First published November 2008
Around 35,000 men are diagnosed with prostate cancer in Britain every year and more than 9,000 die from it. Prostate cancer has become the most common cancer in men and mainly affects older men over the age of 50.
If identified and treated early enough, treatment can be successful, so it is really worth understanding a little about this cancer. An early identification of a problem and a visit to your doctor could save your life.
The prostate is a male sex gland that produces a thick clear fluid which is an important part of semen. The growth and function of the prostate depends on the male sex hormone testosterone. The prostate is about the size of a walnut and is located below the bladder and in front of the rectum.
What causes it?
Like many modern cancers, we are still at the early stages of fully understanding the causes. There appears to be some association with high fat, high meat low vegetable diets, and men with a strong family history of prostate cancer are at greater risk. Ethnic origin also plays a role and Afro-Caribbean and African-American men appear more likely to develop the disease than Asian men.
What are the symptoms?
As men get older, their prostate gland often enlarges. This is not usually due to cancer, but is a condition called “benign hyperplasia”.
In its early stages, prostate cancer often doesn’t cause symptoms, and the symptoms of both benign and malignant tumours are similar. The main indications are problems with passing urine because any enlargement of the prostate can cause pressure on the urethra. Problems such as having to rush to the toilet to pass urine; difficultly in passing urine, and passing urine more often than usual, especially at night, all need to be checked out.
It's important to be aware that there are a number of other, non-cancerous medical conditions that may also cause problems with passing urine. Pain on passing urine and blood in the urine are rarely indications of prostate cancer and are usually due to other causes.
As with all cancers, the earlier you identify the problem, the better than chances of successful treatment, so visit your GP as soon as you think there is a problem.
Your GP will examine you and perform a digital rectal examination. He may feel a number of tests are necessary such as blood tests, x-rays or a scan.
You may be referred to a specialist who may want you to have a biopsy of the prostate. This will show whether or now prostate cancer is present and also whether it is an aggressive form.
All over the world, a TNM system is used to identify the different stages of prostate cancer. This assess the tumour (T); the lymph nodes (N) and secondary cancer or metastases (M).
The T staging runs from T1, for a tumour that is too small to be seen on scans or felt during examination (it may have been discovered by needle biopsy); up to T4 when the tumour has spread into other body organs nearby, such as the rectum (back passage) or bladder.
Treatment mainly depends on whether the cancer is contained within the prostate or has spread around the body. If the cancer is small, the doctor may recommend no further treatment at that stage while they keep a watch on any future growth. Otherwise a number of treatments such as surgery to remove the prostate or radiotherapy may be recommended.
Advanced disease is often treated using hormone therapy to reduce the amount of testosterone in the body to slow down or stop the growth of the cancer cells.
With ongoing research, new treatments are slowly being identified. Recently a new drug Abiraterone has attracted a lot of attention, with scientists claiming it a major breakthrough after finding patients who had failed to respond to previous treatment improved after taking this drug. It is still undergoing tests to ensure it is safe as well as effective.
Can prostate cancer be prevented?
A healthy, low fat diet may help prevent prostate cancer. Eat at least five portions of fruit and vegetables a day, including plenty of tomatoes, and reduce your consumption of red and processed meat. Some advice recommends plenty of selenium, vitamin E and lycopene (found in tomatoes) in your diet as these may protect against prostate cancer.
With the increase in men suffering from prostate cancer, it should no longer be an embarrassing subject to discuss. There can be associated problems that occur with prostate cancer, but doctors are now so familiar with the disease that they should be able to answer your questions quickly and easily. There is also a host of specialist advice and support groups available.
The Prostate Cancer Charity
Helpline: 0800 074 8383
Prostate Cancer Support Association (PSA)
Helpline: 0845 601 0766
Prostate Help Association (PHA)
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