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Health and Wellbeing – Prostate Cancer

21 August 2017

Advice from Mr Ammar Alanbuki, consultant urological surgeon, who has recently joined the urology team at The Montefiore Hospital in Hove. Mr Alanbuki holds clinics on Tuesday afternoons and during August and September will be holding free advice clinics on that day.

With the exclusion of prostate cancer, what other prostate problems are there?

Increased visits to the toilet, struggling to start and/or finish doing a wee or are getting up in the night several times? Then you might have a problem with your prostate. While men will go to their GP with the fear this could be cancer, it is more likely to be a benign (non-cancerous) enlargement of the prostate which affects one in three men in their 50s. The enlarged prostate presses on and blocks the urethra, causing bothersome urinary symptoms.

Lifestyle changes such as reducing the amount of liquid consumed before bedtime and avoiding alcohol and caffeinated drinks can help. If symptoms continue, medication will be prescribed for up to a year, but after that, surgery may be necessary. This could involve removal of part of the prostate, or using a new technique called Urolift which lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra.  

Another prostate problem, more common in men aged 30-50, is prostatitis which causes pain within the pelvic and genital area, and sometimes while urinating. If it comes on suddenly, it is likely to be an infection which can be treated by your GP with antibiotics. Chronic prostatitis (symptoms come and go) can be treated with painkillers and you may be referred to a urologist.

The process of checking for prostate cancer. (is it possible to carry out self-checks or always best to visit a doctor first?).

If you have concerns about any changes in your normal urinary function, or pain or have a family history of prostate cancer, make an appointment with your GP. Prostate cancer is not something you can check for yourself. Going to the toilet more frequently is often the trigger for men to visit their GP. As well as a rectal examination to see if the prostate gland is enlarged, a blood sample will be taken to test for prostate specific antigen (PSA) levels. Don’t panic if your first PSA test is raised, it doesn’t necessarily mean cancer. Of those with a raised PSA level, only 30% are likely to have prostate cancer.

What are the treatments for Prostate Cancer?

A diagnosis of prostate cancer doesn’t immediately need treatment or an operation. In recent years, urologists have adopted a `watch and wait’ approach to men who have a localised, non-aggressive prostate cancer – that is, cancer within the prostate gland itself. This means active monitoring to check the cancer doesn’t grow and therefore avoid invasive treatments which can damage sex life and cause incontinence.

Men on an `active surveillance’ programme are monitored closely with blood tests, repeat scans and sometimes repeat biopsies to ensure it is safe to continue this approach.

If the initial diagnosis shows the cancer to be localised but aggressive, or if the cancer has grown during `active surveillance’, you will be offered treatment such as surgery or radiotherapy.

For cancer that has gone beyond the prostate gland, there is a range of treatments from hormone therapy to painkillers to enable the patient to continue to lead a normal life.

First published in Sussex Business Times August 2017.

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.

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