16 August 2017
Prostate cancer affects thousands of families across the world every year. In the UK it is the commonest male cancer, with approximately 37,000 men being diagnosed each year, that’s over 4 every hour. This number was 1 per hour in the 1970s. Prostate cancer is now the second biggest killer in men. In the 1970s less than a third of men survived but thankfully nowadays this proportion is now 75%.
Mr Vijay Sangar, Consultant Urologist says, "This is due to men seeking help earlier and being diagnosed with prostate cancer with an earlier stage, meaning that treatments are more likely to be successful. The European Prostate Cancer Awareness Day is next month on September 27 2017. As part of this we should highlight the risks of prostate cancer and how men can help themselves."
Prostate cancer usually occurs at any age beyond 40. So who should be worried about prostate cancer?
Well, 10% of prostate cancers run in families. If you have a family history for example, if your father, brother or uncle have been diagnosed then your risk is increased by between 2 and 10 times.
Those from African or Caribbean backgrounds are 2 to 3 times more likely to be diagnosed with prostate cancer.
We also know that if you are overweight, prostate cancer is likely to be more aggressive.
Problems passing water
Men who have problems passing urine usually have non-cancerous enlargement of the prostate but in some cases cancer can co-exist or be the cause of the symptoms. The kind of problems that men can have include passing urine too frequently during the day or night, having a poor flow or having to go urgently to pass urine.
Prostate cancer treatments
Mr Sangar says "Men who have these problems, who have first-degree relatives with prostate cancer or come from certain ethnic backgrounds, should seek help. At Spire Manchester Hospital we can assess men and consider undertaking a PSA and an examination of the prostate gland." A PSA (Prostate Specific Antigen) is a simple blood test, whilst a prostate examination is done easily by your doctor examining you through the back passage with their finger.
If it is felt that there is something abnormal you will need further tests. We may suggest a specialist multi-dimensional MRI scan and subsequent biopsy of the prostate. The biopsy is done under local anaesthetic in the out-patient department and usually takes up to 20 minutes. We can also offer template biopsies via the perineum under general anaesthetic. The biopsy can be uncomfortable and some patients may experience problems passing urine following it. The main risk of a biopsy is infection, but this risk is low and you would routinely be given antibiotics before and after. If the biopsy comes back negative then this can be a relief, although you may need it repeating if things do not settle. However, if the biopsy is positive then we would advise on treatment depending on how early or advanced the disease is. Treatment varies between surgery (radical prostatectomy), radiotherapy, medication or surveillance/monitoring.
Mr Sangar says "Recent treatment advances have helped to a degree. For example robot prostatectomy has helped to reduce some side effects of treatment and has also helped surgeons remove all the cancer with better precision. Patients should remember that in general terms surgery and radiotherapy give the same cure rates. It is the side effects that differ the most. The treatment a patient receives depends on a number of factors including their perception of the treatments being offered and which side effects they are happier accepting. A specialist team should help patients make the right decision for themselves and their families."
The chance of surviving prostate cancer over 5 years, if you live in the UK is approximately 77%, if you happen to live within the North West of England this figure reduces to just under 70% (ONS). "I would encourage men to help themselves and if you do have any concerns please see a doctor" says Mr Sangar, who is a specialist at Spire Manchester Hospital and is supporting European Prostate Cancer Awareness day.
For more information about the European Prostate Cancer Awareness Day please visit http://www.europa-uomo.org/what-is-prostate/.
Vijay Sangar is a consultant urologist. For more information or to book an appointment with Mr Vijay Sangar, please call 0161 447 6700.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.