Dr Hilary on... Prostate Cancer

Find out more about prostate cancer symptoms, diagnosis and treatment

Prostate cancer is the most common cancer in men in the UK with some 40,000 new diagnoses made every year.

Often it is slow-growing and has no impact on a man's life even if he lives into his 80s or 90s. Regrettably however it can sometimes prove to be an aggressive type of cancer and can claim the lives of younger men some of whom would still have been in their 40s.

Early diagnosis may be difficult as the disease is often asymptomatic. As the prostate gland enlarges however it is likely to obstruct the outflow of urine from the bladder leading to frequency, hesitancy before passing urine, dribbling at the end and the feeling that the bladder has not been properly emptied.

The symptoms however are exactly the same as those from benign enlargement of the prostate which is in fact nine times more common. Whilst early diagnosis treatment and research continues to improve the outlook much remains unknown about the cause and best treatment for prostate cancer. Increasing age and being of African Caribbean descent certainly increases the risk. Being of Asian descent decreases it. Also if a first degree relative such as a father or brother had prostate cancer there is an increased vulnerability.

Screening however is not perfect. Blood tests looking for a biological markers are unreliable although they provide better information when conducted on a regular basis as they may then show changing trends. The other main two methods of early diagnosis are the digital rectal examination and biopsy.

The good news is that even when prostate cancer is found provided it is non-aggressive and remains within the capsule of the gland it can be treated with watchful waiting. This means no immediate treatment may be needed. The patient's own preferences towards treatment are very much encouraged as there are options of surgery radiotherapy and hormone treatment. If the cancer has spread already however for example to the bones then cure becomes impossible and palliative care will be arranged.

All treatments unfortunately risk possible complications including erectile dysfunction and unary incontinence so these need to be fully discussed with patients. New approaches to treatment such as high intensity focused ultrasound (HIFU) and cryotherapy aim to reduce these complications but further work needs to be carried out into their efficacy.

Living with prostate cancer will certainly involve challenges but with help from the GP and hospital doctors it is perfectly possible for many men to live for decades with the condition without it being the sword of Damocles hanging over their head which they might imagine.
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