The prostate gland is a small gland found in men that helps with the production of semen. It creates a fluid which is mixed with sperm (produced in the testes) and together it creates sperm. The normal prostate is about the size of a walnut and sits between the neck of the bladder and the penis, with the urethra (the pipe that brings the pee out) running through it.
It is normal for the prostate to get bigger as men age, with symptoms arising from this. This is called benign prostatic hyperplasia (BPH. Because the gland gets bigger, it can press on the bladder causing frequency of urine or a feeling like your bladder is full all the time. If enlarged it also squeezes the urethra, which can lead to difficulty in stopping or starting urination. This is why the main symptoms of an enlarged prostate are increased urination, especially during nighttime, a full bladder feeling, difficulty starting urination and dribbling afterwards. This is common in men over the age of 50 and is usually treatable and not serious.
This is the most common cancer in men, with about 36,000 new diagnoses in the UK every year (about 25% of all newly diagnosed cases of cancer in men)
Most cases of prostate cancer develop in men aged 70 or older.
It is more common in men of African-Caribbean or African descent, and less common in men of Asian descent.
Prostate Cancer Symptoms
- Nocturia (getting up at night to urinate frequently)
- Difficulty in starting urination
- Difficulty stopping urination (dribbling)
- Lower back pain
Detecting prostate cancer early is the key to successfully treating it. We use a screening test called a PSA (prostate specific antigen). However the test on its own cannot be relied on to diagnose cancer. The test basically tells us the size of the prostate, which we then compare with the average reading for someone of a similar age, If the reading is abnormally high this would prompt further investigation. However, it is possible to have a high PSA reading whilst not having cancer, this is possible as men get older and the prostate increases in size. Therefore we recommend that you have a rectal exam at the same time and perform these two tests yearly. During the rectal exam we can feel if the prostate is enlarged and irregular or hard, all signs of possible cancer and if the PSA is abnormal, that would be significant. If you have these checks yearly it is even better as we can see if there is a sudden increase in PSA compared to previous readings.
Prostate Cancer Prognosis
Prostate cancer usually progresses very slowly, so the outlook is generally favourable .It is possible to live for decades without having any symptoms or needing any treatment. Many men die with prostate cancer, rather than as a result of it. It can usually be cured if detected early. Treatment options include removal of the gland, hormone or radiotherapy. However there are also more aggressive types of prostate cancer, that can cause death quickly
Once the cancer has spread (metastasised) to other parts of the body, most commonly the bones, it can no longer be cured. About 10 000 men die of prostate cancer in the UK every year.
A simple blood test and physical exam am can save your life. Don’t let embarrassment delay you seeing your doctor. I also offer a much more specific prostate cancer test called a PCA3 gene test.
I have over 14 years experience providing sexual health screening and I offer a completely confidential, professional, non judgemental service from start to end. If you are not sure if you have been at risk, then I offer a normal consultation to discuss the possible risks and whether screening would be appropriate. We discuss and agree all costs beforehand so you know exactly where you stand and I will always provide you with clear and accurate advice based on current British Association for Sexual Health and HIV (BASHH )guidelines.
Dr Wayne Cottrell is your Private GP and Sexual Health Doctor in Canary Wharf. Let us help you today!