This is the second most common male cancer and has a survival rate of 50%. It mostly affects men aged over 60 – half the sufferers are over 75. Risk factors include family history and a diet low in vegetables and high in animal fats. Treatment includes surgery or radiation. Hormone therapy may be used but side-effects include risk of impotence.
Symptoms include frequent trips to the toilet (especially at night), difficulty in urinating and blood in the urine. However, some men may not show any symptoms of prostate cancer and so the cancer can be found only through routine tests. A test which shows whether there is an elevated level of the protein PSA (prostate specific antigen) in the blood is recommended. Normal PSA concentration in blood is between 0.1-2.6ng/ml. PSA levels of 4 ng/ml or greater should prompt a further consultation with a urologist as they may be a indication of prostate cancer. This test can be carried out by a GP. Although there are home proper diagnosis can only be made through biopsy, which would be carried out by a urologist and usually involve a TRUS (transrectal ultra sound) biopsy and/or a CT scan, MRI scan or a bone scan.
Other Prostate problems
There are a number of other prostate disorders that could account for the symptoms. BPH (benign prostatic hyperplasia) is an abnormal enlargement of the prostate.
As the prostate enlarges, it can squeeze the urethra making it difficult to urinate and can also stop the bladder from emptying fully. It is difficult to tell the difference between BPH and prostate cancer, so a PSA test should be done.
Prostatitis is an inflammation of the prostate caused by infection with bacteria and can also produce similar symptoms to cancer, so a PSA test should be carried out.
Treatments for prostate cancer include – external beam radiotherapy 40 uses
high-energy X-ray beams directed at the prostate. These beams prevent cancer cells from dividing and the tumour growing. This avoids the need for surgery but it may cause damage to the bladder and rectum. Diarrhoea, cystitis and nausea are common short-term side effects, there is a risk of impotence and incontinence and it requires daily hospital visits for six weeks.
Surgery in which the entire gland is removed eradicates the disease in 70% of men. But there is a high risk of impotence and a small risk of incontinence. Patients will also need to stay in hospital for at least one week, and then take six weeks off work to recover.
Brachytherapy is a new form of radiation treatment for localised prostate cancer. Radioactive seeds are implanted directly into the prostate gland, meaning a higher dose of radiation can be given than is possible with external beam radiotherapy. The advantages are similar to radiotherapy, with the added plus that damage to surrounding tissues, such as the bladder, is limited. The downside is that it can cause a burning sensation while urinating which may last for some time, one or two anaesthetics are required and its long-term effectiveness has still to be evaluated.
Diet may help prevent prostate cancer. Again antioxidents (vitamins and amino-acids) that occur naturally in many fruits and vegetables. Vitamins C and E and selenium are all antioxidants. There has been evidence showing a reduction in the number of prostate cancer deaths when vitamin E (50mg) was supplemented in smokers. Selenium supplementation (200mg) was also found to reduce prostate cancer in a small group of men, but more research is needed before routine supplementation can be recommended. Keeping weight down, avoiding fatty foods and eating red and processed meat in moderation. Eat five fruit and vegetable portions per day, including a regular intake of tomatoes, and perhaps include some soya products in your diet. Drink alcohol in moderation (a maximum of 3 units per day) and don’t smoke.
A useful web site is Prostate Cancer Now – www.prostatecancernow.org