Prostate Cancer with Mr Ron Miller

Consultant News

This Movember we caught up with leading Urological Consultant Mr. Ron Miller, who forms part of London Urology at The Hospital of St John & St Elizabeth, to discuss Prostate Cancer.

London Urology is a specialist clinic which provides a comprehensive service to all patients, offering rapid diagnosis, intervention and aftercare.

How common is Prostate Cancer?

Prostate cancer affects 1 in 8 men with over 47,000 new cases in England each year and total of 11,000 deaths each year.

How do you assess and diagnose Prostate Cancer?

Most patients will present a history of prostatism, this means the patient has difficulty in passing urine with an increase in frequency and urge to use the toilet – this is associated with a slow urine stream. Some patients will have a Prostate-specific antigen [PSA] test and be referred on that basis.

At London Urology, a Consultant Urologist will establish history and assess the prostate through a rectal exam, then arrange for a PSA test. The Urologist will also assess the urinary tract with an ultrasound, and in the case of a raised PSA would recommend an MRI scan and biopsy.

Who is particularly at risk of developing Prostate Cancer?

The people most at risk of developing Prostate Cancer are patients who are overweight, have a family history, and who are of Afro-Caribbean origin. Roughly 50% of patients over the age of 80 will have Prostate Cancer. Prostate Cancer in patients under 80 is far more aggressive so it is even more vital to look out for key symptoms and see a specialist if you are concerned.

The peak age of developing the disease is between 60-75, however, cases can occur as young as 40.  Patients over the age of 50 should think about yearly screening which involves history of urinary problems and an examination, if indicated as PSA test.

How have initiatives such as Movember helped in raising awareness of the disease?

Movember has proven very successful, most importantly for organisations involved in researching the disease. The publicity gained from Movember has certainly improved patient responses to early diagnosis, and their willingness to undertake the appropriate tests.

At London Urology we have the latest diagnostic equipment including a 3T MRI scanner, which is one of the most powerful in the country. An accurate diagnosis is therefore much easier and quicker to obtain.

Are there any specific early warning signs?

If patients have urinary symptoms it is important to ask for appropriate screening, especially for elderly patients and those with a family history of Prostate Cancer.

What factors determine treatment?

The objective of treatments is to determine early disease, which is organ defined. This means the disease has not spread outside of the prostate gland, the next most important stage is to determine the aggressiveness through a biopsy. Many cancers can be watched and observed over long periods of time.

Aggressive organ confined cancers require radical treatment with surgery or radiotherapy, robotic prostatectomy offers the best solution in most cases in the group. Many other less invasive treatments are available such as Brachytherapy, Cryotherapy and high intensity ultrasound. Your Consultant will guide you as to which treatment is most suitable in your case. Even patients with advanced Prostate Cancer can benefit from effective hormonal treatments in association with Chemotherapy.

London Urology treats a wide range of Urological conditions including kidney stones, bladder and pelvic pain, incontinence, vasectomy reversal, erectile dysfuntion, peryronie’s disease, hydrocele, varicocele and interirial cystits.

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