19 March 2014
With March being Prostate Cancer Awareness month, and prostate cancer being the biggest male cancer killer in England and Wales, Mr Simon Bott, Consultant Urology Surgeon at Spire Clare Park Hospital, provides some key information about this incredibly common cancer.
What is the prostate?
The prostate is a gland which sits immediately below the bladder surrounding the urethra, the drainage pipe, and creates half of the semen, so none of us would be conceived naturally without the prostate! The prostate grows throughout a man’s lifetime, starting the size of a walnut around age 20 growing on average to the size of a plum by age 70. For some men, it may grow to the size of a small orange.
How common is prostate cancer?
Prostate cancer is incredibly common, and unfortunately leads to over 10,000 deaths a year in England and Wales. Interestingly almost all men, if they live long enough, will develop prostate cancer but most men will never know they have it and die of something unrelated. Only a small proportion of men will get a ‘high risk’ form of prostate cancer which requires treatment to prevent/delay the cancer spreading.
How is prostate cancer diagnosed?
There are not normally any symptoms of prostate cancer until the tumour is a reasonable size. Urinary symptoms such as getting up in the night and poor flow are normally due to benign (non-cancerous) changes in the prostate. PSA blood tests performed by a GP can provide a means of early diagnosis, however these tests are not fool proof but remain the best available test at present. Prostate cancers are also diagnosed by ultrasound scans, biopsies and multi-parametric MRI scans.
Treatments for prostate cancer
A biopsy details how aggressive and extensive the tumour is which provides treatment options. Roughly 50% of men are put on active surveillance, whereby a careful eye is kept on the cancer but no treatment occurs until a sign that the cancer has become more aggressive, avoiding side effects such as urinary leakage, loss of erectile functions and bowel and bladder frequency.
For more aggressive or extensive cancers treatment is needed to cure the cancer. This can be achieved either through keyhole surgery to remove the prostate or by some form of radiotherapy. Radiotherapy can either be given externally and shone into the prostate or internally by implanting a small seed into the prostate, known as brachytherapy. These treatments are offered to patients when the benefits of treatments will outweigh the risks which include urinary leakage, loss of erectile function and bowel and bladder frequency.
In certain men the prostate cancer itself can be treated with ultrasound (HIFU) and therefore do not suffer side effects associated with the treatments that involve treating the whole prostate. This is still somewhat controversial as it was for breast cancer 20 years ago when the whole breast used to be removed. Nowadays the standard treatment is to remove just the cancerous lump. I am sure that prostate cancer will go along the same lines in the future.
Spire Clare Park Hospital, in Farnham, has an excellent team of Consultant Urology Surgeons dedicated to providing investigations and treatments for a wide range of urological conditions including kidney and bladder issues, incontinence, vasectomy’s and prostate cancer and disorders.