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Prostate cancer - the basics

What is prostate cancer?

Prostate cancer is the most common male cancer, making up more than a quarter of all cancers in men.

More than 40,000 men are diagnosed with prostate cancer each year and it results in around 10,793 deaths.

Prostate cancer is more common in men over 65 and in black African-Caribbean men.

More than 8 out of 10 men in England with prostate cancer survive for 5 years or more.

Prostate cancer is usually slow to develop and it may be some years before symptoms are experienced, such as difficulty urinating.

There is no NHS screening programme for prostate cancer because the PSA blood test used to help detect it can sometimes wrongly suggest that healthy men with no symptoms or risk factors have cancer.

If the results of a PSA test suggest possible prostate cancer other tests are used to confirm the diagnosis.

Depending on how advanced the cancer is, men may be offered a range of treatments, or forms of monitoring called watchful waiting or active surveillance.

The prostate

The prostate is a gland in the male reproductive system that produces the majority of fluid that makes up semen, the thick fluid that carries sperm. The walnut-sized gland is located beneath a man's bladder and surrounds the upper part of the urethra, the tube that carries urine from the bladder. Prostate function is regulated by testosterone, a male sex hormone produced mainly in the testicles.

The PSA screening test

Prostate-specific antigen (PSA) is a substance produced by the prostate gland. Elevated PSA levels may indicate prostate cancer or a non-cancerous condition such as prostatitis or an enlarged prostate.

Just as important as the PSA number is the trend of that number (whether it is going up, how quickly, and over what period of time). It is important to understand that the PSA test is not perfect. Most men with elevated PSA levels have non-cancerous prostate enlargement, which is a normal part of ageing. Conversely, low levels of PSA in the bloodstream do not rule out the possibility of prostate cancer. However, most cases of early prostate cancer are found following a PSA blood test.

Prostate cancer cells do not follow normal patterns. Instead, they grow uncontrollably and spread to other tissues. Prostate cancer is typically a very slow growing tumour, often causing no symptoms until advanced stages. Most men with prostate cancer die of other causes - many without ever realising that they have the disease. But once prostate cancer begins to grow more rapidly or spreads outside the prostate, it is dangerous. This aggressive type of prostate cancer can occur at any age. Although the disease tends to progress slowly, it is generally fatal if it spreads beyond the prostate gland itself.

Cancer that has spread beyond the prostate to distant tissues (such as the bones, lymph nodes and lungs) is not curable, but it often can be controlled for many years. Because of the many advances in available treatments, the majority of men whose prostate cancer becomes widespread can expect to live five years or longer.

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