What is Prostate Cancer?

Prostate cancer can occur when abnormal cells in your prostate start to divide and grow in an uncontrolled way. 

Prostate cancer usually develops slowly and does not cause any symptoms until cancer has grown large enough to put pressure on the tube that carries urine from the bladder out of the urethra (penis). Because some prostate cancers can grow slowly, they might not even cause any problems or affect how long you live; this is why many men with prostate cancer will never need any treatment.

However, some prostate cancers grow fast and are more likely to grow and spread into surrounding tissues and organs of the body. This is more likely to cause problems and needs treatment to stop it from spreading.

What is the prostate?

The prostate is a gland situated at the base of your bladder and surrounds the first part of the urethra (the tube that carries urine from the bladder to the penis). The urethra also carries semen, which is the fluid containing sperm. 

The prostate gland produces a protein called prostate specific antigen (PSA). Your PSA levels can be measured by taking a blood test and may help detect early prostate cancer.

Your prostate is usually the size of a walnut but gets bigger as you get older. The most common prostate problems are an enlarged prostate, prostatitis and prostate cancer.

Prostate cancer can affect anyone who has a prostate gland: men, trans-women (someone who was assigned male at birth but identifies as a woman, even if they have taken hormones; the prostate is not removed during genital reconstructive surgery), non-binary people who were born male (assigned male at birth) or some intersex people (someone who may have both male and female sexual characteristics and therefore might have a prostate).

What are the signs and symptoms of prostate cancer?

Prostate cancer does not usually cause symptoms in the early stages. That is why is important to know your risk (that we talk about later on this page), but also to get your prostate and PSA levels checked out.

Most prostate cancers in the early stage start in the outer part of the prostate gland, which doesn't often press on the urethra, causing symptoms.

Symptoms usually appear when the prostate cancer has grown large enough to affect the tube that carries urine from the bladder out of the penis (urethra). If you notice changes in the way you urinate, this is more likely to be a sign of a very common non-cancerous condition called enlarged prostate, or another health problem. But it's still something you should not ignore, and get your prostate and/or your PSA levels checked.

Possible symptoms may include:

• an increased need to pee
• straining while you pee
• difficulty starting to urinate or emptying your bladder
• a weak flow when you urinate
• dribbling urine after you finish urinating
• needing to urinate more often than usual, especially at night
• a feeling that your bladder has not fully emptied

If prostate cancer breaks out of the prostate (called locally advanced prostate cancer) or spreads to other parts of the body (called advanced prostate cancer), it can cause other symptoms, including:

• back pain, hip pain or pelvis pain that doesn't go away with rest
• problems getting or keeping an erection
• blood in the urine or semen
• unexplained weight loss.

These symptoms can all be caused by other health problems, however, it's always advisable to tell your GP about any symptoms you might be experiencing, so they can find out what’s causing them and make sure you get the right treatment if you need it.

What is your risk of prostate cancer?

1 in 8 men in the UK will be diagnosed with prostate cancer in their lifetime. Unfortunately, the causes of prostate cancer are largely unknown, but there are certain things that can increase your risk of developing the condition (these include age and ethnicity). Even if you don't have the symptoms described above, it is a good idea to speak with your GP or take a PSA test if:

• you are aged 50 or over (the most common age for men to be diagnosed with prostate cancer is between 70 and 74 years; if you are under 50, even if your risk is low, it is still possible)
• you have a family history of prostate cancer, breast cancer or ovarian cancer
• you are black (prostate cancer is more common in black men (1 in 4 black men will get prostate cancer in their lifetime) than in white men and least common in asian men)

What is a PSA Blood Test?

A PSA blood test, also called prostate-specific antigen test, measures the level of PSA in your blood and may help detect early prostate cancer or other related prostate problems. 

PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It is normal to have a small amount of PSA in your blood. This amount rises as you get older and your prostate gets bigger. A raised PSA level may suggest problems with your prostate (enlarged prostate, prostatitis), and not necessarily cancer. Also, a few other things can affect your PSA Levels, such as a urine infection, vigorous exercise or ejaculation (at least 48 hours before taking the test), anal sex or prostate stimulation, a biopsy, some medicines (for treatment of enlarged prostate), urinary catheters, other tests or surgery on your bladder or prostate.

If you took a PSA test at home and your PSA level is raised, you should visit your GP to discuss your results. They can give you further information or additional tests/scans as necessary or treatment.

References and Further Reading:

https://www.prostate-cancer-research.org.uk/patient-info/

https://prostatecanceruk.org/prostate-information/about-prostate-cancer

https://www.cancerresearchuk.org/about-cancer/prostate-cancer/about

https://www.nhs.uk/conditions/prostate-cancer/