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Prostate Cancer



What is the prostate? 

The prostate is a gland that is in men. It is often described as about the size of the walnut. It is a small gland that sits below the bladder, near the rectum. It surround the urethra, which is the passage through which urine and semen passes.

The prostate gland produces much of the fluid that makes up semen and enriches sperm. It needs the male hormone testosterone to grow and develop. Even though it is described as being the size of a walnut, it can grow throughout life and can sometimes cause problems such as urinating, which is especially common in older men. This is not always a sign of prostate cancer.

What is prostate cancer?

Prostate cancer is when abnormal cells develop in the prostate, and can continue to multiply in an uncontrolled way and sometimes spread outside the prostate into nearby or distant parts of the body. It is generally a slow growing disease, and the majority of men with prostate cancer live for many years without symptoms and without it becoming life-threatening. However, in some cases, high grade disease exists and can become lethal, and appropriate treatment is key to altering the disease course.

Risk factors for prostate cancer include:

  • Age: the chance of developing prostate cancer increases with age. By the age of 75, the risk of prostate cancer is 1 in 7, and by the age of 85, this increases to 1 in 5.

  • Family history: if you have a first degree relative with prostate cancer, there is a higher risk of developing the disease. The risk is also increased if you have more than one relative with prostate cancer. Risks are higher in men whose relatives were diagnosed at a young age.

Other factors that may increase the risk of prostate cancer include:

  • Genetics: although prostate cancer can’t be inherited, a man can inherit genes that increase the risk of prostate cancer

  • Diet: there is some evidence that eating a lot of processed meat or food that is high in fat can increase the risk of developing prostate cancer

  • Lifestyle: there is evidence to suggest that environment and lifestyle can also affect the risk

Symptoms:

  • In the early stages of the disease, there may be no symptoms. In the later stages, symptoms may include:

  • Feeling the frequent or sudden need to urinate

  • Finding it difficult to urinate

  • Discomfort when urinating

  • Noticing blood in the urine or semen

  • Pain in lower back, upper thighs or hips

How can I be tested for prostate cancer?

Initially, prostate cancer is detected through two main methods:

  1. DRE (digital rectal examination): the prostate can be felt via a digital rectal examination due to its location. The examination can be used to assess the size of the prostate and any abnormalities. A normal prostate on examination does not rule out cancer.

  2. Blood test (prostate specific antigen): the result of this test shows whether there is an increase in this specific protein. Depending on the result, you may require further investigation. A high PSA result does not necessarily mean cancer, as high PSA levels can occur in other prostate problems.

If you are over 50, or over 40 with a family history of prostate cancer, please talk to your doctor about testing for prostate cancer using the PSA test and a DRE as part of an annual health check up. It is important to discuss with your doctor and make an individual informed decision about testing based on the latest available evidence on the benefits and potential harms of testing and subsequent treatment.

The only way a firm diagnosis of prostate cancer can be made is with a biopsy, which is conducted by a specialist.

What can I do to reduce my risk of prostate cancer?

Some of the risk factors described above, such as age and family history, cannot be modified. However, there are some contributing risk factors that can be modified to reduce your risk. These include:

  • Healthy lifestyle: this can also help to improve your general health as well as reducing your risk of prostate cancer. This includes being physically active and staying at a healthy weight (as being overweight or obese can increase your risk of prostate cancer)

  • Reducing processed meats and red meats

  • Being aware of your own risk factors and discussing these with your doctor

 

References

  • American Cancer Society 2016, ‘Can Prostate Cancer Be Prevented?’, American Cancer Society

  • Prostate Cancer Foundation of Australia 2017, ‘What you need to know about prostate cancer’, Prostate Cancer Foundation of Australia

  • Prostate Cancer UK 2015, ‘Can I reduce my risk?’, Prostate Cancer UK

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