Prostate cancer: Risk factors, symptoms and treatment

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In the UK, prostate cancer is the most common type of cancer in men, with more than 40,000 new cases diagnosed every year.

Prostate cancer risk factors

It's not clear why it occurs, but the risk of developing prostate cancer is also increased depending on your:

  • Age. Your chances of developing prostate cancer increase as you get older. The condition mainly affects men over 65, although men over 50 are also at risk.
  • Ethnic group. Statistics show that African Caribbean men are 2-3 times more likely to develop prostate cancer than their white counterparts. They are also more likely to develop prostate cancer at a younger age.
  • Family history. Figures show You are two and a half times more likely to get prostate cancer if your father or brother has had it, compared to a man who has no relatives with prostate cancer. Your risk of getting prostate cancer may also be higher if your mother or sister has had breast cancer.

Symptoms of prostate cancer

The symptoms of prostate cancer can be difficult to distinguish from those of prostate enlargement. Prostate cancer signs may include:

  • Needing to pee more frequently, often during the night
  • Needing to rush to the toilet
  • Difficulty in starting to pee (hesitancy)
  • Straining or taking a long time while peeing
  • Weak flow
  • Feeling that your bladder has not fully emptied
  • Blood in urine
  • Blood in semen
  • Prostate cancer can also have no symptoms, especially in its early stage
🩺 You should see your GP if you have these symptom or you are worried about the possibility of prostate cancer. It's much more likely to prostate enlargement, but it's important to rule out cancer.

Prostate cancer treatment

The outlook for prostate cancer is generally good because, unlike many other types of cancer, it usually progresses very slowly. Many men die with prostate cancer rather than as a result of it.

If the cancer is at an early stage and not causing symptoms, your doctor may suggest  actively monitoring with blood tests and other such as MRI scans or biopsies, and reserving treatment if there are signs that the cancer is growing faster. In elderly men a policy of regular PSA and symptomatic monitoring may be appropriate. Some cases of prostate cancer can be cured if treated in the early stages.

The best option depends on your choice, age and overall health.

You can read more about the treatments offered by the NHS here. However they include:

  • Surgery. The prostate is surgically removed usually used when the cancer has not spread. It can carry risks.
  • Radiotherapy. This uses radiation to kill cancerous cells and is usually offered when the cancer has not spread beyond the prostate. Sometimes hormone therapy is given before or after radiotherapy to increase its effectiveness.
  • Brachytherapy. Also known as internal radiotherapy, this form of treatment is delivered directly inside the prostate
  • New treatments. Newer treatments include high-intensity focused ultrasound (HIFU). Here an ultrasound probe inserted into the rectum releases sound waves that kill cancer cells in the prostate gland by heating them to a high temperature. Cryotherapy, is another new treatment. Tiny needles inserted into the prostate gland deliver a treatment that freezes and kills cancer cells. Whilst these are promising potential treatments, they have not yet been shown to be effective in the long term for all patients and therefore patients undergoing these treatments should expect be entered into clinical trials.

Some cases are only diagnosed at a later stage, when the cancer has spread. If the cancer spreads to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms. There are now many treatment options for patients in this situation, including hormone treatments, chemotherapy, radiotherapy, newer hormonal treatments and newer classes of cancer drugs. This is a rapidly evolving field and patients may be offered the chance to take part in clinical trials of these newer treatments.

Treatment side effects

All treatment options carry the risk of significant side effects, including difficulty having and maintaining erections (erectile dysfunction) and urinary symptoms, such as needing to use the toilet more urgently or more often. For this reason, some men choose to delay treatment until there's a risk the cancer might spread.

Let’s look at the potential side effects in more detail:

  • Erection problems. If you have erectile dysfunction as a result of treatment, speak to your GP. It may be possible to treat you with sildenafil (Viagra) which increases the blood supply to your penis. Other medicines are available if sildenafil is not effective. An alternative is a device called a vacuum pump. It's a tube connected to a pump. You place your penis in the tube and then pump out all the air. This creates a vacuum, which causes the blood to rush to your penis. You then place a rubber ring around the base of your penis to keep the blood in place, allowing you to maintain an erection.
  • Urinary incontinence symptoms. If your symptoms are mild, you may be able to control them by learning some simple exercises. Pelvic floor or Kegel exercises can strengthen your control over your bladder. Find more about them here. If your urinary incontinence is more severe, it may be possible to treat it with surgery. This might involve implanting a male urethral sling, or an artificial sphincter – the sphincter is the muscle used to control the bladder outlet.  

Living with prostate cancer

As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment.

However, if your prostate cancer progresses, you may not feel well enough to do all the things you used to. After an operation or other treatment, you'll probably feel tired and need time to recover. And as well as the possible side effects of treatment, your diagnosis may make you feel anxious or depressed. It may be helpful to talk about the condition with your family, friends, a family doctor, and other men with prostate cancer. The links below have useful information about where to find more support.

Get Support

*The following people have a prostate:

  • Men
  • Trans women: someone who was assigned male at birth but identifies as a woman. Trans women can develop prostate problems, even if they have taken hormones. The prostate is not removed during genital reconstructive surgery.
  • Non-binary people who were assigned male at birth**
  • Some intersex people. An intersex person may have both male and female sexual characteristics and so might have a prostate.

The Prostate Check questionnaire within the Evergreen Life app can help you better understand your current prostate health and how best to protect it.

📲 Not got the app yet? Download the Evergreen Life app by tapping the button below and look out for a notification about your Prostate Check questionnaire*.

*Must be 18 or over and male to receive the Prostate Health Check. If you haven’t told us your age and sex, please first take the GP Check in your Records section.

References
Written by
Dr Brian Fisher MBBCh MBE MSc FRSA

Meet Dr Brian Fisher MBBCh MBE MSc FRSA, Strategy and Clinical Director at Evergreen Life, and a Medical Expert with more than 42 years' experience as a GP.

Article updated:
August 18, 2021
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