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					prostate            Prostate cancer facts
                    Prostate cancer is very common in older men.
                                                                            What is the prostate?
                                                                            The prostate is a small gland about the size and shape


  cancer            Many prostate cancers grow slowly and do not
                    cause problems, but some grow quickly and
                    need early treatment. It is important to
                                                                            of a walnut. It lies below the bladder and surrounds
                                                                            the upper part of the ‘urethra’ – the tube that carries
                                                                            urine and semen out through the penis.The prostate
                                                                            gland produces a thick clear fluid that mixes with
Spot the symptoms   recognise any symptoms and tell your doctor.            sperm to form semen.

   Know the facts   This leaflet provides information about the
                    symptoms of prostate cancer and the tests
                    used for men who have these symptoms.
                    It also explains why there is no national               Bladder
                    screening programme for prostate cancer.
                                                                            Prostate gland
                                                                            Prostate gland
                                                                            Penis
                                                                            Urethra
                    How common is it?
                                                                            Testis
                    Only men get prostate cancer. It is now the most
                    common cancer of men in the UK*. Nine out of ten
                    cases occur in men over the age of 60. It is rare in
                    men under 50.
                                                                            As men get older, the prostate may get bigger and
                    The number of prostate cancer cases reported            restrict the flow of urine. Men may need to empty
                    worldwide is going up. One reason for the increase is   their bladders more often.This very common
                    that men are living longer. They are more likely to     condition is called benign prostatic hyperplasia (BPH).
                    reach old age and develop a prostate cancer. Another    It is not cancer but causes some of the same
                    reason is that more men are being tested and found      symptoms as prostate cancer.
                    to have the cancer.

                    * with the exception of non-melanoma skin cancer
What is prostate cancer?                                  What are the symptoms of                                  The PSA test
Cancer develops when cells in the prostate grow           prostate cancer?                                          If you have symptoms, your doctor may
and divide out of control. Unlike a lot of other                                                                    recommend a PSA test. It is important to be
cancers, many prostate cancers grow slowly and may        Any of the following symptoms may be caused by            aware of the advantages and disadvantages of
not cause problems during a man’s life.                   problems that are much less serious than prostate         the PSA test.
                                                          cancer – so try not to worry if you develop any of
But some prostate cancers are fast growing and do         them, but do get them checked out…                        The PSA test measures the levels of a protein -
cause problems. For example, some of the cancer                                                                     Prostate Specific Antigen - in your blood. Raised
cells may break away and travel to other parts of         •   difficulty or pain in passing urine
                                                                                                                    levels of PSA may indicate that cancer is present.
the body, such as the bones.                              •   having to rush to the toilet to pass urine
                                                                                                                    But the test can be positive for other reasons and
                                                          •   frequent visits to the toilet, especially at night
                                                                                                                    does not provide a diagnosis of cancer.
                                                          •   starting and stopping while urinating
                                                          •   dribbling of urine
What causes it?                                           •   a feeling of not having emptied the bladder fully
                                                                                                                    Advantages of the PSA test
                                                                                                                    • may be reassuring if the PSA level is normal
We do not know what causes prostate cancer, or            and less commonly…
why some prostate cancers grow very slowly while                                                                    • may detect cancer at an early stage when
                                                          • blood in the urine or semen                               treatment can help
others grow quickly and spread. But we do know
                                                          • impotence
that certain things increase a man’s chances of
                                                          • pain in back, hips or pelvis
developing the disease…                                                                                             Disadvantages of the PSA test
• increasing age – the older you are, the greater                                                                   • it can miss cancer and give false reassurance
  the risk                                                What will happen at the                                   • it may lead to anxiety and further tests when
• African ancestry – prostate cancer is more                                                                          no cancer is present
  common in black men than white or Asian men             doctor’s?
• family history – if a close relative has had prostate                                                             There are three main options after a PSA test. If
                                                          Your doctor will ask about your symptoms and may          the PSA is not raised it is unlikely to be cancer. If
  cancer, particularly at a young age, then your risk     suggest a PSA blood test.They may be able to
  may be higher                                                                                                     the PSA is slightly raised further tests may be
                                                          identify a prostate problem by feeling the prostate       required. If the PSA is definitely raised then further
• breast cancer in the family – if a close female         gland through the wall of the rectum (back passage).      tests to find out the cause will be needed.
  relative had breast cancer at an early age (under       This is called a digital rectal examination (DRE).
  40), or any male in your family has had it, your risk
                                                                                                                    A diagnosis of cancer should only ever be made on
  of prostate cancer may be higher                        If your PSA level is high and your prostate gland feels   the result of a biopsy from the prostate.
• diet – eating a diet high in animal fat and low in      enlarged, you will need to go to hospital for further
  fruit, vegetables and fish may increase risk            tests which may include a prostate biopsy. During a
                                                          biopsy, a small piece of prostate tissue is removed.
                                                          Later the tissue is examined using a microscope. If
                                                          cancer is present, your doctors will discuss with you
                                                          options for treatment.
Can men be screened for                                Further information
prostate cancer?                                       For more about cancer visit our patient information
                                                       website www.cancerhelp.org.uk click on ‘specific
Prostate cancer is common and many men ask             cancers’ then ‘prostate cancer’.
about screening for early detection of the cancer.
The PSA test is now available to men over the age      If you want to talk in confidence about cancer, call
of 50 who do not have symptoms but would like to       our information nurses. Direct line 020 7061 8355
be tested.Your doctor must provide you with            or freephone 0800 (CANCER) 226 237 or email
information about the limitations of the test before   cancer.info@cancer.org.uk
you go ahead with it.
                                                       Your doctor can give you an information sheet called
Experts do not think that widespread PSA testing       ‘PSA Testing for Prostate Cancer’.
of the population would be helpful. At present
there is no evidence that screening would lead to a
reduction in the number of deaths caused by
prostate cancer.                                       About Cancer Research UK
If population screening using the PSA test             Cancer Research UK is the leading charity dedicated
were introduced                                        to research on the causes, treatment and prevention
                                                       of cancer. If you would like to support our work
• some men would be diagnosed with cancer at an        please call 020 7009 8820 or visit our website.
  early stage when treatment can help
• some men with cancer would be missed
                                                       Cancer Research UK
• other men without cancer would be given tests        PO Box 123
  they do not need                                     London WC2A 3PX
• some men with very slow growing cancers would        020 7242 0200
  get treatment they do not need.
                                                       www.cancerresearchuk.org
If you have concerns about whether or not to have      www.cancerhelp.org.uk
the PSA test, talk to your doctor or practice nurse.
They will discuss the issues with you and provide
you with an information sheet that outlines the
pros and cons in more detail.



                                                       May 2003
                                                       Registered charity no.1089464