Everything you need to know about prostate cancer

1 in 8 men in the UK will be diagnosed with prostate cancer in their lifetime. If you are over 50, your dad or brother have been diagnosed with prostate cancer, or if you are a black man, your risk is even higher. 

An increased awareness of prostate cancer, screening tests, earlier diagnosis and new and innovative treatment options means that the number of men surviving prostate cancer in the UK has tripled in the last 40 years. But can you name the signs and symptoms of prostate cancer, and do you know your personal risk?

Mr Jeremy Oates, Consultant Urological Surgeon at The Wilmslow Hospital and The Christie Private Care, both part of HCA Healthcare UK, shares his expert insights and answers some of the most common questions about prostate cancer.

What is prostate cancer?

Prostate cancer is the most common cancer in men in the UK. It develops when cells in the prostate begin to grow abnormally and form a tumour.

What are the symptoms of prostate cancer?

It’s important to be aware of symptoms and get any changes checked as soon as possible. Prostate cancer is highly treatable, particularly when diagnosed at an early stage. Common symptoms to be aware of include:

• Difficulty in starting to urinate 
• A weak flow when you do urinate
• The feeling that your bladder hasn’t emptied properly
• The desire to urinate more frequently – particularly at night
• A sudden urge to urinate
• Leaking urine before you get to the toilet

Most of these symptoms result from the normal growth of the prostate with age, but these symptoms need to be investigated by healthcare professionals so that cancer can be properly ruled out.

Other symptoms to look out for, which could indicate that the cancer has spread beyond the prostate include:

• Back, hip or pelvis pain
• Problems with getting or sustaining an erection
• Blood in the urine or semen
• Unexplained weight loss.

Again, in many cases these symptoms will not indicate cancer, however it is always important to get anything unusual checked out by your GP so you can find out what the cause is and seek appropriate treatment.

What are the risk factors for prostate cancer?

Your individual risk of developing prostate cancer depends on multiple factors including your age, genetics, ethnicity and certain lifestyle factors.

Age. As is the case with many cancer types, the risk of prostate cancer increases with age, particularly if you are over the age of 50. However you can develop prostate cancer at a younger age so it is important not to ignore any symptoms and have these checked by your GP or a healthcare professional – no matter your age.

Inherited risk. Prostate cancer can also run in families, this is known as an inherited or hereditary risk. You are at a higher risk of developing prostate cancer if your brother or father has had it. There is an even greater risk if they have been diagnosed under the age of 65 or if more than one close relative has had prostate cancer.

Ethnicity. Certain ethnicities are also at an increased risk. Prostate cancer is twice as common in men of African- Caribbean and African descent than in white men; 1 in 4 black men in the UK will get prostate cancer at some point in their lives.

Obesity. Whilst it is not known how to prevent prostate cancer, we do know staying at a healthy weight is important. Research suggests that if a man is overweight or obese, his chance of being diagnosed with aggressive or advanced prostate cancer is increased.

If you are over the age of 50, a black man over age of 45, or have a family history of prostate cancer, you may want to speak to your GP or a Consultant specialist about your prostate health and the checks that can be done for prostate cancer.

How is prostate cancer diagnosed?

If you are experiencing symptoms of prostate cancer, such as problems passing urine or urinating more frequently, it’s important to diagnose what is causing these symptoms as soon as possible. These symptoms can be caused by various health conditions and do not necessarily mean you have cancer, but it’s important to see your GP as soon as possible so that cancer can be ruled out.

When visiting your GP they may perform a digital rectal examination (DRE), this enables them to physically assess how your prostate feels. They may also arrange for you to have a PSA blood test. This blood test checks the levels of a substance called Prostate Specific Antigen (PSA) in your blood. PSA levels do naturally increase as a man ages, however high levels of PSA can be an indication of prostate cancer, or other prostate related conditions. So, if your PSA level is elevated or your GP believes that your symptoms need further investigation they will refer you to a specialist for further tests.

How is prostate cancer treated?

If you are diagnosed with prostate cancer the type of treatment or treatments recommended by your multidisciplinary team will vary depending on your individual diagnosis, including the stage of prostate cancer you have been diagnosed with.

If your cancer is slow-growing, and therefore unlikely to cause any significant issues, then active surveillance, which is often referred to as watchful waiting, may be recommended. This will require you to have regular follow-ups to monitor for any changes, meaning you will only begin treatment if the cancer progresses, to avoid unnecessary treatment and its side effects.

If your prostate cancer requires treatment, this can successfully be achieved by robotic surgery to remove the whole prostate or through one of a number of different types of radiotherapy. Radiotherapy options vary from patient to patient and would be discussed in detail by a specialist prostate radiotherapist. Even advanced prostate cancers can be managed for long periods of time with hormone treatments and chemotherapy.

If you have noticed any changes to your health or any of the symptoms covered in this article, do not delay in getting these checked by your GP or a healthcare professional.

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