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Q.
What is the prostate?
A. The prostate is a small gland located underneath the
bladder in men. It is shaped like a doughnut and fits around
the tube (called the urethra) which carries urine out of
the bladder. The prostate produces the fluid that mixes
with sperm when a man ejaculates.
Q. What is prostate cancer?
A. Prostate cancer is now the most common cancer in men
in many western countries. However, most prostate tumours
are slow-growing and may not need treatment. Others grow
quickly and eventually spread to the bones, where they can
cause severe pain. Currently there are 30,000 new cases
a year in the UK; 215,000 in the USA; 20,000 in Canada and
12,000 new cases a year in Australia.
Q. What are the symptoms of prostate cancer?
A. The main symptoms are: difficulty passing urine, inability
to urinate, passing urine often (particularly at night),
weak or interrupted urine flow, pain when urinating, blood
in the urine and pain in the lower back, hips and upper
thighs. However, all of these symptoms can also be caused
by other conditions such as benign prostate enlargement.
Men with any of these symptoms should consult their doctor.
Risk Factors
Q. What causes prostate cancer?
A. In most cases, we do not yet know the cause of prostate
cancer. Exposure to high levels of radiation is one known
cause, but this only accounts for a tiny proportion of cases.
However, between 5% and 10% of cases run in families, where
the patient inherits a high risk of this type of cancer.
Q. Which men are at risk?
A. Prostate Cancer is very rare in men under 50. The risk
increases after the age of 50 with half of all cases occurring
in men over 75. Men from families with a history of prostate
cancer are at higher risk than normal.
Q. Is diet linked to prostate cancer?
A. Some evidence suggests that a low-fat diet can reduce
the risk of prostate cancer. Other studies have suggested
that a diet high in tomatoes, Vitamin E, cruciform vegetables
(such as broccoli, cabbage, cauliflower and brussel sprouts)
and selenium can also reduce your risk. However, apart from
selenium (see below), these findings have not been confirmed.
Q. Will a vasectomy increase the risk of prostate
cancer?
A. It was thought that a vasectomy increased the risk of
getting this cancer, but more recent research has suggested
that there is no real difference in risk between men who
have had a vasectomy and those who have not.
Q. Can prostate cancer be prevented?
A. Although there is no known way of preventing prostate
cancer, studies have shown that men who took 200 microgrammes
of selenium each day substantially reduced their risk of
prostate cancer.
Q. Does prostate cancer run in families?
A. Some families have a higher risk of prostate cancer than
others. The normal risk of getting prostate cancer some
time in your life is 1 in 13. Having one or more close relatives
(father or brother) who got prostate cancer under the age
of 70 increases your risk by two or three times (ie your
lifetime risk is between 1 in 7 and 1 in 4).
Testing / Screening
Q. Is early diagnosis important?
A. If prostate cancer is diagnosed early, it can be treated
very successfully. However, when the cancer is advanced,
it becomes very difficult to cure. All men over 50 should
be aware of the warning signs and take themselves to their
doctor.
Q. What tests can be used to detect prostate cancer?
A. A number of different tests are used, but none of them
is conclusive on its own.
• Rectal examination - by inserting a gloved finger into
the back passage your doctor can actually feel the prostate
gland, to find out whether it is larger than it should be.
Even if it is enlarged, this does not mean that it is cancerous.
• PSA blood test - if the level of Prostate Specific Antigen
(PSA) in your blood is too high, this suggests that there
is a prostate cancer, but there are several other conditions
which cause an increase in blood PSA levels.
• Ultrasound - a small probe is inserted into the back passage
and used to do an ultrasound scan, showing the exact size
of the prostate.
• Biopsy - this involves taking a tiny sample of tissue
from the prostate. A probe is inserted into the back passage
and a small needle jabbed into the prostate itself.
• X-rays - an x-ray can reveal whether there is any cancer
which has spread to the bones near the prostate.
Q. Is 'screening' available for prostate cancer?
A. At the moment, routine screening for prostate cancer
is not carried out in any country, because none of the available
tests are accurate enough. Screening men with the existing
tests, such as the PSA blood test, would pick up many men
without the cancer and would miss many who do have the cancer.
However, if you have a family history of prostate cancer,
screening may be available. You should talk to your doctor
about this.
Q. Can prostate cancer be cured?
A. In half or more of patients the cancer is detected at
an early stage and treatment is successful for nine out
of ten of these cases. The other half of the patients are
not diagnosed until the cancer is advanced and has spread.
Treatment can give these patients several extra years of
life and stop the pain of the disease, but cannot normally
cure them.
Treatment
Q. What treatments are available for prostate cancer?
A. Sometimes prostate cancers are so slow growing that no
treatment is needed. However, when treatment is necessary,
there are three main types used:
• Surgery - in an operation called a prostatectomy, the
whole prostate gland is removed.
• Radiotherapy - in radiation treatment, high energy rays
kill the cancer cells. This will help destroy the original
tumour and also reduces the pain caused by tumour cells
which have spread to the bones.
• Brachytherapy - this is a newer type of radiotherapy in
which small radioactive pellets or wires are inserted directly
into the prostate tumour, killing it from the inside. This
is at least as effective as the other treatments and sometimes
more so. There are also usually fewer side-effects with
brachytherapy.
• Hormone therapy - since the growth and division of the
prostate cancer cells depends on androgens (the male hormones),
drugs can be used to either reduce the level of androgens
produced by the body or block the effect of androgens on
the cancer cells. These stop the growth of the tumour and
sometimes shrink it. However, after about five years, most
prostate cancers go on to develop the ability to grow without
androgens and the hormone therapy stops working.
Surgery - in an operation called a prostatectomy, the whole
prostate gland is removed.
Q. What are the side-effects of prostate cancer
treatment?
A. There are normally no side-effects from surgery, although
there is a risk of impotence as an after-effect. Radiotherapy
causes general side-effects such as tiredness, diarrhoea
and nausea. These will all go away after the treatment has
finished. The only long- term effect is impotence, which
happens in about half of patients having long-term radiotherapy.
Almost all patients receiving hormone therapy experience
impotence while the treatment is being taken. Hot flushes,
tiredness and weight gain are also common, but will cease
when the treatment stops.
The good news is prostate cancer need not be a death sentence.
Early diagnosis is so important and there is a great deal
all men can do to safeguard their health.
If you found these FAQs helpful and would like to assist
AICR in funding further research and education, please consider
donating here.
http://www.aicr.org.uk/
ProstateFAQs.stm?source=Adwords
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