A recent review of prostate cancer diagnoses in the UK has
led to the discovery that almost 40% of cases are diagnosed in the later stages
of the disease.
Furthermore, in February this year, the number of deaths from
prostate cancer in men surpassed the number of deaths from breast cancer in
women, which had never happened before in the UK. What is causing this
startling rise in prostate cancer deaths and why isn’t the disease being picked
up sooner? (1)
The key message is, that if your male and over the age of 50 you should get tested regularly.
Early diagnoses often means it can be treated successfully.
Where can I buy a Self-Check Prostate PSA test kit? - click here.
What is the prostate?
The prostate gland is a crucial part of the male
reproductive system. It is responsible for the production of the white fluid,
which along with sperm, makes up semen. It is found within the pelvis,
enveloping the upper part of the urethra, which is the tube through which urine
from the bladder flows out of the body. Prostate cancer develops when mutations
(changes) in the DNA of cells in the prostate cause cells to proliferate
uncontrollably. It is unclear why this happens, but a genetic link has been
found, with men whose father or brother has/has had prostate cancer more likely
to be affected by it themselves. (2)
Why the increase in
prostate cancer, and why the late diagnoses?
The main reason for the increase in cases and deaths is
thought to be our aging population. Prostate cancer is more likely to develop
in men over 50, and the risk increases further with age. With life expectancy
continually rising in the UK, this means more chance for prostate cancer cases
to arise, and consequently more related deaths. (1, 2)
Also, prostate cancer symptoms can be difficult to
recognise. In the earlier stages, people with prostate cancer may show few or
no symptoms. This may last for decades, until the prostate enlarges to such an
extent that it puts pressure on the urethra. Once this has occurred, changes in
the pattern and ease of urination may become apparent. You may find it
difficult to begin urinating, and you may need to forcefully push to achieve a
normal urinary flow. It might also feel as if you can’t get the last drops of
urine out of your bladder. Prostate cancer can also cause sudden urges to
urinate, and waking up to urinate several times in the night. Erectile
dysfunction is another symptom that can occur as a result of prostate cancer.
(1, 2)
It is important to note that the above symptoms are not always
caused by prostate cancer - other conditions such as benign prostatic
hyperplasia (BPH) also cause these symptoms. But any men experiencing such
changes in urination must see their GP to rule it out. (2)
How can prostate cancer
be identified in the early stages?
There are a number of tests that can be carried out to
assess prostate health. The most common test is the prostate -specific antigen (PSA) blood test.
To buy your Self-Check PSA home test kit - click here.
PSA levels are increased in men with prostate cancer at any stage,
but also in other conditions such as BPH, so raised PSA does not necessarily
indicate presence of prostate cancer. Nevertheless, the PSA test is available
free of charge on the NHS to men over the age of 50 if they ask their doctor
for it. (1, 2)
A digital rectal examination (DRE) involves a doctor or
nurse inserting a gloved, lubricated finger into the back passage to feel the
shape and size of the prostate. It is not reliable enough to be used as a
diagnostic test alone, but can be combined with a PSA test or biopsy. (3)
A biopsy involves taking a small sample of tissue from the
prostate which is examined for any abnormalities. However, approximately 20% of
cancerous samples are not identified, and the procedure can cause problems such
as bleeding and infection of the prostate. (3)
What if I am
diagnosed with prostate cancer?
Quite often, there is no urgent action required after a
diagnosis, other than looking out for the aforementioned symptoms, sometimes
called ‘watchful waiting’. If treatment is started in the early stages, it
usually comprises hormone therapy, radiotherapy and possible surgery. In the
latter stages, when the cancer has often spread to other areas of the body,
treatment is supportive (prolonging life and easing pain and discomfort). (2)
Since the symptoms of urinary incontinence and erectile
dysfunction can be embarrassing and debilitating, men with prostate cancer may
develop depression or anxiety. Prostate
Cancer UK has a wealth of information on living with prostate cancer as
well as links to support groups, a helpline and advice from nurses specialising
in the condition. (2)
As we said at the beginning of this blog - the key take away message is, that if you are male and over 50 you should get tested regularly.
Early diagnoses often means it can be treated successfully.
Where can I buy a Self-Check Prostate PSA test kit? - click here.
References
BBC News. Prostate cancer: Four in 10 cases
diagnosed late, charity says [cited 12 April 2018]. Available at: http://www.bbc.co.uk/news/health-43669439
NHS Choices. Prostate cancer [cited 12 April
2018]. Available at: https://www.nhs.uk/conditions/prostate-cancer/
NHS Choices. Should I have a PSA test? [cited 12
April 2018]. Available at: https://www.nhs.uk/Livewell/Prostatehealth/Pages/psa-test.aspx
Author: Gabby Gallagher MPharm
Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 18/04/18