March is prostate cancer awareness month. This is a great opportunity for cancer charities, hospitals, health information providers and support organisations to raise the profile of the most common cancer in men. 

Here, nurse Richard takes a quick look at some of the key points – but there's loads more to read on our website.

Basic facts

Prostate cancer is the most common type of cancer in men in the UK, with nearly 42,000 men diagnosed each year. This is about one quarter of all new cancers in men – and over 110 a day.

Like many cancers, prostate cancer is largely a disease of advancing years. It is rare in men under 50 years and becomes more common as men get older. It’s thought that approximately 80% of men in their 80s will have a small area of prostate cancer.

Most prostate cancers grow very slowly and so, particularly in elderly men, are unlikely to cause any problems. However, for some men, prostate cancer can grow more quickly and may spread to other parts of the body.

Splay showing the selection of booklets Macmillan have on Prostate cancer - Having tests for prostate cancer; Understanding early (localised) prostate cancer and Understanding advanced (metastatic) prostate cancer.

To test or not to test?

Prostate cancer is a lot more common than it was 35 years ago – incidence rates have tripled over that time. One reason for this dramatic increase has been the introduction of the PSA test.

All men have a small amount of the protein PSA (prostate-specific antigen) in their blood. It is produced by the prostate gland and turns semen into a liquid. Prostate cancer cells produce PSA, so men with prostate cancer tend to have more PSA than normal. Checking the amount of PSA with a simple blood test, can show if further tests are needed.

Men in the UK are not routinely offered PSA tests to screen for prostate cancer. There are many reasons for this:

  • The PSA test is not completely reliable. For every 100 men with a raised PSA level, only about 30 will have prostate cancer detected in a biopsy. Also, approximately 15% of men with a normal PSA level will have prostate cancer.
  • The amount of PSA in the blood can be high for reasons other than prostate cancer.
  • If the PSA level is high, a man may need further tests such as a biopsy (which can be painful and lead to blood in the urine, the semen or bowel motions). In a few men, the biopsy can lead to infection of the prostate gland, which can be difficult to get rid of. In 5–10%, of men the biopsy will not show cancer even if it is present.
  • Many small prostate cancers detected by PSA screening would never grow enough to cause any symptoms at all during a man’s lifetime.
  • Many prostate cancers grow very slowly and the side effects from treatment (radiotherapy or surgery) may be worse than the effects of the prostate cancer. If the tests show there is an early cancer it can be difficult to decide whether or not to have treatment.

Research hasn't yet shown whether finding and treating prostate cancer early gives an improvement in survival. This can make it difficult to decide whether to have a test. If you are considering a PSA test, talk it through with your GP. They can give you all the necessary information and arrange a test if you want it.

This video discusses the symptoms of prostate cancer and explains the PSA test

Urologist Shiv Bhanot describes the symptoms of prostate cancer and explains the PSA test (prostate-specific antigen test).

You should also see your GP if you have symptoms of prostate cancer

Treatment issues

Prostate cancer is treated in different ways, depending on the individual.

For many men the initial plan may be to do nothing and keep a close eye on the situation. Treatment can then start if things begin to progress. Treatment (see below), if needed, may be to cure the cancer or to control it. This approach is offered to men with slow-growing prostate cancer that is small in size. It helps to avoid the side effects of treatment for as long as possible and possibly altogether. However, some men find it difficult to accept that they have cancer but aren’t treating it!

The main treatments that can be used are surgery, radiotherapy and hormonal therapy. Each treatment has its own advantages and disadvantages. The choice of which treatment to have may come down to the man’s preference about side effects. If you are asked to choose between treatments it’s best to get as much information as you need to help you make the decision. Talk everything through with your doctor, specialist nurse or the team on our support line. You can call us free on 0808 808 00 00.

Living well with prostate cancer

Nigel describes his experience of living with locally advanced prostate cancer, the side effects of treatment, and becoming a Cancer Voice for Macmillan.

If you’re going through or have finished treatment, you may have side effects. There’s a range of different types depending on which treatment you’ve had. Many of the side effects can be managed pretty well – be sure to tell the doctors and nurses involved in your care so they can help you.

Some of the most troublesome on-going problems that a lot of men experience are:

  • Sexual problems and erection difficulties
  • Urinary incontinence
  • Infertility.

Not all men experience these problems, and for many men the side effects will be temporary. There are lots of things that can be done to help reduce the impact of these side effects to help you live well after treatment. We discuss many of them on our website.

To see what else Macmillan's cancer information team has been blogging about, please visit our blog home page! You can subscribe to receive our blogs by email or RSS too.

We're with you every step of the way

The Macmillan team is here to help. Our cancer support specialists can answer your questions, offer support, or simply listen if you need a chat. Call us free on 0808 808 00 00.

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