Prostate cancer is the most common cancer in men, and the second most common cancer overall. It affects nearly 50,000 men in the UK per year, and causes approximately 11,000 deaths. The ten year survival rate for prostate cancer is very high (around 84%). 1 in 8 men will be diagnosed with this type of cancer during their lifetime. More than half of cases each year are diagnosed in men over 70 (54%).
What is prostate cancer?
The prostate is a small gland found in men just below the bladder. It surrounds the urethra (tube) which carries urine from the bladder to the penis. This tube also carries semen. The prostate gland creates a thick clear fluid that forms part of semen. Testosterone plays a vital part in the function of the gland. The gland can get bigger as men get older due to a condition called benign prostatic hyperplasia (BPH). This does not normally lead to cancer but cancer cells can be found in an enlarged prostate.
Very early stage prostate cancer does not normally have any symptoms. Normally if a tumour grows it presses against the urethra which can affect urination and sexual function. Prostate cancer can grow very slowly, especially in older men. The most common symptoms are:
* Having to rush to the toilet to urinate
* Needing to urinate more often, especially at night
* Trouble passing urine (if it stops and starts)
* Feeling like you can’t completely empty the bladder
* Blog in your urine or semen (rare)
* Pain when passing urine (rare)
* Weight loss
* Difficulty getting an erection
The symptoms are similar for both prostate cancer or a non-cancerous (benign) tumour in the prostate. Most enlargements of the prostate are benign, non-cancerous and easily treated. If you have any of these symptoms make sure you visit your doctor as soon as possible.
In very rare cases prostate cancer can spread to the bones (secondary prostate cancer). Symptoms can include pain the back, hips, pelvis and other bony areas.
The medical profession still aren’t completely sure what causes prostate cancer. There are risk factors which can increase your chances of developing prostate cancer.
*Age – the risk of contracting prostate cancer increases as you get older. It is rare in men under 50.
*Family history of cancer – if your father or brother has had prostate cancer you are 2 to 3 times more likely to also get prostate cancer. If you have inherited a faulty gene this can increase your chances of getting this type of cancer.
*Ethnicity – prostate cancer is more common in black Caribbean and black African men (due to a mixture of inherited genes and environmental factors).
*Having cancer in the past
*A high calcium diet
As early stage prostate cancer usually doesn’t have any symptoms, it’s quite difficult to diagnose. Only when it becomes more advanced do symptoms occur. It can mimic the symptoms of an enlarged prostate. If you have any symptoms when you go to your GP they will examine your prostate and do a PSA (prostate specific antigen) blood test. PSA is produced by the prostate gland and it’s a marker for the presence of prostate cancer (it can also be present in other conditions). If the GP is concerned, then s/he can send you to see a specialist who will do an examination and arrange a prostate biopsy. You may also get an MRI scan. If cancer is present, then the next step is to get a CT scan and/or a bone scan. Then discussion can start about what treatment is best.
Treatment depends on the type of prostate cancer the patient has, the size of the cancer and the stage the cancer is at, as well as the PSA test. If the cancer is confined to the prostate gland, it is normally treated by surgery or radiotherapy. It could be a very slow growing tumour, in which case it is monitored and no treatment may be required at that time. The main treatments are surgery to remove the prostate gland, radiotherapy or surveillance to monitor it. After treatment the patient is very closely monitored and a PSA test is done at regular intervals. If the cancer has spread then the most common treatment is hormone therapy to keep the cancer under control or chemotherapy can also be effective.
Coping with Prostate Cancer
Being diagnosed with cancer can be devastating at first, but early prostate cancer can be cured and most men survive. Surgery can cause urinary problems such as incontinence or leakage, and radiotherapy can often irritate your bladder, bowel (causing diarrhoea) and making you want to pee more often. Hormone therapy can cause extreme tiredness and weight gain. These symptoms can be managed by medication and treatments but you need to get advice on these things as soon as possible. Treatment can affect your sex life as the nerves which facilitate erection are found around the prostate. Medication and artificial devices can help with erectile dysfunction. Fertility is affected with surgery as the tubes carrying the semen are disconnected, but sperm can be retrieved if necessary beforehand. Radiotherapy generally does not affect fertility and hormone therapy suppresses it for a short time.
You may be affected physically by radiotherapy or feel tired and lethargic a lot (Please read my blog on cancer fatigue for advice on how to cope with this). If your sex life has been affected there are ways to get it back on track.
Feeling shocked and numb after a receiving a diagnosis is very common, both for the patient and the family. Try to talk about how you feel instead of keeping it all locked up inside. Try and maintain a positive attitude and don’t stop doing the things you enjoy. Make sure you get the accurate information you need at each stage of treatment and don’t be scared to have the information repeated if necessary.
If you are struggling with a diagnosis of prostate cancer or any other type of cancer then please contact me for a free consultation to work out ways to move forward.