Should I get tested for prostate cancer?

Prostate cancer is the most common cancer in men, with more than 50,000 men being diagnosed every year. In this article, a consultant urological surgeon explains why you should consider getting tested for prostate cancer.

It is estimated that 12 per cent of men will be diagnosed with prostate cancer in their lifetimes, and each year there are around 12,000 prostate cancer-related deaths. Although it is more commonly diagnosed in men over 65, the risk of developing significantly increases after the age of 50, and it is likely that a lack of testing and awareness can contribute to underdiagnosis, and that many men under 50 are unaware they are in the earliest stages or precancerous.

Prostate cancer tends to develop very slowly and may be asymptomatic over many years. During the course of prostate cancer, the prostate, which is a small gland in the pelvis that produces the fluid that transports sperm from the testicles (semen), becomes enlarged, and eventually becomes big enough to obstruct the urinary tract, which will typically be accompanied by symptoms such as:

• Increased frequency of urination
• Difficulty starting urination
• Painful urination
• Painful ejaculation, or inability to ejaculate
• Blood in the urine (haematuria)

Who is at risk for prostate cancer?

Aside from being older than 50 years old, there are other risk factors for prostate cancer to consider. Men who are of African descent have higher incidences of prostate cancer, whereas Asian and Indigenous American men have the lowest amount, and those who have a family history of prostate cancer could be at more risk of developing it, especially those who have fathers or brothers with prostate cancer.

Men who fit these characteristics should consider getting tested earlier and more frequently than their peers.

How is prostate cancer diagnosed?

Often, men who begin to struggle with symptoms seek diagnosis. In such cases, a blood test is one of the preliminary tests, which will reveal elevated levels of prostate-specific antigen (PSA).

However, an enlarged prostate and the accompanying symptoms are not necessarily indicative of prostate cancer – an enlarged prostate commonly occurs in ageing men due to a hormone called dihydrotestosterone which triggers growth. When the prostate enlarges or becomes inflamed, it begins to produce PSA. High levels of PSA can be due to benign prostate enlargement (BPE), prostatitis, a urinary tract infection (UTI), ageing, medications like testosterone-replacement therapy, or even just vigorous exercise.

To confirm the diagnosis, further tests such as digital rectal exams (DRE), MRIs, and prostate biopsies may be performed.

That being said, even those men who aren’t experiencing any symptoms are still encouraged to undergo screening tests to stay informed on their prostate health. Catching a disease in its earliest stages means it will also be the easiest to treat, both for the doctors and the patients. At more advanced stages, the prognosis becomes less certain, and the condition could be so deteriorated that the outlook may not be positive.

How is prostate cancer treated?

Prostate cancer has four stages (I – IV) which describe the spread and aggression of the cancerous cells, and according to Cancer Research UK, prostate cancer discovered at Stage I has a nearly 100 per cent survival rate for at least 10 years after discovery, whereas Stage IV has a survival rate of almost 25 per cent within 10 years of discover. At Stage I, the cancer is localised, likely just in a small area of the prostate and simple to address, but at Stage IV, the cancer will have spread to other organs and penetrated deeply into the tissue. This is why an early diagnosis is pivotal.

Management and treatment of prostate cancer depend on the stage and grade of the cancer, as well as the patient’s overall health. Options include:

• Active surveillance for low-risk cases
• Surgical removal of the prostate (prostatectomy)
• Radiation therapy
• Chemotherapy
• Cryotherapy, which is performed by liquid nitrogen being injected into the prostate to destroy the cancer cells

In recent years, newer treatments like immunotherapy and targeted therapies have also emerged, offering hope for better outcomes with fewer side effects. Understanding these aspects of prostate cancer can help guide discussions with healthcare providers and inform decisions about screening and treatment.

If you have concerns regarding your prostate, consult with a specialist on Top Doctors