also increases the risk of breast and ovarian cancer in women.
5. Obesity: There are links with obesity and prostate cancer. Staying a healthier weight and exercising regularly may be important.
What are the symptoms?
The symptoms of prostate cancer can be similar to other prostate conditions such as benign prostatic hyperplasia (BPH) which is a non-cancerous enlargement of the prostate, but men should seek medical advice if they have any of the following symptoms:
- Frequency – having to pass urine more often than usual
- Nocturia – waking up in the night several times to pass urine
- Hesitancy – difficulty in starting to pass urine and difficult emptying your bladder
- Weak flow of urine
- Urgency – a sudden strong urge to empty your bladder
- Blood in urine or sperm
- Other symptoms that can occur if the cancer has spread include back pain, bone pain, unexplained weight loss and loss of appetite.
Having these symptoms does not mean you have prostate cancer, however further investigations may be necessary and you should speak to your GP if you have concerns.
There is currently no screening programme on the NHS for prostate cancer. However an individual’s risk is assessed by their doctor and further tests are initiated.
PSA test – This is a blood test. It is normal for men to have some PSA in their blood, but high levels can also indicate prostate disease, both cancerous and benign. A raised PSA can be due to BPH, urinary tract infection and other benign conditions as well as cancer.
Testing Free and Bound PSA
This test calculates the ratio of ‘free’ and ‘protein bound’ PSA in the blood. Free PSA is associated with benign conditions whilst bound PSA is associated with malignancy. Research has shown that the proportions of free and bound PSA are different in men with prostate cancer compared to those that have benign disease. PSA testing is not diagnostic and further investigations would be required to diagnose prostate cancer.
In addition to the PSA blood test, further investigations include a rectal examination, trans-rectal ultrasound scan, MRIs and biopsy.
At the London General Practice we screen for cancers individually or as part of one of our comprehensive health screens. Our genetic testing cancer panel can also help you understand if you have an increased genetic risk of developing any one of 57 hereditary cancer conditions.