Prostate cancer: What you need to know
Prostate cancer awareness has risen due to high-profile figures, such as Stephen Fry and Elton John, opening up about their diagnosis and life after treatment.
However, with no national screening programme in place, many men choose to defer thinking about the subject until the condition becomes aggressive or symptoms interrupt everyday life.
Here resident urology consultant surgeons and oncologists from the Bath Prostate Centre at BMI Bath Clinic talk about what men should know about prostate cancer and how new technology is increasing the safety of prostate treatment.
What is prostate cancer; is it really that common?
Around 130 men are diagnosed with prostate cancer every day in the UK. It tends to affect over-50s, though younger men can get prostate cancer too.
Only men have a prostate. It’s a gland that’s normally the size and shape of a walnut, and it sits below the bladder and around the urethra – the tube that men pass urine and semen through.
In some cases, the cancer is aggressive and can grow quickly. It can also spread to other body areas, most commonly bones or lymph nodes. A family history of prostate cancer, and certain other cancers, can increase the risk. Whilst age and race are well-established links also, there is emerging evidence of lifestyle related risks.
What are the symptoms?
At the Bath Prostate Centre, we offer a prostate assessment clinic to get to the source of associated symptoms quickly.
These can include difficulty or a frequent urge to urinate, signs of blood in urine or semen, painful ejaculation and urination and problems gaining an erection.
Not all these symptoms mean a man has cancer, which is why careful assessment is advised.
Finally, some men do not have any symptoms but are concerned about their risk of cancer or know someone with prostate cancer. Our specialists can discuss the need and value of PSA or other testing.
How is it diagnosed?
Often, the first test will be physical, with the physician using a gloved finger to check for any abnormality in the texture, shape or size of the gland. A blood test may also be recommended, looking at the level of PSA, a substance that’s naturally produced by the prostate gland.
If an abnormality is discovered, you may be referred for additional tests. This could include an ultrasound probe to create a picture of your prostate gland, or an MRI scan to identify suspicious areas that require further evaluation. There has also been much research into other tests that may be relevant to a small number of men.
It is possible you will be offered a prostate biopsy, where small samples are taken from your prostate with a needle, to examine it for disease. If cancer is confirmed, a pathologist will determine how aggressive it is. A scale, the Gleason grade, is used to rate the degree of aggressiveness (from 6 to 10 where 6 is the lowest risk prostate cancer).
How can it be treated?
The treatment options available to you will vary depending on a huge number of circumstances such as how far your cancer has spread, how quickly it is growing and other factors such as your health.
When prostate cancer is detected at the earliest stages, there are three treatment approaches. This may include regular check-ups and PSA tests for ultra-low risk cancer, while for higher-risk cancer that has not spread, you may be offered minimally invasive surgery or carefully planned radiotherapy.
Surgery seeks to remove the prostate in its entirety. External beam radiotherapy involves targeted radiation to the prostate to kill cancer cells. The goal is to minimise the risk of the cancer spreading. Your specialist will help choose the treatment most suited to you, including any novel treatments.
If your prostate cancer has already reached a more advanced stage, you may be offered alternative treatment options such as hormone therapy or chemotherapy.
What’s new? Are there ways of reducing the risks associated with treatment?
Radiation therapy is effective in targeting and treating prostate cancer, but as with any procedure there are potential side-effects.
These can be mild and go away on their own, but for some patients they can last for years after treatment ends and profoundly impact quality of life.
Side-effects can include rectal pain and bleeding, chronic diarrhoea, urinary urgency/leakage, and erectile dysfunction.
To potentially reduce these sideeffects we offer an innovative treatment named Spaceoar Hydrogel.
This absorbable hydrogel temporarily creates space between the prostate and the rectum, reducing the radiation dose delivered to the rectum during prostate radiation therapy.
It has already been used to help more than 50,000 prostate cancer patients worldwide, plus it has been shown to reduce the risk of side-effects such as rectal bleeding, bowel dysfunction and incontinence plus can help to maintain sexual potency.