• Prostate cancer is the most common male cancer after skin cancer.
    • Frequently the cancer is slow growing and may not cause a man any trouble during his lifetime.
    • Prostate cancer occurring in younger men is more likely to have time to become a threat to life.
    • If you have a father or brother diagnosed with prostate cancer, you may have a higher risk of developing it yourself.
    • The PSA test can indicate the presence of early prostate cancer and also the risk of developing prostate cancer in the future using PSA levels in your blood.
    • A positive test does not necessarily mean you have cancer – a biopsy is needed to be sure.
    • Treatment for prostate cancer can cure the cancer but may affect potency and continence. Not all men need to be treated.
    • Urinary symptoms in older men are often caused by benign prostate growth. This cannot ‘turn into’ prostate cancer.

Having a large prostate doesn’t increase your chances of having prostate cancer.

Introduction

Prostate cancer is the most common male cancer after skin cancer Although it occurs mainly in men over 50 years, a significant number are diagnosed in their 40s.

Many men are aware of others who have been diagnosed with prostate cancer at the same age. This raises the questions, what is my risk? Should I be tested?

Before deciding to have a test, you need to know a little more about prostate cancer, the tests and the treatment.

Features contributing to risk

There are some good, not-so-good and unusual features of prostate cancer:

Good News

    • Because most prostate cancers are slow growing and many occur in older men, they may not be a threat to life. A man may therefore have this cancer, but it may not cause him any trouble.
    • If prostate cancer is detected and treated before it spreads beyond the prostate, it can be cured. Surgery that removes the whole prostate, or radiotherapy which destroys the cancer, can cure it.
    • The PSA test (explained below) can indicate the presence of prostate cancer at an early stage by measuring PSA levels in your blood.
    • The PSA test can also be used to indicate your risk of having prostate cancer in the future.
    • If prostate cancer is detected after it has extended beyond the prostate area it can be slowed down by hormone treatments, radiotherapy and chemotherapy.
    • If you have urinary symptoms such as frequent emptying of the bladder and a weak urinary stream, this may not be due to prostate cancer, but to benign prostate enlargement (non-cancerous growth).
    • Benign enlargement of the prostate does not ‘turn into’ cancer

Table 1: What is the chance of a diagnosis or dying from prostate cancer?

Age (years) Number diagnosed
before 80 years		Number dying
of prostate cancer
4016425
5016325
6014524
708619

Of 1000 men of this age, how many would be diagnosed and how many would die from prostate cancer before 80 years of age?

Not-so-good News

  • The prostate is just beneath the bladder, surrounding the urine outlet tube and close to nerves that are important for erections. This means that treatment can affect potency (ability to have erections) and continence (ability to ‘hold on’ to urine).
  • Because these cancers grow at different rates, we are not always sure which of the early cancers pose a threat and thus whether treatment of early disease is needed.
  • It is not always easy to know whether a cancer is confined to the prostate and thus whether it is curable or not.
  • Early prostate cancer usually does not have any symptoms.
  • If a man is diagnosed at a young age (eg. 50s), prostate cancer is likely to progress and eventually affect life and health.

Unusual News

It is possible to have had an operation on the prostate and still get prostate cancer. Operations for benign enlargement of the prostate (such as a trans-urethral resection, TURP or ‘rebore’) only remove part of the prostate. After this operation it is still possible to develop cancer in the remaining part of the gland.