Table of Contents
What is prostate cancer?
Prostate cancer occurs when cells in a man’s prostate gland grow in an unusual way to form an abnormal growth called a tumour. The prostate, normally a golf ball-sized gland that sits below the bladder, helps produce the fluid in semen. There are different kinds of prostate cancer. While most grow slowly and cause no symptoms for many years, some spread aggressively and can cause serious illness and death.
As you age, your prostate can also grow for other reasons, such as prostatitis (inflammation of the gland) or benign prostatic hypertrophy. These conditions are common in older men.
What are the symptoms of prostate cancer?
Even if you have prostate cancer, you may not notice any symptoms unless the cancer grows large enough to cause problems.
Some symptoms of advanced prostate cancer include:
- needing to urinate frequently or suddenly
- finding it difficult to urinate (e.g. trouble starting, or being unable 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
While these symptoms might not mean prostate cancer, if you notice any of them, check with your doctor.
What causes prostate cancer?
While experts don’t fully know all the causes, a factor that increases your risk is obesity, which also increases the risk of aggressive prostate cancer.
Prostate cancer becomes more common with age. It is also more common if a close relative (e.g. a father, brother or son) was diagnosed with prostate cancer before 65 years of age.
Your ethnicity also affects your risk of getting prostate cancer. Men of Caucasian heritage are more likely to develop prostate cancer than Asian men, while men of African background experience the highest rates of death from prostate cancer.
In 1% to 2% of cases, men inherit genes (BRCA1 or BRCA2) that increase the risk of developing prostate cancer. These are the genes that can also cause women to have an increased risk of breast or ovarian cancer.
When should I see my doctor?
See your doctor if you notice any unusual or ongoing changes in your toilet habits (e.g. when you urinate). Most often, these won’t mean you have cancer, but finding cancer early improves the odds of treating it successfully.
If you don’t have any symptoms but are concerned about your risk, your doctor can also explain the risks and benefits of prostate cancer screening, such as having a PSA test.
How is prostate cancer diagnosed?
There are several tests your doctor may perform to check your prostate:
- Digital rectal examination (DRE): Your doctor inserts a gloved, lubricated finger into your rectum to feel the prostate’s size and check for anything unusual.
- Prostate Specific Antigen (PSA) test: A simple blood test to measure a protein produced by your prostate. A high PSA might be a sign of prostate cancer, or another condition.
- MRI scan: A detailed scan of your prostate to help identify signs of cancer.
While these tests are helpful, a prostate biopsy is the only way to confirm a diagnosis of prostate cancer. A urologist, who your doctor will refer you to, removes some cells from your prostate using a thin, hollow needle. The cells are then examined under a microscope to check for cancer.
Confirmed prostate cancer is graded on a scale of 1 to 5 (known as a grade group system), based on how likely the cancer is to grow and spread to the rest of the body. Grade groups 4 to 5 are considered high risk.
An older system of grading, known as the Gleason score, grades the cancer from 1 to 10. A Gleason score of 8 to 10 is considered high risk.
Should I get prostate cancer screening?
There are several reasons for this:
- A high PSA level can be a result of something other than cancer.
- Experts don’t fully agree on what is a normal or abnormal PSA level.
- Most men with a slightly raised PSA level have a biopsy that confirms no cancer.
- Many prostate cancers are low risk, slow growing, and are unlikely to cause harm if left untreated.
- Testing and treating low risk, slow growing cancers may cause more harm than good.
You should speak to your doctor if you have a family history or ongoing symptoms of prostate cancer, such as difficulty passing urine. Your doctor can help you make an informed decision about whether prostate cancer screening is suitable for you.