Prostate cancer symptoms and treatment: What to check for

Former prime minister Rishi Sunak told the BBC that a targeted prostate cancer screening program was urgently needed and would “save countless lives”.

Sunak is an ambassador for the charity Prostate Cancer Research and made his comments as the UK's National Screening Committee reviews its 2020 decision not to recommend routine screening.

However, not everyone thinks extending screening is a good idea.

Prostate cancer can behave in different ways, and while some can spread quickly, others grow very slowly and may require little or no treatment.

The prostate is a walnut-sized gland located just below the bladder in the pelvis.

It surrounds the urethra, the tube that carries urine out of the body through the penis.

Prostate cancer is abnormal and uncontrolled cell growth and often develops slowly.

There may be no signs or symptoms for many years, and some people never have any problems because of it.

But in other cases, the cancer can be aggressive and fatal.

Prostate cancer detected at an early stage has a better chance of being successfully treated.

Prostate Cancer UK states that one in eight men will develop prostate cancer at some point in their lives.

According to Cancer Research UK, around 52,300 men are diagnosed each year in the UK and there are around 12,200 deaths from prostate cancer each year.

It most often occurs in older age – among men over 75 years of age. Cases under 50 years of age are rare.

Your risk of prostate cancer is higher if you have a close relative – a father, brother, grandfather or uncle – who has had prostate cancer.

It is also more common in black men.

Common ones:

• need to urinate more frequently, especially at night
• Difficulty starting to urinate, weak discharge and it takes a long time
• blood in urine or semen

These symptoms can be caused by other medical conditions, but it is important that any changes are checked by a doctor.

There is no single diagnostic test. Doctors make a diagnosis based on various indicators.

This may include a prostate-specific antigen (PSA) blood test and scan, as well as a biopsy, which involves taking a small sample of tissue to be tested in a laboratory.

PSA tests are not routinely used to screen healthy men for prostate cancer because the results can be unreliable.

A high PSA does not always mean cancer. It may increase, for example, if there is an infection.

Some men with elevated PSA levels may have prostate cancer that would not cause problems or require treatment, causing unnecessary worry and the need for further testing.

Men over 50 can usually ask their doctor for a PSA blood test if they want. Your healthcare provider will explain the potential benefits and risks of getting a PSA test.

If you decide you want to have a PSA test, you should avoid sexual activity and vigorous exercise, such as cycling, for two days beforehand as this may affect the results.

Doctors are also considering whether adding MRI to PSA tests could improve the situation.

Researchers have repeatedly considered whether introducing screening would be beneficial.

These studies overall suggest that offering all men of a certain age a PSA test would result in only a small reduction in the number of men dying from prostate cancer.

This was announced by the UK National Selection Committee in 2020. did not recommend screening for this disease.

However, latest prostate cancer research report calls for a screening program targeting men aged 45–69 years with a family history of prostate cancer and black men. This group includes around 1.3 million men in the UK.

The charity estimates the program will cost £25 million a year – or around £18 per patient – similar to bowel and breast cancer screening.

It said the benefits of introducing targeted screening for those most at risk would outweigh the financial and logistical costs.

But others argue it would take scanning capabilities away from patients being treated for other conditions.

Some medical experts are skeptical about the value of screening. They argue that there is still a risk that patients will be treated for cancer when it is not urgently needed, and then have to live with side effects such as incontinence and erectile dysfunction.

There are various options available and your doctor will be able to advise which option is most suitable.

If the cancer is at an early stage, is not causing symptoms, and is not growing quickly, it may be possible to keep it under observation or “watch and wait.”

Some types of prostate cancer can be cured with treatments such as surgery and radiation therapy.

Hormone therapy can also slow the growth of cancer.

It is also possible to destroy cancer cells using extreme cold (cryotherapy) or high-intensity focused ultrasound.