In the UK, more men now die of prostate cancer than women of breast cancer.

While those dying from breast cancer has steadily decreased over the past few years, men dying from prostate has increased. This should be a cause for concern in all men.

Treated.com spoke with Laura James, Head of Clinical Services at Prostate Cancer UK about prostate cancer.

This article was written to coincide with Prostate Cancer UK’s planned marches happening throughout June. More information can be found at the bottom of this article.

What is Prostate Cancer?

The prostate is a gland located just under the bladder. It’s purpose is to create a thick white fluid called semen, which acts as a vehicle for sperm.

The prostate is usually the size and shape of a walnut.’ Laura explains. But even though it starts off small, as men age, the prostate can grow in size. Men often experience urinary flow problems when it becomes enlarged, because it pushes against the urethra (the tube men pee and ejaculate through).

Cancer can develop when certain cells in the prostate gland form one or more cancerous tumours. Sometimes the cancer can expand and spread to other parts of the body. The longer a man’s prostate is left untreated, the more he is at risk.

Who is at risk?

Men aged 50 or over, men with a family history of prostate cancer and black men are more at risk of getting prostate cancer. In the UK, about 1 in 8 men will get prostate cancer at some point in their lives, this rises to 1 in 4 for black men.

Because prostate cancer often doesn’t cause symptoms in its early stages, awareness of risk is a man’s best defense against the disease, and anyone with concerns about their risk should discuss them with their GP.

What are the symptoms?

Early on, many men don’t even realise they have prostate cancer because they aren’t showing any symptoms or signs. This has a lot to do with how the cancer expands.

If the cancer begins to press against the tube through which a man urinates - the urethra - then he may exhibit some symptoms affecting the way he pees.

In most cases, the expansion of the cancer will not press against the urethra. In cases where there are symptoms, this could just be because the prostate is enlarged, but not cancerous. It might also be a different health issue. Regardless, anybody who notices irregularity when they visit the toilet should seek an appointment with their GP.

Changes might include:
  • An uncontrollable urge to urinate - it might happen before reaching a toilet
  • More frequent trips to the toilet to pee
  • Leaking after using the toilet
  • The sensation that the bladder is not empty
  • Trouble getting started when taking a trip go to the toilet

If the cancer is breaking/has broken through the capsule of the prostate and may be affecting the area just outside of it, this is called locally advanced prostate cancer. If it makes its way to other parts of the body, this is considered advanced prostate cancer. In such cases, symptoms become more visible and can include:

  • Pain related to the back or pelvis, or even hips
  • An inability to maintain an erection
  • Urine or semen having a red tainted hue, meaning blood is present
  • A sudden change and decrease in weight
  • Increased tiredness/fatigue

How is a diagnosis made?

Initially, the doctor may ask for a urine sample, take a blood sample to test for PSA (prostate-specific antigen) and perform a rectal examination.

He or she will make an assessment based on the initial tests, and take into account things like age, family history and ethnic group. Referral to a hospital might happen if a risk is identified.

An MRI scan and then a biopsy - the examination of body tissue under a microscope - is likely to be conducted at this stage to check whether prostate cancer is present.

What treatment is available?

There are several treatments available. The treatment used will depend heavily on a number of factors, including:

  • The stage of the cancer
  • The rate at which it is growing
  • The pros and cons surrounding each treatment
  • Side effects associated with certain treatments
  • A man’s personal ideas about each treatment

Treatment will also depend on whether the cancer is contained within the prostate (localised), has moved slightly outside the prostate (locally advanced) or has spread to other areas of the body (advanced).

If the cancer is localised, treatment might not be recommended immediately. This is because it can grow slowly. Regular check ups are an important option because this is a good way to measure the rate of growth.

There are three main routes of treatment for localised prostate cancer:

  • Surgery
  • External beam radiotherapy
  • Brachytherapy

If the cancer is locally advanced and has grown just outside of the prostate, then the treatment may include:

  • External beam radiotherapy with hormone therapy (and sometimes with high dose rate brachytherapy)
  • Surgery, often followed by hormone therapy and radiotherapy
  • Hormone therapy alone

In the case of advanced prostate cancer, which has grown and spread to other parts of the body, unfortunately, it cannot be cured. However treatment can help to reduce symptoms and keep the cancer under control. This might involve:

  • Hormone therapy
  • Chemotherapy
  • Or other methods being tested in clinical trials

You can read about each treatment in more detail on Prostate Cancer UK.

What research is being conducted?

Laura commented that specifically, ‘we focus on funding research in three key areas: better diagnosis, better treatments and better prevention. By tackling these areas, we can make the biggest impact to men with, or at risk of, prostate cancer.’

She added, ‘Earlier and accurate diagnosis will be key to saving more lives, so developing tests which can be used as part of a routine national screening programme will be a significant step forward. In addition, improving treatments for the disease, particularly at the advanced stages, will also help to benefit more lives.

We need to continue to raise much more money to achieve our goals.’

Is enough being done to help men struggling with prostate cancer?

We know that awareness of prostate cancer and the risks associated with it has been increasing over recent years.’ Laura comments. From 2018 onward, there has been a dramatic and unprecedented spike in public interest surrounding this issue.

She believes this rise in attention around the subject of prostate cancer is largely down to the fact it has become the third biggest cancer with regard to the amount of people dying from it. She also suggests celebrities and famous personalities have played a role in raising awareness, like Stephen Fry and his honest and frank account of his own personal struggle.

We want to transform the way prostate cancer is diagnosed and treated and to do so we need to invest millions more in research. We have plans, we have the expertise, but we need a much bigger team of supporters to make it a reality.’ Laura concludes.

Prostate Cancer UK are planning a wave of marches throughout the UK to help raise awareness.

Further details of marches planned for your area can be found on the Prostate Cancer UK websiteAnyone with concerns about prostate cancer may contact Prostate Cancer UK’s Specialist Nurses in confidence on 0800 074 8383 or online via the Live Chat instant messaging service: www.prostatecanceruk.org