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Men's Health

Prostate Cancer

Prostate cancer is diagnosed mainly in men over the age of 50 years. Excluding some forms of skin cancer, Prostate Cancer is the most common type of cancer in Australian men. Prostate Cancer is a condition in which cells within the prostate grow and divide abnormally so that a tumour grows in the prostate.

Prostate Cancer cells can be very slow-growing and not cause any problems or symptoms, and may not become life-threatening. However, in other cases, the cancer cells can grow more rapidly and may spread to other parts of the body. It is not known why some cancers grow at different rates and, in particular, which cancers will spread to other parts of the body.

– Prostate Cancer is the most common form of cancer in men, excluding some types of skin cancer.
– Approximately 20,000 new cases diagnosed each year.
– Approximately 3,300 deaths recorded each year in Australia.
– One in 5 men in Australia will develop prostate cancer in their lifetime.

The E.J. Whitten Foundation was created to support Prostate Cancer Awareness and help save men’s lives.

About the Prostate

The prostate is a small gland about the size of a golf ball. It is found only in men. It sits just below the bladder and surrounds part of the urethra.  The prostate produces some of the fluid that makes up semen.The growth of the prostate depends on the male sex hormone, testosterone, which is made by the testes.

It is common for the prostate to get larger as men grow older. This is called benign prostatic hyperplasia (BPH). This is not cancer even though the symptoms of BPH—such as poor urinary flow, needing to urinate often at night, and trouble starting to urinate—are quite common in older men. They do not usually have anything to do with cancer.

What is prostate disease?

Prostate disease is a very common health problem for men. Prostate disease is a term used to describe any medical problems involving the prostate gland. Not all prostate disease is cancer.

Typical prostate problems experienced by men include:

  • Prostatitis which is inflammation or swelling of the prostate gland.
  • Benign prostatic Hyperplasia (BPH) which is a benign (non-cancerous) enlargement of the prostate gland. BPH is the most common form of prostate disease.

Aside from Prostate Cancer, inflammation and enlargement of the prostate are not generally life-threatening but can be very painful disorders that may affect the quality of life.

How many men are affected?

  • Prostate disease is a very common health condition for men.
  • Approximately 50% of Australian men may experience some type of prostate problem at some stage of their life.

The Risk Factors

The causes of Prostate Cancer are not known. However there are certain risk factors that have been linked with the development of Prostate Cancer including:

  • Family history of prostate cancer – those men with a father or brother who has had Prostate Cancer
  • Age – men over the age of 50 years
  • Diet – a diet high in animal fat and protein
  • Race – Afro-Caribbean men are more at risk of having Prostate Cancer than Asian men

The Symptoms

Early Prostate Cancer usually causes no symptoms. Many men over fifty have urinary symptoms such as:

  • a need to pass urine more often, especially at night
  • difficulty starting
  • difficulty holding back the flow
  • not being able to urinate when you feel you need to
  • poor urine flow or a flow that stops and starts
  • painful ejaculation
  • decreased libido
  • reduced ability to get an erection

However, these symptoms are generally caused by benign prostatic hyperplasia (BPH) and not by cancer. BPH cannot turn into Prostate Cancer.

Later stage Prostate Cancer may cause symptoms including:

  • pain or burning when urinating
  • blood in urine
  • pain in the lower back, hips or upper thighs

Usually these symptoms are not caused by cancer. However, you should have any symptoms checked by a doctor.The most common symptom is bone pain, often in the vertebrae, pelvis or ribs. Spread of cancer into other bones such as the femur is usually to the proximal part of the bone. Prostate Cancer in the spine can also compress the spinal cord, causing leg weakness, urinary and faecal incontinence.

Testing for Prostate Cancer

How prostate cancer is diagnosed.

If your doctor thinks you might have Prostate Cancer, a number of tests can be done to find out for certain. These tests will also check the size of the cancer and find out if it has spread. It is important that you understand what it will mean if a test shows you have cancer. You need to think beforehand about whether you would want to have treatment. This will depend on your age, health, what you want and the stage of the cancer. Your doctor can help you decide what is best for you.

prostate-cancer-psa-test
Blood test (PSA) to measure levels of prostate specific antigens in the blood.

You may have some or all of the following tests:

Blood test (PSA) to measure levels of prostate specific antigens in the blood. If the levels of PSA are high and a rectal examination is abnormal, there is about a 60% chance of Prostate Cancer being found. However, most men with a normal feeling prostate and a slightly raised PSA level do not have cancer.

Digital rectal examination (DRE) where the doctor places a finger inside the rectum, or back passage, to check for changes to the surface of the prostate:

Biopsy Bone scan
Computerised tomography (CT) scan
Magnetic resonance imaging (MRI)
‘Staging’ the disease

The tests described above show whether you have cancer. They will also show where the cancer is and whether the cancer cells have spread to other parts of your body. This helps your doctors ’stage’ the disease.

‘Stage’ describes the extent of the cancer in your body. It helps show which treatment is needed. It also is a guide to prognosis.

A common ’staging system’ used for Prostate Cancer is the TNM system (T = tumour N = nodes M = metastases)

  • T followed by a number between 1 and 4 shows whether and how far the cancer has spread in the area of the prostate. A higher number after the T (for example, T3 or T4) means it has spread beyond the prostate into tissue around the prostate, or to nearby organs (the bladder or rectum). Men with T1 or T2 disease have cancer that is probably confined within the prostate (early prostate cancer).
  • N1 means the cancer has spread to a lymph node or nodes near the prostate. N0 means the cancer has not spread to any lymph nodes.
  • M followed by 1a, b or c shows that the cancer has spread to bone or other sites.Ask your doctor to explain the stage of your cancer in a way you can understand. This will help you choose the best treatment for your situation.

Treatment for Prostate Cancer

The type of treatment will depend on a number of factors. These include:

  • The stage of the cancer- localized in the prostate gland or spread to other parts of the body
  • The Gleason score- high (more aggressive) or low grade biopsy grading
  • The level of PSA in the blood stream
  • The man’s age
  • The man’s general medical health
  • The side-effects of treatment

However, the final decision about the most appropriate treatment needs to be made on an individual basis, taking into account the wishes and decision of each patient.

Options for men whose cancer has not spread.

There are several options for men whose cancer has not spread beyond the prostate.

  • Watchful waiting
  • Surgery – (Radical (total) prostatectomy)
  • Transurethral resection of the prostate (TURP)
  • External radiotherapy
  • Brachytherapy (internal radiotherapy)

Options for men whose prostate cancer has spread

  • Hormone treatment with surgery
  • Hormone injections
  • Palliative treatment
  • Prognosis

If the Prostate Cancer is aggressive and has spread to other parts of the body, hormone therapy in combination with surgery or radiotherapy is often recommended.

Prostate Cancer can be treated best when the cancer is found early and is still confined to the prostate.
In many cases, the cancer does not go away after treatment but stops growing or shrinks in size. Men usually return to normal or near normal good health. This may last for months or years.

After your treatment is finished, your doctor will recommend regular check-ups. If you have any new symptoms, you should see your doctor.

If you would like more information visit:

The Andrology Australia site: www.andrologyaustralia.org
Prostate Cancer Foundation of Australia: www.prostate.org.au

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