What is the Prostate?

The prostate is a gland present in all men. It’s located at the base of the bottom under the bladder and surrounds the tube that carries urine out of the body. The prostate helps to make semen. It is typically the size of a walnut and gets bigger as men get older

 

What is an Enlarged Prostate?

An enlarged prostate is common in men over 50 and is not usually caused by cancer. As the prostate grows, it can press on structures which can cause a variety of urinary symptoms. An enlarged prostate is not the same as prostate cancer, and it doesn’t increase your risk of prostate cancer. However, it’s possible to have an enlarged prostate and prostate cancer at the same time.

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A benign enlarged prostate can cause men difficulties. A doctor will advise how to lessen these symptoms, with lifestyle measures and medications.

 

What is Prostate Cancer?

When the body replaces its old and dying cells, it is via a carefully controlled process. In the prostate, if these cells start to grow in an uncontrolled way, this can be due to cancer in the gland. Beyond a certain level of growth, it has implications for how the rest of the body can function.  In some cases, the uncontrolled cells can spread, seed and grow in other near or distant parts of the body. If this happens it is very serious.

 

How common is Prostate Cancer?

Prostate cancer is the most common male cancer in the UK. About 1 in 8 men will get it in their lifetime. We don’t know what causes prostate cancer but the risk of getting it increases with:

• Age: it mainly affects men over 50. The most common age for men to be diagnosed is between 65 and 69 years. Under 50, the risk is low, it can develop but not commonly.

• Family history: if your relatives have prostate cancer or breast cancer, this can increase your risk of prostate cancer. This is linked to your genetics. Your risk is higher if you have a close relative diagnosed under the age of 60.

• Ethnicity: It is more common in men of African, Caribbean, and mixed ethnicity. In the UK, the risk for black men is 1 in 4.

• Diet and Lifestyle: Being overweight and living an unhealthy lifestyle may predispose you to prostate cancer.

 

What symptoms should I look out for?

Most men with early prostate cancer don’t have symptoms. Symptoms can arise if the cancer presses on nearby structures, especially causing urinary symptoms.

 

What should I do?

If you have symptoms or think you may be at risk of prostate cancer, speak with a doctor who can advise on the best course.  

 

What if I don’t have any symptoms?

Speak to your doctor if you are over 50, (or over 45 if you have a family history of prostate cancer or are of African, Caribbean or mixed ethnicity), even if you don’t have symptoms.

 

Physical examination of the Prostate

Your doctor may recommend examination of your prostate through your back passage (rectum). This can feel uncomfortable or embarrassing, but the test is quick and not usually painful. Your doctor may also examine your abdomen, penis, testicles, and lymph nodes.

Physical examination of the prostate is not a completely accurate test. Your doctor can’t feel the whole prostate. Also, a man with prostate cancer may have a prostate that feels normal. If there is anything unusual, your doctor may recommend further tests.

 

What blood test?

You may be offered a PSA blood test. PSA is a protein, made by normal prostate cells but also prostate cancer cells. It’s normal to have a small amount of PSA in your blood. The level typically rises with age as your prostate enlarges. A raised PSA level suggests a problem, but not necessarily cancer. However prostate cancer can cause high PSA levels.

A PSA test alone doesn’t tell you the problem but helps to decide on further investigations. Your doctor will explain the pros and cons of a PSA test.

 

After your assessment

Together with the physical examination, the PSA blood test and your history, your doctor can explain what is happening, and what should be done next.