Prostate cancer: What you need to know

As prostate cancer overtakes breast cancer to become the most common form of the disease, cancer experts outline key facts about the condition.

Prostate cancer has become the most commonly diagnosed cancer in the UK, and diagnoses have overtaken those for breast cancer.

It’s thought the increase is largely due to more awareness of the disease, combined with an ageing population – you’re much more likely to get prostate cancer if you’re over 50.

There were 57,192 new prostate cancer cases in 2018 (the most recent data available), just ahead of 57,153 breast cancer cases, 48,054 cases of lung cancer and 42,879 of bowel cancer, according to an analysis by the charity  Prostate Cancer UK (PCUK).

There are now around 400,000 men in the UK living with or after the disease, and PCUK specialist nurse Laura James says: “Prostate cancer diagnoses have more than doubled in the last 20 years. A lot of this is thanks to a big boost in awareness, with celebrities like Bill Turnbull and Stephen Fry speaking publicly about their own experience and encouraging men to speak to their GPs. This has led to a big increase in prostate cancer referrals, and it’s fantastic to see that more men than ever have been taking charge of their own health.”

Here’s what you should know about prostate cancer…

1. Where’s the prostate?
PCUK explains that prostate cancer starts in the prostate gland, which is at the base of the bladder and is about the size of a walnut. The prostate gland gets bigger as you get older, and its main job is to make the thick white fluid that creates semen when mixed with sperm produced by the testicles.

2. No initial symptoms

PCUK says localised prostate cancer (contained inside the prostate) doesn’t usually cause any symptoms. Signs don’t normally appear until the prostate is big enough to affect the urethra (the tube that carries urine from the bladder out of the penis). This may lead to an increased need to wee, straining while you wee, a weak flow, dribbling urine after you finish, and a feeling that your bladder hasn’t fully emptied. PCUK says that while some men might have urinary problems, “these can be mild and happen over many years and may be a sign of a benign prostate problem, rather than prostate cancer.” Another cause of such symptoms can be a non-cancerous enlarged prostate, which is very common. But anyone with any symptoms should get them checked by a GP.

3. How is it diagnosed?
Men with symptoms may have a Prostate Specific Antigen (PSA) blood test, as those with prostate cancer may have a raised PSA level. However,  Cancer Research UK (CRUK) says PSA levels can also be raised in benign prostate conditions, or if you have an infection, so a diagnosis of cancer isn’t usually made on a PSA test result alone. Men may also have an examination of the back passage (rectum), which involves a doctor feeling inside the rectum using their finger. There may be scans and a biopsy too.

4. You may never need treatment

Some prostate cancers grow too slowly to cause any problems or affect how long you live, says PCUK, and because of this, many men with prostate cancer will never need any treatment. However, some prostate cancers grow quickly and are more likely to spread, so they need treatment.

5. Know the risk factors
You’re more at risk of prostate cancer if you’re over 50 – CRUK says prostate cancer is most common in men aged 75 to 79 years – if a close relative (father or brother) has had prostate cancer, or if you’re black.

6. One in eight men get it
One out of every eight men will be diagnosed with prostate cancer in their lifetime, says PCUK. This rises to one in four for black men.

7. Rare genetic risk

CRUK says some genes can increase the risk of prostate cancer, but they’re rare and are only linked to a small number of prostate cancers. The risk increases by up to five times in men with the gene BRCA2, and it might also increase with the BRCA1 gene. Both genes can also cause breast and ovarian cancers.

8. Death rate
One man dies from prostate cancer every 45 minutes, according to PCUK.

9. World incidence
The World Cancer Research Fund (WCRF) says Ireland has the third highest rate of prostate cancer in the world, with 132.5 cases per 100,000 men in 2018, behind Guadeloupe with 189.1 cases, and Martinique  with 158.4. The UK has the 16th highest rate at 80.7.

10. Keep active & maintain a healthy weight
CRUK says there’s evidence that being active might help to lower the risk of developing prostate cancer. Plus, being overweight or obese increases your risk of advanced prostate cancer.

Prostate Cancer UK specialist nurses are available on 0800 074 8383.

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4th Dec 2020
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I was diagnosed with prostate cancer at the age of 68. After a scan and a biopsy I was put on a programme of "active surveillance". (Who thinks up these names? This one was obviously intended to appeal to the boys.) This means that the tumor is small and of a type not likely to grow or spread much. I have a blood test and a brief phone call from the consultant every six months - the calls are usually along the lines of "Well, that looks stable. Talk to you next May..."

It's important to reassure men who think they may have symptoms that prostate cancer is not necessarily a disaster. See your GP.

According to my nurse specialist, 80% of men who reach the age of 80 have it: in most cases it never develops enough to need treatment. I am confident that I will be run over by a bus at the age of 92.

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