Prostate cancer

What is the prostate gland?

The prostate is a small gland found only in men. It lies below the bladder between the pubic bone and the rectum. It is shaped like a doughnut and surrounds the urethra (the tube that carries urine from the bladder to the penis). The prostate is about the size of a walnut but grows bigger as you get older and can grow to the size of a satsuma. Around 8 in 10 men will have an enlarged prostate by the time they reach 70.

The prostate is a vital part of the male reproductive system, producing semen – a secretion that nourishes and protects sperm. The prostate relies on the male hormone testosterone (the male hormone which is produced by the testes) to make it grow at puberty and help it function properly throughout adult life. Because of the location of the gland, enlargement can sometimes lead to problems in urinating as the urethra can become blocked.

What is prostate cancer?

Prostate cancer differs from most other cancers in the body, in that small deposits of cancer within the prostate are very common and may remain dormant for some time before they progress and in some men they may not grow at all but in some cases it can be more aggressive.

The annual death toll from prostate cancer in Britain has doubled to over 10,000 in the past 20 years and is now the most commonly diagnosed male cancer, with over 45,000 men affected each year.

What causes prostate cancer to develop?

The causes of prostate cancer are unknown, though there are some factors that are thought to increase the chances of you developing prostate cancer (see below). Prostate cancer occurs when cells in the gland start to grow in an uncontrolled way, causing a tumour to develop. This eventually presses on the urethra, causing the classic symptoms of needing to pass urine frequently, interrupted flow or even difficulty in urinating. As the disease progresses, cancer cells break away from the prostate gland and spread to other parts of the body, particularly the bones.

What are the risk factors for having prostate cancer?

Age is the biggest risk factor, it is rare in men under 50, but after this age the incidence rises steeply, faster than any other cancer. The average age when patients are diagnosed is over 65. Prostate cancer can run in families, the more relatives who have had problems with their prostate the higher the risk that you too will suffer. There is also more of an increased risk if breast cancer runs in your family.

There is also strong evidence of racial links with a vast majority of Afro-Caribbean men developing the disease, whilst very few Asian men develop prostate cancer. Men who eat a diet high in animal fat and protein may also increase their risk of the disease.

What are the symptoms of prostate cancer?

The symptoms of both a benign prostate enlargement and a malignant tumour are similar. The majority of men as they get older, will suffer from a gradual enlargement of the prostate, this is not cancer and can be treated. The symptoms of prostate cancer may include any of the following:

• Difficulty in passing urine.
• Passing urine more frequently than usual, especially at night
• Urgency in passing a urine, a strong urge to go.
• A weak or interrupted stream of urine.
• A feeling that the bladder has not completely emptied.
• Painful ejaculation.
• Blood in the urine or pain on passing urine.

If you have any of the symptoms mentioned you must have them checked by your doctor.
Remember, most enlargements of the prostate are not cancer and are not life threatening, though the symptoms may be the same.

Cancer of the prostate is often a slow growing cancer, particularly in older men, and symptoms may not occur for many years. Occasionally, the first symptoms are pain in the back, hips or pelvis caused by the cancer spreading to the bones. Affected bones can become painful and tender.

How is prostate cancer diagnosed?

The first two tests for diagnosing cancer of the prostate are a rectal examination and a blood test. During a rectal exam the doctor will place a gloved finger up your back passage to check the size of the prostate and to feel if any lumps are present. This can be uncomfortable but doesn’t take long.
The blood test looks for a substance called P.S.A. (Prostate Specific Antigen). P.S.A. is a substance produced by the prostate and a small amount normally leaks into the blood. Men with cancer of the prostate tend to have more P.S.A. in their blood. However, prostate glands which are enlarged, as a result of another condition or old age can also produce more P.S.A.

We sell a test on this website which can rapidly identify the presence of P.S.A. in blood. Click here for more information or to buy our prostate disorders test. Remember, this test will not diagnose prostate cancer but can give an idea of the state of the prostate gland.

There are a number of other tests that may also be done to see if you have prostate cancer. No one test on its own is conclusive. Other tests you may have include an ultrasound and a biopsy. During a biopsy a small piece of tissue is removed from the affected area for analysis under a microscope.

What treatment is available for prostate cancer?

If you are diagnosed as having prostate cancer the treatment you receive will depend on the type of cancer and if it has spread. Your age and general health will also be taken into consideration. As mentioned earlier some prostate cancers grow slowly and may not require any treatment. However, you will have have regular check-ups to make sure that the cancer hasn’t started to grow or spread, the doctors call this “watchful waiting”.

If treatment is required you may have surgery to remove the tumour, this usually involves the removal of the prostate gland. The prostate gland is not essential to life but you may suffer from impotence and incontinence (leakage of urine from the bladder) after surgery. Radiotherapy or hormone therapy are other methods of treatment available. Hormone therapy involves eliminating the effects of testosterone. It is known that testosterone helps prostate cancer grow and spread, so when deprived of it, most cancers will shrink. You may have these treatments on their own or with surgery. Your doctor will discuss all treatment options with you.

There are new treatments available for cancer all the time and a new prostate cancer treatment to heat and destroy cells or freeze them is being trialled though these new treatments will not be available to everyone so ask your doctor for information.