Prostate cancer: the facts

Today one man in 20 is diagnosed with prostate cancer, around 27,000 every year, and it has now become the most common cancer in men - overtaking lung cancer. This is largely due to a likely increase in the number of cases diagnosed, through the greater use of PSA tests, and the influence of an ageing population. The majority of men with prostate cancer are aged over 60 years, with an average age at the time of diagnosis of 75 years. Although this cancer can also occur in younger individuals, it is very rare under the age of 50. Little is known about the genes and molecular mechanisms which cause prostate cancer. Prostate cancer can run in families. Men with a brother or father who developed prostate cancer have a 3-5 fold increased risk. Two prostate cancer genes have been reported, and may be responsible for around 10% of familial cases. Further genes remain to be discovered.

Studies of Asian immigrants to the US show that whilst those brought up in Asia have a low incidence of prostate cancer, Asians raised to adulthood in the US acquire that country's higher risk. This observation suggests that environmental and dietary factors that are different between the two countries may influence the incidence of prostate cancer. Diets high in animal fats and milk products may be associated with a higher risk, and diets high in green vegetables may be protective. It has also been suggested that Lycopene (the compound that gives the tomato its appealing red colour), selenium and vitamin E in the diet may protect against prostate cancer.

What are the symptoms? In its early stages, prostate cancer often does not cause symptoms. But when they do occur, they may include any of the following problems: -

Difficulty in urinating

Delays in urinating

Stopping and starting urinating

A weak stream of urine

Urinating more often than usual

Blood in the urine

Pain and stiffness in the lower back and hips

It is vital that you do go and see your doctor as soon as possible if you are suffering from any of these symptoms so that the cause can be diagnosed and any relevant treatment administered. Screening and testing The PSA test (Prostate Specific Antigen) can be used to screen for early prostate cancer. A raised result does not necessarily mean that cancer is present. A positive biopsy is needed to confirm cancer, which will occur in about one man out of every five. If prostate cancer is diagnosed, it is not necessarily life threatening and curative treatment many not be required - as most men diagnosed with early prostate cancer following a positive PSA test would be expected to have slowly growing cancer which should not cause any problems during their natural lifespan.

in the US many men have regular PSA tests from the age of 50. Men are advised to visit their doctor if they experience any of the symptoms of early prostate cancer described above. Treatments The method most commonly used to treat prostate cancer varies in different countries. Prostatectomy - removal of the prostate - is common. Radiotherapy is also used. An alternative is active monitoring or surveillance ensuring that the prostate cancer situation is being carefully managed. Both radiotherapy and surgery can result in impotence although this is more common with surgery (50-80% of patients). Surgery may cause incontinence whereas conventional radiotherapy may cause bowel side effects.