Catching prostate cancer early is crucial. Here is what you should know

Prostate cancer is the most common form of male cancer and the fourth cause of cancer deaths in the UK. Current evidence suggests there is little a man can do to reduce his risk. But there are ways to improve your chances of survival — most notably, by catching the cancer early.

Know the symptoms
Ninety per cent of men who are diagnosed at the very early stages live at least five more years. This drops to just 30 per cent if the cancer has reached stage four and has started to spread to other parts of the body.

Unfortunately, according to Martin Ledwick, Cancer Research UK’s head cancer information nurse, ‘very early prostate cancer doesn’t generally cause any symptoms at all’. He says: ‘If a tumour isn’t large enough to put much pressure on the tube that carries urine out of the body — the urethra — you may not notice any effects from it.’

Symptoms of growths in the prostate are similar whether they are non-cancerous or cancerous, he explains. ‘These can include having to rush to the toilet to pass urine; passing urine more often than usual, especially at night; or difficulty passing urine, including straining to pass it or stopping and starting.’

Ledwick says those with symptoms should be checked by a doctor as soon as possible. ‘Although most enlargements of the prostate aren’t cancer and can be easily treated, if it is cancer the earlier it’s picked up, the easier it is to treat it and the more likely the treatment is successful,’ he says.

Know your risk
A man’s lifetime risk of being diagnosed with prostate cancer is one in eight in the UK. There is no conclusive evidence that men can do anything to lower their risk.

The biggest risk factor is age — your risk increases the older you get. Then there is family history. A man is twice as likely to develop prostate cancer if his father had the disease and three times as likely if his brother had it. Having a grandfather, uncle or nephew with prostate cancer increases your chances to just under twice that of a man with no family history.

There are links to other cancers. A Swedish study found that if a man’s mother has had breast or ovarian cancer his risk of developing prostate cancer also increased.

A man’s risk also seems to depend on his ethnicity. A study by Public Health England looking at hospital data reported that men classified as ‘black Caribbean’, ‘black African’ and ‘other black’ had twice the risk of being diagnosed with prostate cancer as white men. Asian men had the lowest lifetime risk of developing the disease.

Get tested
If you are high risk or have had symptoms it is worth speaking to your GP about a prostate-specific antigen (PSA) blood test.

Unlike in other countries, in Britain there is no national screening programme for prostate cancer. Such a programme is thought to do more harm than good. That is because it picks up low-risk, slow-growing prostate cancers (along with the deadlier, high-risk ones) that are unlikely to cause any problems. Men may then undergo treatment and tests unnecessarily.

Research is now focusing on whether risk factors like age, ethnic background, family history and other genetic risk factors can be combined with tests like PSA to improve screening methods and detect aggressive prostate cancer with greater accuracy.

Dr Anne Mackie, director of screening at Public Health England, says: ‘There needs to be a better understanding about benign (not harmful in effect) and aggressive forms of the cancer.’

  • Nick Summerton

    The change in your PSA – over a year – is also very important too irrespective of your initial level. So, in accordance with the current research evidence, I would now strongly recommend annual testing for PSA (and, for women, CA125). Dr Nick Summerton, GP & Medical Director, Bluecrest Health Screening

    • @nsmartinworld

      You didn’t mention the percent of PSA false-positives, and the unnecessary surgeries that follow.

  • shadsfan

    By far the best option is to have an annual physical and get your prostate checked along with everything else. We seem to encourage that and do it well in Canada where the ratio of people electing to have an annual physical is far higher than in the UK and, as a preventative measure, saves the health care system millions in post care costs and many lives. Logically and practically pre-check prevention is way better than post op care.

  • gnostic

    My father died from prostate cancer at 69, or more precisely died of ignorance. His demise led me to have a PSA test every year starting at 47. It was obvious when the changes occurred as the PSA ramped up. It was also a very difficult decision to opt for major surgery, with all the risks that entails, when you have no symptoms but I could see my future if I didn’t. Six years on I am still clear. Last year my younger brother embarked on the same path of treatment. If you have prostate or breast cancer in the family then a yearly PSA check is essential to know where you stand.

  • @nsmartinworld

    The developer of the PSA test says it is wrong 80% of the time when used as a screening tool.

    It’s nuts that this article doesn’t even hint at false-positives.