IN MY VIEW . . . MEN FEAR IT’S CANCER, BUT IT’S MORE LIKELY A BENIGN PROSTATE PROBLEM

THERE is no doubt that, with high-profile examples such as Stephen Fry and growing awareness, prostate cancer is now much more on men’s radars.

Clearly, greater awareness is vital. But, more often than not, men’s urinary problems are not the much-feared cancer.

About 50 per cent of those aged 50 and 80 per cent of those aged 80 have urinary symptoms due to benign prostatic hyperplasia (BPH), a non-cancerous condition where the prostate gland becomes larger.

The symptoms vary over time but gradually worsen over years, and include hesitancy (difficulty starting), weak stream, a sense of incomplete emptying and getting up at night more than once to pass water.

What worries me is that many men become concerned these symptoms are a sign of prostate cancer, when most men with prostate cancer have no symptoms — or only minimal ones — until the cancer has spread, commonly to the skeleton. Then there is bone pain, weight loss and occasionally pain in the groin area or blood in the urine.

The confusion arises because the conditions may occur in tandem, and age is the main risk factor for both. Screening (being checked to see if there is cancer when there are no symptoms) is not as simple as having the blood test for prostate-specific antigen (PSA), which leads to too many false positives and a small incidence of false negatives.

The best way to screen for prostate cancer is with a digital rectal examination by a doctor, supplemented by the PSA blood test. Abnormalities should be followed up by an MRI scan — and a biopsy if there are any suspicious areas.

It is no longer considered good enough to carry out a biopsy without an MRI first. In fact, it’s expected that later this year, MRI scans will officially become a first-line investigation.

The message is, be aware. And if you do need screening, ask your GP about a scan.

For further information on this issue, visit theurologyfoundation.org.