Prostate cancer: what to look out for, and how to tackle it

Did you know that prostate cancer is the UK’s most common cancer in men? In recognition of the Movember campaign to raise awareness for men’s health, Top Doctors contacted leading urologist Mr Sudhanshu Chitale to talk to us more about the prostate, and how to look out for the early signs of cancer.

What is the prostate?

The prostate is a small gland below the bladder. It sits around the urethra and helps to influence urine flow. Its primary function is to create a white fluid that mixes with sperm made in the testicles to form semen.

The most common cancer in men in the UK

With over 40,000 new cases every year, 1 in 8 men will get prostate cancer at some point in their lives (source: Prostate Cancer UK). More than 10,000 men die from prostate cancer every year. The statistics for prostate cancer are comparable to rates of breast cancer in women.

Who is at risk of prostate cancer?

Nobody knows exactly what causes prostate cancer, but several factors seem to correlate with an increased risk:

• Prostate cancer is more common in men of African/Caribbean descent.
• It is less common in men of Asian descent.
• Chances of developing prostate cancer increase with age – most cases occur in men over 50.
• If you have one or more male relatives with prostate cancer, you will have an increased (x2 to x8) chance of developing it.
• It is often said that high intake of red meat and high-fat dairy products can contribute to development of prostate cancer, but the link is unconfirmed.

Looking out for signs of prostate cancer

One worrying thing about prostate cancer is that in many cases, years, and even decades can pass without any signs or symptoms. The cancer develops slowly, which can be a good thing if detected early, but means it can remain undetected until the cancer progresses or spreads.

Prostate cancer symptoms include:

• Urinary problems – these can be mainly indicative of other problems besides prostate cancer (e.g. benign prostatic hyperplasia) but are worth getting checked out for:
• Needing to urinate more frequently
• Straining while peeing
• Feeling like you still need to urinate even when finished
• Blood in the urine or semen
• Bone pain and/or fractures – these symptoms can occur when the cancer is at an advanced stage
• If cancer spreads to the spine the following symptoms can occur:

1. leg weakness
2. urinary incontinence
3. fecal incontinence

Diagnosis

As symptoms often don’t manifest for years, regular screening is best way to detect prostate cancer before it spreads, and subsequently deal with it. Urologists can test for it in these ways:

• Blood tests / urine tests
• Genetic tests
• Physical prostate exam
• MRI prostate scan
• Biopsy​

Treating prostate cancer

The good news is that prostate cancer is treatable and mostly curable if diagnosed early, before it spreads. Treatments that can be effective at an early stage include:

• Removing the prostate (robotic surgery)
• Radiotherapy
• Hormone therapy in combination with the above

In fact, active treatment may not be immediately necessary if the prostate becomes enlarged, but does not affect bodily functions.

Since the above treatments can have side-effects such as incontinence and erectile dysfunction, many men choose to delay treatment, but require careful monitoring, referred to as “active surveillance”.

However, if the cancer spreads out of the prostate, there is no cure. Treatment is then focussed on controlling the disease, treating the symptoms and prolonging life.

If you are showing any symptoms suggestive or even remotely indicative of prostate cancer, you should consult your doctor or a specialist, particularly if you have a strong family history of prostate cancer in the men in your family and/or a strong family history of breast cancer in women.