Prostate cancer occurs when abnormal cells develop in the prostate. These abnormal cells can continue to multiply in an uncontrolled way and sometimes spread outside the prostate into nearby or distant parts of the body.
Only men have a prostate. It is a small gland that sits below the bladder near the rectum. It surrounds the urethra, the passage in the penis through which urine and semen pass.
• The prostate gland is part of the male reproductive system. It produces most of the fluid that makes up semen that enriches sperm. The prostate can create and intensify sexual stimulation when rubbed.
•The prostate needs the male hormone testosterone to grow and develop.
•The prostate is often described as being the size of a walnut and it is normal for it to grow as men age. Sometimes this can cause problems, such as difficulty urinating. These problems are common in older men and not always symptoms or signs of cancer.
Prostate cancer is generally a slow growing disease and the majority of men with low grade prostate cancer live for many years without symptoms and without it spreading and becoming life-threatening. However, high grade disease spreads quickly and can be lethal. Appropriate management is key.
In the early stages, there may be no symptoms. In the later stages, some symptoms of prostate cancer might include:
•Feeling the frequent or sudden need to urinate
•Finding it difficult to urinate (for example, trouble starting or not being able to urinate when the feeling is there or poor urine flow)
•Discomfort when urinating
•Finding blood in urine or semen
•Pain in the lower back, upper thighs or hips.
These symptoms may not mean you have prostate cancer, but if you experience any of them, go and see your doctor.
Men over age 50, or 40 with a family history of prostate cancer, should talk to their doctor about testing for prostate cancer using the PSA test and DRE as part of their annual health check-up. Men should make an individual informed decision about testing based on the latest available evidence on the benefits and potential harms of testing and subsequent treatment for prostate cancer.
HOW IS PROSTATE CANCER DETECTED AND DIAGNOSED?
A doctor will usually do a blood test and/or physical examination to check the health of the prostate.
• Blood test (Prostate Specific Antigen (PSA) test): The result shows whether there is an increase in this specific protein. Depending on the result, you might need further investigation by a specialist. A high PSA test result does not necessarily mean cancer. Prostate diseases other than cancer can also cause a higher than normal PSA level.
• Digital Rectal Examination (DRE): Because of where the prostate is located, the doctor inserts a gloved, lubricated finger into the rectum to check the size of the prostate and assess if there are any abnormalities. A normal DRE result does not rule out prostate cancer.
If your tests show you may be at risk of prostate cancer, the next step is a biopsy. A biopsy is the only way a firm diagnosis of prostate cancer can be made. A urologist removes small samples of tissue from your prostate, using very thin, hollow needles guided by an ultrasound. The prostate is either accessed through the rectum (trans-rectal) or the perineum (trans-perineal), which is the area between the anus and the scrotum. A biopsy is usually done as an out-patient procedure and the doctor will likely advise a course of antibiotics afterwards to reduce the chance of infection. The tissue is sent to a pathologist to identify whether the cells are malignant (cancerous) or benign (not cancerous).
Adapted from: The PCFA Prostate Cancer Resources & www.prostate.org.au