We live in an age where men are starting to realise the importance of looking after themselves and their health needs. Prostate disease has received a lot of press coverage and consequently creates anxiety in men who may have urinary symptoms. Many men are therefore asking: “Should I have my prostate checked?”
Prostate cancer is the most common cancer in men and generally affects men over the age of 50. Approximately on third of men over the age of 50 will have some cancer cells within their prostate and nearly all men over the age of 80 have a small area of prostate cancer.
These cancers usually grow very slowly and may never cause any problems, although in other cases the cancer can grow rapidly and spread to other parts of the body, particularly the bones.
Although the causes of prostate cancer are still unknown there are some factors that are known to increase the chance of developing the disease.
Men are more likely to develop the disease if a close relative, such as a father, uncle or brother has had the disease. In addition Afro-Caribbean or African-American men have a greater risk of developing prostate cancer and Asian men have a lower risk.
What are the symptoms?
Men with early prostate cancer may not have any symptoms, since these only occur when the cancer is large enough to put pressure on the urethra, also men over the age of 50 can often have an enlargement of the prostate which is due to a non-cancerous condition known as Benign Prostatic Hyperplasia [BPH].
The symptoms of both BPH and prostate cancer are similar and include:
- difficulty in passing urine
- pain on passing urine
- passing urine more frequently than usual, especially at night
- blood in the urine
- pain in the bones [if the cancer has spread to the bones]
Is there a screening programme in the UK?
Men in the UK are not routinely offered screening tests for prostate cancer at present since this is still controversial. However, in both the USA and Austria the death rates from this disease has dropped for the first time in decades since the introduction of screening programmes, notably the PSA blood test. However, determining the cause of a drop in mortality from cancer is difficult so it is probably unlikely that a UK screening programme will be introduced in the near future.
What is PSA?
Prostatic Specific Antigens, PSA is a protein that is produced by the prostate and is a normal component of the seminal fluid. It is normally found in the blood in small amounts. Men with cancer of the prostate usually have more PSA in their blood and generally the higher the level the more likely it is to be cancerous.
However, interpretation of the result can sometimes be difficult since as men grow older their PSA levels increase. In addition, raised levels of PSA in the blood may also be found in several other conditions such as Benign Prostatic Hyperplasia, prostatitis [inflammation of the prostate], and even after physical exercise. Most enlargements of the prostate are not cancerous.
At the Prostate Evaluation Clinic at the Hospital of St John & St Elizabeth we have a range of specialists in Urology and Urological Oncology that can assess the likelihood of prostate disease. A blood test in isolation can often be misleading and distressing and in all cases where symptoms exist, physical examination must also be undertaken. This sometimes can require examination by ultrasound and occasionally by MRI scan.