What every man needs to know about cancer prostate
With the news that Rod Stewart has secretly battled and beaten prostate cancer, we take a look at the key facts all men should be aware of about this common disease…
What is it?
The growth of a cancerous tumour inside the prostate – the walnut-sized gland buried deep inside the body between the penis and rectum. It’s job is to make the fluid part of semen.
How common is it?
As many as one in eight men in the UK will be diagnosed with prostate cancer in their lifetime, this equates to about 47,500 new cases per year. It has now overtaken breast cancer when it comes to the number of lives it claims each year – around 11,800 compared to 11,500 for breast cancer.
Who is most at risk?
Age is the single most important risk factor in the development of prostate cancer. Prostate cancer is very rare in men under 40 and is most commonly diagnosed in those over 70, as in Rod Stewart’s case.
A third of new cases each year are diagnosed among men aged 75 and over. Having a family history of prostate cancer and being black also puts you at higher risk.
How important is it to catch it early?
As with all cancers, early diagnosis is critical to survival rates – but most men with early prostate cancer don’t have any signs or symptoms.
Unfortunately, by the time it causes symptoms it is often because it has already spread.
Rod Stewart’s cancer was picked up early during a routine health check – most likely a private medical screening, as it’s not something routinely checked on the NHS.
Are there any symptoms to look out for?
It’s vital to see your GP if you have any difficulty urinating – whether it’s a weaker flow, pain, leaking or need to pee more often.
These changes are more likely to be a sign of an enlarged prostate – a very common noncancerous problem that occurs with age. But they can be linked to cancer so they must always be checked. Red flag symptoms that require an urgent GP appointment include: back, hip or pelvis pain, new problems getting or keeping an erection, blood in the urine or semen and unexplained weight loss. These can occur when cancer has spread.
Why isn’t there a national screening programme?
Mainly because the tests we do are considered too inaccurate.
The only technique we currently have for screening prostate cancer is a blood test looking for elevated levels of a protein called PSA, which is produced by cancer cells.
But while the PSA test can successfully catch some cancers early, it’s also notoriously unreliable giving both false positive and false negative results at times. A study published last year found that a nationwide PSA screening programme wouldn’t be effective. Researchers at Bristol and Oxford Universities found no difference in the 10-year death rate among men aged 50 to 69 who were screened by a PSA test versus those
who weren’t. Experts believe this is because the test picks up the more common slow-growing tumours that would do no harm if left untreated, but misses many of the more aggres
sive cancers.
Can I ask for a test?
GPs won’t automatically offer the test to men with no symptoms you however, if you’re over 50, you do have the right to ask for one. Currently, most men only see their GP by the time the cancer is symptomatic
PSA test can catch some cancers early but is also notoriously unreliable
and has spread. By this time it’s difficult to cure. So while imperfect, the PSA test is the only way to detect who might have the cancer at an earlier, treatable stage,
Current guidelines give men over 50 – the highest risk group – the right to the test along with advice on the pros and cons of taking it.
Men with a higher than average prostate cancer risk – including a strong family history – can ask for a PSA test from the age of 45.
Some doctors will offer a rectal examination to check your prostate. This involves gently inserting a lubricated, gloved finger into your bottom to check the size of the prostate and feel for bumps or other abnormalities. It’s uncomfortable but only takes a couple of minutes.
Will I need a biopsy?
If you’ve had a positive PSA test, you may be referred for a biopsy to check for cancer or sent for an MRI scan.
MRIs have helped reduced the need for a biopsy by a quarter, which is helpful as the procedure can be uncomfortable and cause infections. Having an MRI also appears to double detection rates of aggressive cancers, so it’s worth asking your doctor if this is possible.
If I have cancer, will I need treatment?
Not necessarily. Prostate cancer is usually slow growing and doesn’t always spread outside of the gland, so if it’s caught at an early stage a policy of ‘watchful waiting’ is often followed. The aim is to keep an eye on the cancer, avoiding treatments which can cause unwanted side effects, including erection problems and urine leaking.
What are the treatment options if it’s cancer?
More aggressive prostate cancers need immediate treatment to stop them spreading and becoming life-threatening. Options can include surgery to remove the entire prostate, radiotherapy and hormone therapy.
Once the disease has spread to other organs it’s not usually possible to cure it, so the goal is to extend your life for as long as possible.
Treatments such as radiotherapy, hormone treatment and chemotherapy can then be used to help slow down the cancer’s progression and maintain a good quality of life for as long as possible.
What are survival rates?
Although cases of prostate cancer are rising, reassuringly, the disease is actually less likely to kill you now than 10 years ago – thanks to better detection rates and treatment.
And as Cancer Research UK point out, the number of men getting and dying from prostate cancer is increasing mostly because of population growth and because we are living longer. The overall survival rates of the disease have actually increased by 6% in the last 10 years and tripled in the last 40.
Can I do anything to reduce my risk?
Regular exercise, quitting smoking, losing weight if you need to and having a healthy diet that includes plenty of antioxidant-rich fruit and veg have all been found to lower your risk of prostate cancer.
Some studies have also found that regular sex or masturbation might be beneficial.
Experts believe ejaculation may flush out harmful chemicals that might otherwise build up in the prostate and lead to cancer.
I heard that all men will get prostate cancer one day – is this true?
Experts now believe all prostates will become cancerous eventually, so the longer you live the higher your risk.
Research shows that about 80% of men who reach the age of 80 have some cancer cells in their prostate. This is because the prostate changes and grows bigger as you get older, making it particularly susceptible to cancerous changes.
However, this scary fact masks what is actually positive news. A great many of these cancers grow so slowly that even without treatment they will never become lifethreatening – with most men living with the condition until they eventually die of some other, unrelated cause.
Exercise, quitting cigs and having a healthy diet can help reduce risk