Who Is At Risk Of Prostate Cancer?
The risk of prostate cancer increases with age and is doubled if a relative has the disease and is quadrupled if a father or brother has it. Latent or inactive cancer may be found in 50 per cent or more of 80-year-olds, but in them it is generally of no concern and is unlikely to require treatment.
What Are Prostate Cancer Symptoms?
It is uncommon for early cancer to produce urinary symptoms. However, symptoms may include urgent and frequent urination, getting up at night to urinate, or slowing of the urinary stream with difficulty starting or emptying. A urine infection or blood in the urine may occur. See your doctor if you experience any of these symptoms because they are more likely to be due to other problems.
How Is Prostate Cancer Diagnosed?
Sometimes prostate cancer is found incidentally after an operation for a benign (non-cancerous) enlargement of the prostate. It may be found during a routine check by your doctor, who examines the prostate gland with his/her finger in the rectum. This is called a digital rectal examination.
No blood test clearly shows whether you do or don't have cancer. There is now a blood test which can help your doctor to manage prostate cancer. This is called PSA, as it tests for prostate specific antigens. The level of PSA in the blood can be raised by many infections and conditions, including a benign enlargement of the prostate, as well as prostate cancer. However, if a digital rectal examination is suspicious and/or the blood PSA is raised, your doctor may suggest a biopsy.
A biopsy involves taking a small piece of tissue from the prostate with a special needle so that it can be examined under a microscope by a pathologist. The needle is positioned in the prostate with the help of an ultrasound probe in the rectum.
If the biopsy is positive, the doctor may order a bone scan to ensure the disease hasn't spread into the bones. If it has spread, different treatment may be needed to control the progress. If it hasn't spread, you probably have an early cancer.
What Are Prostate Cancer Treatments?
For early prostate cancer, there are several options that you should discuss with your doctor.
* Watchful waiting
No immediate treatment may be needed in some men, especially those who have small, slowly growing tumours, or those with limited life expectancy. Your doctor will see you periodically to monitor your condition.
* Radiotherapy (treatment with X-rays)
This has been standard therapy for small, localised prostate cancer for many years. Radiotherapy involves daily outpatient treatment that lasts about 15-30 minutes each time, for up to seven weeks. Some patients can suffer irritation of the bowel or bladder, but this can usually be controlled by medication. Loss of erections (impotence) may be a problem.
* Radical prostatectomy
A biopsy of the lymph nodes takes place initially to see if the cancer has spread into them. If it hasn't spread, the surgeon then removes the entire prostate gland (radical prostatectomy), preserving adjacent nerves where possible. If the cancer is confined to the prostate, the results of radical prostatectomy and radiotherapy are similar. The possible complications of this surgery include incontinence (usually mild), impotence and blockage of the urine flow.
* Hormone therapy
Hormone therapy involves eliminating the effects of the male hormone, testosterone - it is known that testosterone helps spread prostate cancer. Hormone therapy can be accomplished by removing the hormone-producing part of the testicles through a small incision in the scrotum. Alternatively, medications can be taken to stop the testicles from producing testosterone or to block the effects of the male hormone. This medication must be taken for life.
You should carefully discuss with your doctor the full implications of all these treatments, their side-effects and their impact on your working and family life.
Your doctor will arrange follow up blood tests, especially to determine the PSA level. A rise in PSA may mean the disease has returned. Careful monitoring means that any progress of the cancer can be treated early by hormone therapy.
What About Survival From Prostate Cancer?
If prostate cancer is diagnosed before it has spread, it may be treated with radiotherapy, hormones, radical prostatectomy or watchful waiting. Your survival depends upon the biological activity of the tumour and your general level of fitness. Men over 70 seldom benefit from radical surgery.
* If you have just been found to have prostate cancer, don't panic.
* If you're anxious that you may have a problem, ask your doctor to check you out.
* During treatment, try to eat well, stay active and keep track of your weight. And remember to follow your treatment program exactly as your doctor advises.
Article by Dr Mike Kirkby, Published by Dr Vivienne Balonwu.