Prostate Awareness Month: Commonly Asked Questions about Prostate Health

Did you know prostate cancer is the most commonly diagnosed cancer in Australian men? With an estimated 3,452 deaths in 2017, it’s important to raise much needed awareness.

September is International Prostate Awareness Month and St John Medical would like help to raise awareness by answering the most commonly asked questions. Here’s what you need to know.

What is Prostate Cancer Awareness Month?

The Prostate Cancer Foundation of Australia (PCFA) is a broad-based community organisation and the peak national body for prostate cancer in Australia. PCFA supports men and their families through world leading innovative research, evidence-based information and resources, support groups and prostate cancer specialist nurses.

Right now, researchers are developing new, more accurate screening tests for prostate cancer. It has become a top priority to address the alarming number of false negatives and false positives that arise with Prostate-Specific Antigen (PSA) testing, which is currently the primary screening test for prostate cancer worldwide.

This research will help combat aggressive cancer with more accurate diagnosis. It will result in earlier detection and more accurate prognosis of prostate cancer. It’s world-class and is set to save and improve the lives of so many men and their families.

You can get involved by supporting research to help improve prostate cancer screening with a donation.

What is Prostate Cancer?

The prostate is a gland in the male reproductive system located below the bladder and in front of the rectum. Prostate cancer occurs when abnormal cells develop in the prostate, forming a malignant tumour (cancerous growth). These abnormal cells can continue to multiply in an uncontrolled way and sometimes spread outside the prostate into nearby or distant parts of the body.

There are three different stages of prostate cancer:

1. Localised prostate cancer: When the cancer is only found in the prostate gland.
2. Locally advanced prostate cancer: When the cancer has extended beyond the prostate and may include seminal vesicles or other surrounding organs such as the bladder or rectum.
3. Metastatic prostate cancer: When the cancer has spread to distant parts of the body such as bone.

A slow growing disease, the majority of men with low grade prostate cancer live for many years without symptoms and without it spreading and becoming life-threatening. However, high grade disease spreads quickly and can be lethal, so appropriate management is key.

What are the Symptoms?

In the early stages, there may be no symptoms. In the later stages, some symptoms of prostate cancer include:

• Feeling the frequent or sudden need to urinate
• Finding it difficult to urinate, e.g. trouble starting or not being able to urinate when the feeling is there or poor urine flow
• Discomfort when urinating
• Finding blood in urine or semen
• Pain in the lower back, upper thighs or hips
• Swelling in the legs or pelvic area
• Weak or numb legs or feet
• Bone pain that doesn’t go away or leads to fractures
• Tiredness, shortness of breath, dizziness, fast heartbeat or pale skin

These symptoms may not mean you have prostate cancer, but if you experience any of them, go and see your doctor.

What are the Risk Factors?

Factors that are most strongly linked to an increased chance of developing prostate cancer include:

• Age: Prostate cancer is an age-dependent disease, which means the chance of developing it increases with age. The risk of getting prostate cancer by the age of 75 is 1 in 7 men. By the age of 85, this is increased to 1 in 5.
• Family history: If you have a first degree male relative with prostate cancer, you have a higher chance of developing it than men with no such history. The risk increases again if more than one male relative has prostate cancer. Risk are also higher for men whose male relatives were diagnosed when young.
• Genetics: Every person has a set of many thousands of genes inherited from both parents. Changes to genes can increase the risk of prostate cancer being passed from parent to child. Although prostate cancer can’t be inherited, a man can inherit genes that increase the risk.
• Diet: There is evidence to suggest that eating a lot of processed meat or food that is high in fat can increase the risk of developing prostate cancer.
• Lifestyle: There is evidence to suggest that environment and lifestyle can affect the risk of developing prostate cancer.

To reduce your risk of prostate cancer:

• Diet: Eat meals that are nutritious. Refer to the Australian Guide to Healthy Eating. Remember, what is good for the heart is good for the prostate.
• Physical activity: Try to exercise at least 30 minutes a day.

How is it Detected and Diagnosed?

A doctor will usually do a blood test and/or physical examination to check the health of the prostate:

The Prostate Specific Antigen (PSA) test

Results will show whether there is an increased in this specific protein. Depending on the result, you might need further investigation by a specialist. A high PSA test result doesn’t necessarily mean cancer. Prostate diseases other than cancer can also cause a higher than normal PSA level.

The Digital Rectal Examination (DRE)

The doctor will insert a gloved, lubricated finger into the rectum to check the size of the prostate and assess if there are any abnormalities. A normal DRE result does not rule out prostate cancer.

If your tests show you may be at risk of prostate cancer, the next step is a biopsy. A biopsy is the only way a firm diagnosis of prostate cancer can be made:

1. A urologist removes small samples of tissue from your prostate, using very thin, hollow needles guided by an ultrasound.
2. The prostate is either assessed through the rectum (transrectal) or the perineum (transperineal), which is the area between the anus and the scrotum.
3. A biopsy is usually done as an outpatient procedure and the doctor will advise a course of antibiotics afterwards to reduce the chance of infection.
4. The tissue is sent to a pathologist to identify whether the cells are malignant (cancerous) or benign (not cancerous).

What are the Treatment Options?

Treatment and care of people with cancer depends on:

• The stage of the disease
• The location of the cancer
• The severity of symptoms
• Your general health and wishes

Treatment for prostate cancer may involve the following:

• Active surveillance (for low-risk, localised prostate cancer)
• Radical prostatectomy surgery
• Radiotherapy
• Cryosurgery
• Hormone therapy
• Chemotherapy
• Immunotherapy

After treatment, you may need regular visits to the doctor for digital rectal examinations and PSA tests to check whether the cancer has come back.

If you or someone close to you is in need of a prostate check, please book in for a check up with any of our highly qualified GPs. For more information visit our website to book an appointment online.