Ascension : Prostate cancer facts
Submitted by The Islander (Nathan Prince) 18.10.2007 (Article Archived on 01.11.2007)

Today one man in 14 is diagnosed with prostate cancer, almost 32,000 every year, and it has now overtaken lung cancer to become the most common cancer in men.

This increasing incidence is largely due to a higher number of cases being diagnosed, (through the greater use of PSA tests), and the influence of an ageing population.

10,000 men a year die from prostate cancer in the UK, which makes it the second most common cause of cancer mortality in men after lung cancer.

The majority of men with prostate cancer are aged over 60 years. Although this cancer can also occur in younger individuals, it is very rare under the age of 50.

Risk factors

§         Age - The majority of men with prostate cancer are aged over 60 years and the disease is very rare in men under 50.

§         Family History-  Men with a brother or father who developed prostate cancer at a young age have an increased risk. Men with a family history of breast cancer also have an increased risk.

§         Race- Prostate cancer is more common in men of African descent.

§         Environment- Possible factors include high fat consumption and low green vegetable consumption as well as exposure to radioactive substances.

§         Protection- It has also been suggested that Lycopene (the compound that gives the tomato its red colour), selenium and vitamin E in the diet may protect against prostate cancer.

But in most cases, we simply do not know what causes it to occur or how to prevent it. Little is known about the detailed or molecular mechanism of development of prostate cancer. 

Everyman is carrying out the research to find out why.

Signs and symptoms

One of the problems related to prostate cancer is that, in its early stages, it often does not cause symptoms. When they do occur they may include any of the following problems:

• Having to rush to the toilet to pass urine


• Passing urine more often and/or at night


• Difficulty getting the flow of urine started


• Starting and stopping whilst passing urine


• Discomfort (pain or burning) whilst passing urine


• A feeling of not having emptied the bladder fully


• Dribbling of urine


• Blood in urine or semen


• Pain or stiffness in the back, hips or pelvis

The prostate enlarges as men get older, and most men have some symptoms affecting urination. These symptoms can be caused by other conditions that are less serious than prostate cancer, such as a non-cancerous enlarged prostate gland or a kidney infection.

However, it is important that you do go and see your doctor as soon as possible if you are suffering from any of these symptoms so that the cause can be diagnosed and any relevant treatment administered.

Diagnosis

None of the following tests is an individually conclusive indicator of prostate cancer.

Your doctor is likely to use more than one test to determine whether or not you are affected by prostate cancer. Everyman is carrying out further research to find a more efficient, comprehensive test - as an early diagnosis is so important to successful treatment.

v      Rectal Examination

Your doctor can actually feel the size of the prostate gland. However, an enlarged prostate does not necessarily indicate prostate cancer.

v      PSA Blood Test

Tests the level of ‘Prostate Specific Antigen’ in the blood. A high reading suggests prostate cancer but could be caused by other conditions.

v      Biopsy

A tiny sample of tissue from the prostate is taken using a probe which is inserted into the back passage and the tissue then analysed.

v      Ultrasound

A small probe is inserted into the back passage and a scan taken to show the exact size of the prostate.

v      Bone Scan

Can be taken to determine whether there is any cancer that has spread to the bones near the prostate.

Treatment

There are currently four main options:

Surgery

The entire prostate gland is removed in an operation called a ‘prostatectomy’.

Radiotherapy

High energy rays are used to destroy the cancer cells.

Hormone treatment

Drugs can be used to lower the level of testosterone in the blood, which has the effect of slowing or stopping the growth of the cancerous tumour. However, some prostate tumours develop the ability to grow without  testosterone.

Brachytherapy

A treatment where radioactive ‘seeds’ are implanted directly into the tumour.

These treatments carry the risk of side-effects including incontinence and long-term impotence.

Everyman is working hard to develop more improved treatments for men with prostate cancer.

What is PSA?

The PSA (Prostate Specific Antigen)

The PSA test can be used to screen for early prostate cancer. The PSA Blood Test - tests the level of ‘Prostate Specific Antigen’ in the blood. A high reading suggests prostate cancer but could be caused by other conditions, the PSA test is not a foolproof test for prostate cancer.

·         Two out of three men with a raised PSA will not
have any cancer cells in their prostate biopsy.

·         Up to 1 in 5 men with prostate cancer will have a normal PSA result.

A positive biopsy is needed to confirm cancer.

If prostate cancer is diagnosed, it is not necessarily life-threatening and curative treatment many not be required. Most men diagnosed with early prostate cancer following a positive PSA test would be expected to have slow growing cancer which should not cause any problems during their natural lifespan.

There is controversy over whether PSA testing should be used in routine screening for prostate cancer. Many medical professionals feel it would be wrong to introduce national screening in this country because the effectiveness of screening is unproven and the side effects of treatment can be significant. As a result there is no NHS PSA testing programme because it has not been demonstrated that it leads to an improvement in mortality. However every man over 50 has a right to a PSA test if they request it and in the US many men have regular PSA tests from the age of 50.

Everyman is undertaking further research to find a more efficient, comprehensive test - as an early diagnosis is so important to successful treatment.

Frequently Asked Questions

Will any treatment affect my sex drive and will I still be able to father children?

Different treatments for prostate cancer can cause impotence, reduced ejaculation, a lowered sex drive, urinary incontinence, bowel problems, hot flushes and sweats and tiredness. Surgery, radiotherapy and hormone therapy all have different side effects which need to be considered in any decisions about treatment.

Will I lose my masculinity?

Treatment for prostate cancer is likely to cause infertility. This should be discussed with your doctor before you start treatment.

Is the chance of developing prostate cancer influenced by dietary or environmental factors?

Eating a diet high in animal fat and low in fresh fruit, vegetables and fish and being exposed to cadmium (a heavy metal) or 'radiation' have been identified as possible risk factors which may be associated with prostate cancer. However research is still continuing in this area. Some preliminary research suggests that Lycopene (the compound that gives the tomato its red colour), selenium and vitamin E in the diet could play a preventative role in the development of prostate cancer.