What is prostate cancer?
Prostate cancer is a malignant tumour in the prostate.
Most prostate cancers develop slowly and do not cause symptoms. Fast-growing prostate cancer is less common. The risk of getting prostate cancer increases with age. The average age for diagnosis of prostate cancer is 69.
Because of the development in diagnostic tools and longer life expectancy, more prostate cancers are now detected. Prostate cancer is the most common cancer in men in Europe. The survival rate for prostate cancer in Europe is relatively high and is still going up.
Symptoms of prostate cancer
Prostate cancer is generally asymptomatic, which means that there are no clear symptoms to indicate that it is there. In most cases, symptoms are caused by benign prostatic enlargement (BPE), or an infection. If prostate cancer does cause symptoms it is usually a sign that the disease has advanced. Because of this it is important that you see a doctor to understand what may be causing any symptoms you notice.
The symptoms may include:
- Urinary symptoms such as urinary frequency or a weak stream of urine
- Blood in the urine
- Erection problems
- Urinary incontinence
- Bone pain could be a sign that the cancer has spread through the body. This is known as metastatic disease.
Prognosis and importance of screening
The 5-year survival rate for most men with local or regional prostate cancer is nearly 100%.
For men diagnosed with prostate cancer that has spread to other parts of the body, the 5-year survival rate is 31%.
The European Association of Urology recommend early screening to well-informed men at elevated risk of having prostate cancer:
- men>50years of age
- men>45years of age and a family history of prostate cancer or of African descent
Diagnosis of prostate cancer
One of the most frequently used tools to diagnose prostate conditions is PSA (prostate specific antigen) testing, which is a blood test to check the levels of this protein. If the PSA level is too high, this may suggest that the cells in the prostate are behaving unusually. This could be because of a tumour in the prostate, but also because of prostate irritation (sports, intercourse, urinary catheter), an infection or a benign enlargement of the prostate.
Digital rectal examination
Your health care provider will do a rectal examination with a finger to feel the size, shape, and consistency of the prostate. This test is known as a digital rectal examination (DRE).
In some cases, you may be advised to have a scan. Different types of scans are available, such as ultrasound, CT scan, MRI scan, and bone scan.
None of these tools will provide a definite answer on whether or not you have prostate cancer.
If your prostate cancer risk is high, you may need a biopsy of prostate tissue. This test will confirm if you have a tumour or not.
(Adapted from EAU European Association of Urology guidelines 2020, EAU Patient information)