Understanding prostate cancer

Cancer of the prostate, the sex gland in males, commonly occurs in older men and is considered a typical aging disease. Someone can have prostate cancer for many years, undetected because they don’t have symptoms. While 20% of men will develop the disease in their lifetime, only 3% of these men will die as a result of the disease. Esteemed, London-based consultant urologist and surgeon, Mr Christopher Anderson, explains the disease in further detail and outlines some of the main known causes. 

What is the role of the prostate?

The prostate is a gland that is involved in the functioning of the male reproductive system. Located between the bladder and the rectum, it is approximately the size of a walnut. The prostate surrounds the urethra, the tube which carries urine from the bladder out of the body and is responsible for the production of the liquid that makes up semen. When a man orgasms, the sperm mixes with the liquid from the prostate, helping the sperm to move more freely.

What is prostate cancer? 

Cancer occurs when cells begin to grow abnormally. In healthy tissue, the cells grow and divide to form new cells. Old cells will die and the new cells will replace them. Abnormal cell growth happens when the process goes wrong, new cells grow without the old cells dying. The excessive cells form a growth or tumour, which can be either benign (non-cancerous) or malignant (cancerous).

Prostate cancer is a result of abnormal cell growth that happens in the tissue of the prostate. Initially, the cells will grow out of control and spread within the prostate and they can eventually grow to spread to the neighbouring organs. It is also possible for the cancerous cells to spread to other parts of the body via the blood vessels or lymphatic system.

Is prostate cancer usually fatal?

Prostate cancer can either be harmless or very aggressive. In the instance of slow-growing cancer, the patient will experience very few symptoms and if they do die, they are likely to die with cancer rather than from cancer. Aggressive cancers progress quicker and can spread to other parts of the body, like lymph nodes, other organs, and commonly the bones.

What causes prostate cancer?

The exact causes of prostate cancer are unknown to researchers, but it depends on genetic and non-genetic (environmental factors).

Genetic factors are inherited and unchangeable traits that predispose someone to develop the disease. A family history of prostate cancer may increase someone's risk of prostate cancer. According to research, 9% of cases may be a result of genetic factors. 15% of those with prostate cancer have a first-degree relative who also has prostate cancer, in comparison to 8% of those without a relative. It is now possible to test for mutations of the Hereditary Prostate Cancer 2 (HPC2) gene, to determine if someone has a gene that puts them at risk.

Studies have also found that environmental factors likely play a bigger role in why someone develops prostate cancer. Environmental factors include:

• Age: usually prostate cancer develops in men aged over 50.
• Diet: A diet high in fat, particularly animal fats, and lacking nutrients increases the risk of developing cancer.
• Hormones: High levels of testosterone can increase risk.
• Race: Black men are twice as likely to develop and die from the disease as white men.

While genetic factors can’t be altered, lifestyle changes can be made to reduce the risks of prostate cancer developing. By quitting smoking, improving diet, maintaining a healthy weight, and exercising, one can improve their chances of not developing cancer.

What are the signs and symptoms?

In the early stages of this form of cancer, it is rare that symptoms are experienced. Normally, it is detected during a routine screening. If symptoms do occur, the symptoms depend on how advanced the cancer is and whether it has spread to other parts of the body.

How is prostate cancer detected? Why are regular screenings important? 

Symptoms of prostate cancer are rare, so screening is important so that if the cancer is growing, it is detected early and the chance of curing it increases. There are common tests performed to check for prostate cancer:

• Digital rectum exam (DRE): a doctor will insert a gloved finger into the rectum and assess the texture and size of the prostate.
• PSA blood test: PSA is a protein that is produced by the prostate, and while small amounts are commonly found in the blood if a blood test detects high levels, it suggests there is something wrong with the prostate.

Other tests that can be undertaken include a transrectal ultrasound, MRI scanning, and a prostate biopsy.

Annual screening involving DRE and PSA blood tests should be done annually once a man is over the age of 50. For patients at high risk, screening may be recommended from the age of 40 or 45.

If you’re interested in finding out more about prostate cancer, or would like to book a consultation with Mr Christopher Anderson, you can do so by visiting his Top Doctors profile.