Apart from skin cancers, prostate cancer is the commonest cancer affecting Australian men. Over 17,000 new cases will be diagnosed in 2018 representing 23.8% of all cancers and is the third leading cause of male cancer deaths. More men die of prostate cancer in Australia than women die of breast cancer with an estimated 3,500 prostate cancer deaths projected for 2018 compared to 3,128 female breast cancer deaths.
What is the prostate gland and what is prostate cancer?
The prostate gland is a small, walnut-sized organ that sits below the bladder and provides nutrients for sperm. Prostate cancer occurs when the prostate gland cells grow in a haphazard, unregulated way. The cells can then break free and spread to other parts of the body.
What are the signs and symptoms of prostate cancer?
Prostate cancer generally does not cause any symptoms in its early stages. Accordingly, symptoms are not a reliable guide as to whether cancer is present or not. When prostate cancer becomes advanced it can have effects such as difficulty urinating, blood in the urine, and bone pain.
How can I tell if have prostate cancer?
An abnormal prostate-specific antigen (PSA) blood test or abnormal prostate examination are the first signs. PSA is an enzyme made by the prostate and is found in the bloodstream normally. However, high levels may indicate prostate cancer. There is some controversy about PSA testing. While its use has led to significant reductions in prostate cancer deaths, one criticism is that it can lead to the diagnosis of cancers that were never going to be a problem. However, doctors are now better able to tell which cancers need to be treated and which can be safely monitored.
Should men get PSA tests?
Men should talk to their GP about the pros and cons of PSA testing. Testing should start at age 50. Men who have risk factors for prostate cancer (family history of prostate cancer, or a strong family history of breast or ovarian cancer) should start in their 40s. If the PSA test or prostate examination is abnormal, then a referral to a urologist is required who may then order a prostate MRI and possibly perform a prostate biopsy.
What are the treatment options if cancer is found?
Treatment options for prostate cancer that is contained to the prostate include:
- Surveillance/watchful waiting
- Radical prostatectomy
- External beam radiotherapy
If the cancer has spread, a range of options are available including various “hormonal” treatments, which inhibit the effects of testosterone, and chemotherapy.
Take home message.
Prostate cancer is a significant disease affecting many Australian males. The most important take-home message is for men to talk to their GPs about prostate cancer testing.
Written by Dr Troy Gianduzzo – Urologist