Know Your Prostate

Read about the author Samantha Evans

Prostate cancer is now the most commonly diagnosed cancer, having overtaken breast cancer. According to Prostate Cancer UK, this news comes a decade earlier than previously predicted, largely due to increased awareness that has led to more men getting diagnosed but not all men. New cases of prostate cancer have more than doubled over the last 20 years, while about 400,000 men in the UK are living with the disease or have survived it.

It still kills one man every hour: not just dads, but brothers, granddads, sons, nephews and uncles. Over 40,000 men are diagnosed with prostate cancer each year. This is because the majority of cases are symptom free, and a limited amount of accurate tests for life-threatening forms of the disease means there is no national screening programme in the UK.

What is the Prostate?

The Prostate is a gland, usually the size and shape of a walnut, which grows bigger as you get older. It sits underneath the bladder and surrounds the urethra, which is the tube that carries urine (wee) out of the body. The prostate’s main job is to help make semen – the fluid that carries sperm.⁠
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Men, trans women, non-binary people who were assigned male at birth and some intersex people all have a prostate.⁠
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The most common prostate problems are an enlarged prostate, prostatitis (inflammation) and prostate cancer.

Who is at greater risk of developing Prostate Cancer?

Worryingly, a survey of 2864 adults, of which 1291 were at increased risk to prostate cancer, conducted by YouGov on behalf of Prostate Cancer UK found that 4 out of 5 men (83%) at increased risk of prostate cancer are unaware of the danger and are therefore not taking measures to reduce their risks and speak to their GP. 75% of the men at higher risk said that even if they were aware of the disease but did not have any symptoms, they would not discuss it with their doctor.

Men who are at an increased risk of developing prostate cancer are those who have a family history of their father or brother having the disease, men aged over 50 and black men. Black men have a 1:4 chance of developing the disease during their life.

The men in the survey were asked about their awareness of prostate cancer, including what could increase their risk and what would make them talk to their GP about their concerns. The survey found that 84% of men over 50 did not realise they had a higher than average risk of developing prostate cancer. This was also true of 90% of black men and 50% of the men with a family history. 70% of the men over 50 said that even if they were aware of their higher risk but remained symptom free, they wouldn’t speak to their GP. This was also true for 69% of black men and 65% of the men with a family history.

Lifestyle changes can reduce your risk

A major study by Oxford University (2016) has found that every four inches (10 cm) on a man’s waist increases risk of deadly prostate cancer by 18%.

The 14-year-long study of almost 150,000 men has established strong links between middle-aged spread and the most aggressive forms of the disease. Researchers said a 37-inch waist increased your risk of fatal prostate cancer by 18% than was associated with a 33-inch waist. Having a high body mass index also increased the risk of developing a more aggressive form of the disease.

Eating healthily, exercising regularly and maintaining a healthy weight can significantly lower your risk.

It can also reduce nightime visits to the toilet and improve your sexual function too.

A more pleasurable activity is masturbation. Regular masturbation has been found to reduce your risk of developing prostate cancer by 22%

Recognising the Symptoms of Prostate Cancer

It is important that you know the signs and symptoms that may signal there is an issue with your Prostate. The most common reason for this is an enlarged prostate gland, however if you notice any of these symptoms you should seek medical advice as soon as possible.

These include:

• Difficulty when starting to urinate or emptying your bladder
• A weak urine flow when you first start to pee
• The sensation that your bladder has not emptied completely
• Dribbling urine after you have finished peeing
• The need to get up at night to urinate
• Urgency – the sudden need to urinate, which may lead to some leakage of urine before you make it to the toilet.

You may notice other symptoms which may be a sign that prostate cancer has spread to other parts of the body, however these symptoms can also be a sign of prostatitis, a common condition which causes swelling and inflammation of the prostate, diabetes or side effects of some medications so get them checked out.

• Pain in your back, hips or pelvis
• Difficulty in getting or maintaining an erection
• Blood in your urine or semen
• Unexplained weight loss

Currently, existing diagnostic tests are not as accurate as they could be, making diagnosis difficult at times. There is currently no way to distinguish between malignant and benign forms of the disease when a man is first diagnosed, therefore the treatments offered may not be the most appropriate for their form of the cancer. There is currently no screening programme for prostate cancer in the UK. One reason for this is that the PSA test isn’t good enough at finding prostate cancer to be used as part of a screening programme.

Choosing to have invasive treatment such as surgery, radiotherapy or chemotherapy can lead to long term health problems, including sexual dysfunction, but choosing to have the disease process monitored can lead to anxiety and depression and the fear that the disease may spread.

Addressing the higher risk for Black African-Caribbean Men

“Hear me Now” : The uncomfortable reality of prostate cancer in black African-Caribbean men was a report by Rose Thompson from the BME Cancer Communities (February 2013) which looked at the inequalities within BME communities and found that:

Black african-caribbean men are at a 2-3 fold greater risk of developing the disease due to lack of knowledge about their family history, increased risk and that they often develop it at a younger age.

There has been little research on prostate cancer in different ethnic groups in the UK which is why we need better education around prostate cancer, understanding your risk, finding out your family history and recognising symptoms to ensure all men are vigilant about their prostate health but especially if they are in a higher risk group. Awareness of cancer is generally lower in BME groups than amongst white men and women, as is the take-up of screening with people more likely to present later with symptoms, which may be more advanced and require more invasive treatment.

Yet this is preventable with better education for the general public, within BME communities, awareness campaigns, recognising symptoms, although some younger men do not present with symptoms so need to know their risk to help open the conversation and enable access to early diagnosis and effective treatment. Getting the message out in public places, on the back of toilet doors, in GP practices and hospitals, changing rooms, sports facilities, mens sheds groups, on public transport, in workplaces and leisure and entertainment industry could really make a difference too.

Many GPs and other healthcare professionals have the opportunity to identify those patients who may be at greater risk, offer them blood tests at a younger age, prostate examinations and keep them under surveillance.

Prevention is the best medicine

If you are unaware that you may be at risk to developing prostate cancer, visit your doctor. Your GP will be able to examine you and ask you questions about your general health and family history. They will also be able to give you advice about how to reduce your risk of prostate cancer developing by making changes to your lifestyle, including diet, exercise and regular prostate massage.

Men over 40 are invited to a Wellman screening appointment where you have your prostate will be examined for any abnormalities and asked questions about your urinary habits, number of nocturnal visits to the toilet and any difficulty in urinating.

The Prostate Cancer Risk Management Programme gives men over 50 the right to have a PSA test on the NHS – as long as they’ve talked through the advantages and disadvantages with their GP or practice nurse.

Many advocates are calling for a NHS Prostate Cancer Screening programme in the UK, for all health bodies and policy makers to work together to improve ethnic data collection and to address the barriers to accessing diagnosis and treatment because the earlier prostate cancer can be diagnosed, the more effectively it can be treated and managed.

Prostate Cancer UK hold many fund-raising events to raise money to help research the disease. Go to Prostate Cancer UK to find out how to get involved and make a difference to your prostate health today for anyone you know who has a prostate

Movember UK are the leading charity changing the face of men’s health, focusing on all aspects of male health, both physical and mental.

Prostate cancer doesn’t just affect those going through it, it impacts upon their partner, intimate and emotional relationship. children, family, friends and work colleagues, so we must ensure that we educate everyone to help them to understand their risk and seek help.

If in doubt, seek medical advice, it could just save your life!

Useful websites
Prostate Cancer UK : www.prostatecanceruk.org
Movember UK : www.uk.movember.com
Macmillan : www.macmillan.org.uk
Orchid : www.orchid-cancer.org.uk
Tackle Prostate Cancer : www.tackleprostate.org
College of Relationship and Sexual Therapists : www.cosrt.org.uk
BME Cancer Communities : www.bmecancer.com
Out with Prostate Cancer : www. outwithprostatecancer.org.uk (a support groups for gay and bisexual men and trans-women)