What is prostate cancer?
Prostate cancer is cancer of the male prostate gland and the most common cancer in men in the UK.
The prostate is found between the bladder and the penis and is involved in semen (sperm) production.
It isn't known why some men get prostate cancer while others don't but there are risk factors that make development of the cancer more likely, including:
- Age - most cases are diagnosed after age 50
- Ethnic background - cases are more common in men from African-Caribbean or African descent
- Close family history of prostate cancer - dad or brother
- Lack of exercise
- Diet and nutrition - foods containing lycopene which is in cooked tomatoes, and selenium found in Brazil nuts, may reduce the risk - while eating a higher calcium diet may increase it
Prostate cancer is not usually an aggressive cancer and is slow to develop over many years. This means symptoms may not be noticed until it is at a more advanced state. Symptoms can include:
- More frequent urination - including peeing more at night
- Having to get to the toilet quickly to pee
- Finding it harder to start to pee once you get to the toilet - medically called hesitancy - or straining to urinate
- Weaker urine flow and taking longer to finish peeing
- Having a feeling the bladder isn't empty after urine has stopped flowing
Later symptoms can include:
Seek medical advice for possible prostate cancer symptoms.
Unlike some other cancers there is no NHS screening programme for prostate cancer because the blood test used to help detect it can sometimes wrongly suggest that healthy men with no symptoms or risk factors have cancer.
A doctor will begin to diagnose prostate cancer based on the symptoms, family and medical history, and a physical examination.
They will want to rule out other possible causes of symptoms affecting urination, including an enlarged prostate that's common in older men but isn't cancerous.
Prostate cancer tests include:
- Digital rectal examination - the doctor wears a glove to examine the inside of the rectum (bottom) with a finger to check for changes of the prostate
- Urine test to rule out an infection
- Blood sample taken for a PSA (prostate-specific antigen) test
If the results of the examination and/or the PSA test suggest possible prostate cancer a referral will be made to a cancer specialist and team of experts - called a multidisciplinary team (MDT). Other tests are used to confirm the diagnosis. This includes a transrectal ultrasound-guided biopsy (TRUS) where a special probe and needle are used through the rectum to take a sample of tissue for laboratory analysis. This procedure can be uncomfortable and a local anaesthetic will be given to ease the pain. This test can cause side effects including urinary incontinence and erectile dysfunction.
If this test is inconclusive a transperineal (template or targeted) biopsy may be carried out.