Prostate Cancer: What Is It, What Are The Warning Signs And How Effective Is Testing?

Everyone knows what female breast cancer is and that a self-examination and mammogram are used to detect it. However, prostate cancer doesn’t get quite as much press, so here’s what men need to know about this disease.

What Is Prostate Cancer?

Prostate cancer only affects men because only men have a prostate. The prostate is a gland in the male reproductive system which sits just under the bladder in front of the rectum. Prostate cancer is a very slow developing disease and its most common form is adenocarcinoma. This cancer develops in the gland cells which make the fluid that’s added to the semen. Other types of cancer can start in the prostate gland, like sarcomas, small cell carcinomas and transitional cell carcinomas. This is extremely rare, though. Most types of prostate cancer are adenocarcinoma. According to an article in The Telegraph newspaper on March 6th 2018, these are the stats for prostate cancer:

  • 47,300 UK men were diagnosed with prostate cancer in 2015. 
  • It’s the most common cancer among men and the 2nd biggest cause of cancer deaths in men. 
  • One in eight men will be diagnosed with prostate cancer in their lifetime. That likelihood is doubled for black men, with one in four being affected by the disease. 
  • Men whose fathers or brothers have had prostate cancer are more than twice as likely to develop the disease. 
  • 65–69 is the average age at which men are diagnosed. 
  • 84% of men survive 10 or more years following a prostate cancer diagnosis. 
  • 11,287 men in the UK died from prostate cancer in 2014 – equivalent to one every hour. 
  • 330,000 men are living with or after the disease in the UK.

What Are The Warning Signs?

Because of how slowly prostate cancer can develop, many men die of old age or something else never knowing they even had the disease. However, that’s not always the case and it’s important to look out for these warning signs of prostate cancer:

  • Increased frequency of urination and urgency to urinate. 
  • Urinating multiple times during the night. 
  • Hesitating to urinate. 
  • Having a hard time starting the flow. 
  • Loss of bladder control. 
  • Blood in urine. 
  • Blood in semen. 
  • New onset of erectile dysfunction. 
  • Pain in the bones of the lower back, hips, and/or ribs.

All of these could be signs of something else, but you should see your doctor if you have any of these symptoms.

One way your physician might screen you for prostate cancer is through the dreaded Digital Rectal Exam (DRE) in which a gloved finger is stuck in the rectum to feel for any abnormalities in the prostate. Prostate cancer can also be found by determining how much Prostate-Specific-Antigen (PSA) is in the blood. PSA is a substance made by the cells in the prostate gland. When levels increase, this could be a sign of prostate cancer, but as other things can increase the production of PSA in the blood, such as an enlarged prostate or older age, this isn’t always an accurate test for cancer.

Every man in the UK over the age of 50 is entitled to a PSA test, subject to referral by their GP. However, before you go rushing out to get yourself tested, it’s interesting to note that a recent study funded by Cancer Research UK into PSA testing concluded that ‘screening for prostate cancer does not save lives, and may do more harm than good’. The study was the largest ever PSA trial conducted, comprising almost 600 GP practices in the UK with a group of more than 400,000 men aged 50-69. Almost half of the sample were invited to take a one-off PSA test, while the other half were not and both groups were followed up after around 10 years. The results showed that there were 8,054 (4.3%) prostate cancers in the screened group and 7,853 (3.6%) cases in the non-screened group. Furthermore, both groups had the same figure of 0.29% of men dying from the disease. The study also points out that the PSA tests detected some tumours which were unlikely to be harmful, missed others which were fatal, and caused unnecessary anxiety in men subjected to treatment for a disease which often shows no symptoms and from which many men survive without treatment. Since the PSA examination is unable to distinguish between aggressive prostate cancer and symptomless prostate cancer, the resulting therapies, including surgery, which can result in impotence and incontinence, make a clear case for finding a new way to much more accurately diagnose the more aggressive form of the disease.  

With this said, it’s up to you if you decide to get tested. Your doctor might do the DRE, PSA exam or send you for a much more accurate prostate biopsy if he or she suspects you may have prostate cancer. For most men, discussion of testing should begin around the age of 50, but if you’ve a family history of the disease, then discussions with your doctor should begin by the age of 45. The bottom line with prostate cancer is that it has a very high survival rate and you’ll most likely succumb to old age before you do to prostate cancer. However, you should always be aware of the symptoms of prostate cancer as well as your family history of the disease and discuss all of this with your doctor because, as with all cancers, the earlier it’s detected, the easier it is to treat.

Look out for my follow-up blog in which I’ll be talking about the natural approach to preventing and healing prostate cancer.  

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