Prostate Cancer Q&A with John Beatty, Consultant Urologist
Nearly 70 percent of men in the UK (68 percent) do not know that being overweight is a risk factor for prostate cancer: the most common male cancer. Research, conducted independently on behalf of BMI Healthcare, shows a lack of knowledge and education around the major contributing factors of the cancer are responsible for the death of over 11,250 men each year.
The research also reveals that over half of men, (52 percent) aren’t aware that family history is a risk factor for the cancer, and 42 percent don’t know that age also plays a part in the incidence, mortality, and survival rates of the cancer. According to the new figures, an overwhelming 97 percent of men in the UK don’t know that being tall affects your risk of prostate cancer development, 87 percent don’t know the impact of your ethnicity, and a worrying 86 percent aren’t aware that taking anabolic steroids is a risk factor.
We spoke to John Beatty, Consultant Urologist at BMI Healthcare, to find out more about prostate cancer, the signs of the disease and the ways it is treated.
What is prostate cancer?
The prostate gland is positioned in front of the rectum at the base of the bladder and produces seminal fluid. The bladder outlet pipe or urethra passes through the prostate. Prostate cancer occurs when normal prostate cells become abnormal and start to disrupt the structure of the prostate over time. Depending on how abnormal the cells are, the cancer may grow and cause problems in the region of the prostate or further away if it spreads.
What are the common symptoms of prostate cancer?
Most early prostate cancers have no or few symptoms. Symptoms can be related to local growth and this may result in problems with passing urine, bleeding in the urine, bowel symptoms and erection problems. If the prostate cancer has spread to distant sites in the bones or lymph it may result in pain most commonly in the back.
Who is most at risk of prostate cancer?
It is a cancer of the ageing male and is the most common non-skin cancer in men over 70 but can occur at an earlier age. Men who have fathers, brothers or grandparents with prostate cancer may be at increased risk especially if they developed prostate cancer at a young age. Afro-Caribbean and black men may also have an increased risk.
What are the different stages of prostate cancer?
Prostate cancer is divided into low, intermediate and high risk. Risk depends on PSA (prostate specific antigen), rectal examination, imaging and biopsies. Cancer confined to the prostate is known as localised prostate cancer. If it is not confined to the prostate and has not spread to distant sites it is known as locally advanced prostate cancer. Prostate cancer that has spread to distant sites, most commonly lymph nodes or the bones, is called metastatic prostate cancer.
How is prostate cancer detected?
Perhaps the more important question is how clinically significant prostate cancer is detected? Most men are referred to specialists because of a raised PSA. However, this does not necessarily mean they have cancer. At an initial appointment further tests may include urine testing, blood tests, scans and biopsies. A rectal examination will be performed and the prostate examined for abnormal areas. The only way to definitively diagnose prostate cancer is by taking small samples of the prostate (prostate biopsy). Recent trials have suggested that MRI scans in some instances may prevent unnecessary biopsies of very low risk (clinically insignificant) prostate cancers or lead to better targeting of lesions within the prostate.
What treatments are available for prostate cancer?
Treatments on the whole are individualised to patients depending on age, prostate size, medical problems, previous surgery and local expertise. Often there is a choice and your specialist will help in the decision-making. The most common curative treatment options available are radiation to the prostate or surgery. Radiation kills the cells in the prostate by burning them and can be given either from outside the body or directly into the prostate (brachytherapy). Surgery can be performed by an open or keyhole approach. Robotic surgery is the most recent advance in keyhole surgery and gives the surgeon improved vision and dexterity. Another potential curative approach is to try and target a specific area of cancer in the prostate with focal treatment using ultrasound (HIFU) or most recently laser light to destroy cancer cells. Focal prostate cancer treatment is still evolving and is currently not routinely available. If prostate cancer has spread, hormones with or without chemotherapy is the most common treatment.
BMI Healthcare’s research assessed 818 men in the UK, highlighting the degree of awareness of prostate cancer symptoms. The campaign is in line with the global health awareness event, Prostate Cancer Awareness Month which last throughout March.