Prostate cancer affects 1 in 8 men - who is at risk?

Prostate cancer is one of the most common cancers in the UK, with over 130 men diagnosed every day [1].  

Most men do not have any signs or symptoms of prostate cancer, especially in the early stages, so it’s important to understand your risk. 

In this blog we discuss: 

• What is the prostate? 
• What is prostate cancer? 
• Signs and symptoms of prostate cancer 
• What is my risk of prostate cancer? 
• Does testosterone increase my risk of prostate cancer?
• How do I test for prostate cancer? 
• Where can I get support? 

What is the prostate?

The prostate gland is found in men or people assigned male at birth. A healthy prostate is walnut-sized and grows as you get older. It sits underneath your bladder, surrounding the urethra (the tube which carries urine out of the body) and produces a fluid that, together with sperm cells (and fluids from other glands), makes up semen [2].  

What is prostate cancer?

Prostate cancer can develop when cells in the prostate start to grow in an uncontrolled way. The causes of this are largely unknown. Sometimes it can occur slowly and may not lead to adverse effects or decrease your life expectancy. Other times, prostate cancer can grow quickly and may spread – this type of cancer usually requires treatment, such as chemotherapy [3].  

Signs and symptoms of prostate cancer

The early stages of prostate cancer do not commonly cause symptoms [4]. 

If cancer grows and develops, it may start to press against the urethra, changing the way you urinate and causing symptoms. 

Symptoms, when something is pressing against your urethra, include: 

• Difficulty urinating or emptying your bladder  
• A weak flow when you urinate  
• A feeling that your bladder hasn’t emptied properly  
• Dribbling urine after you finish urinating  
• Needing to urinate more often than usual, especially at night  
• A sudden need to urinate 
• You may sometimes leak urine before you get to the toilet [4, 5] 

These symptoms are not always a sign of cancer, and a non-cancerous enlarged prostate (benign prostatic hypertrophy) can cause similar symptoms. It is best to discuss any new symptoms with your GP.   

If prostate cancer spreads to other parts of the body, it can cause other symptoms. 

Possible symptoms if prostate cancer spreads: 

• Back pain, hip pain, or pelvis pain 
• Problems getting or keeping an erection 
• Blood in the urine or semen 
• Unexplained weight loss 
• Pain in the testicles [4, 5] 

When discussing your symptoms with a medical professional, they will assess your risk of prostate cancer.  

What is my risk of prostate cancer?

In the UK, about one in eight men will get prostate cancer in their lifetime [6]. And some men may have a higher risk of developing it than others, including: 

• Men aged over 50 years – the overall risk of prostate cancer increases with age. The most common age for men to be diagnosed is between 75 and 79 years old. 
• Being of black ethnicity – in the UK, about one in four black men will get prostate cancer in their lifetime, which is double the risk compared with white men. It's least common in Asian men.
• Men with a family history of cancer – prostate cancer tends to run in families. Having a father, brother, grandfather, or uncle with prostate cancer increases your risk.

Several lifestyle factors may increase your risk of experiencing prostate cancer. Therefore, eating a healthy balanced diet and keeping physically active, can help reduce your risk of prostate cancer [4]. 

Lifestyle factors that may increase your risk of prostate cancer: 

• Being overweight  
• Lack of exercise/living a sedentary lifestyle 
• Eating a poor diet, especially one low in vegetables but high in processed meats and saturated fats

If you want to find out more information about your risk, Prostate Cancer UK offers a quick risk checker to assess your risk of developing prostate cancer. 

Does testosterone increase my risk of prostate cancer?

There is no substantial evidence to suggest that testosterone replacement therapy (TRT) increases the risk of developing prostate cancer. Find out more about TRT and prostate cancer. 

How do I test for prostate cancer?

There is no single definitive test for prostate cancer, and men are not routinely screened in the UK [6].  

It is important to be aware that all tests available have pros and cons, which a medical professional will be able to discuss with you. 

The most common prostate cancer tests

1. Blood tests

There is a specific blood test that can be done to help detect signs of prostate cancer. A blood test, such as our PSA (Prostate Specific Antigen) Blood Test, tests for the prostate-specific antigen biomarker. If this biomarker is raised, it could indicate prostate cancer.  

However, a PSA test can also give false-positive and false-negative results [6]. 

That’s why it’s important that a doctor looks at your results in context with your risk and symptoms to determine your next steps.  

If you are over 50, you may be eligible to have this blood test for free on the NHS.  

2. A physical examination

A doctor or nurse may examine your prostate. They will do this by inserting a gloved finger into your rectum (bottom). It is usually very quick, and you should not feel any pain. 

They will then check to make sure there are no unusual bumps or lumps and see whether your prostate is enlarged. This exam can help identify any masses that could be causing your symptoms.  

3. MRI scan 

An MRI is a type of scan that produces detailed images of the inside of your body. An MRI takes place in a hospital and tends not to last longer than an hour for the prostate.  

Your MRI results will be quite quick. If they indicate a problem, it can be addressed later with either a biopsy or in some cases, surgery.  

4. Biopsy 

A biopsy involves a small piece of tissue being removed from your body to undergo further testing and examination. There are several types of biopsies used to diagnose prostate cancer [7]. 

The different types of biopsies used to diagnose prostate cancer include [8]: 

• A transperineal biopsy – a needle is inserted into the prostate through the skin behind the scrotum. It is usually done under general anaesthetic and has a reduced infection rate.  
• A transrectal biopsy – an ultrasound probe (a machine that uses sound waves to build a picture of the inside of your body) is inserted into the rectum. This picture helps the radiographer see where to pass the needle and take the biopsy. You will be given a local anaesthetic to numb the area to ease discomfort.  
• A biopsy may also be taken during a cystoscopy examination 

Where can I get support?

If you are experiencing symptoms or are concerned about your risk of prostate cancer, it is best to speak to a doctor. 

If you are nervous about speaking to your GP, Prostate Cancer UK offers a simple form that you can fill out and take with you to your appointment, which may make a difficult conversation easier to initiate. Cancer is not an easy subject, but by talking about it, we can help to raise awareness of the risks and symptoms of prostate cancer. 

A routine test, such as our Advanced Well Man Blood Test, could help to rule any conditions in or out of your health conditions.

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REFERENCES 

1. Cancer Research UK. Prostate cancer statistics. [online] Available at: <https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer#heading-Zero> [Accessed 28 September 2021]. 
2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the prostate work? 2011 Feb 15 [Updated 2016 Aug 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279291/
3. Prostate Cancer UK. 2020. Trans women and prostate cancer. [online] Available at: <https://prostatecanceruk.org/prostate-information/are-you-at-risk/trans-women-and-prostate-cancer> [Accessed 28 September 2021]. 
4. Prostate Cancer UK. 2019. About prostate cancer. [online] Available at: <https://prostatecanceruk.org/prostate-information/about-prostate-cancer> [Accessed 28 September 2021]. 
5. NHS UK. 2018. Prostate cancer - Symptoms. [online] Available at: <https://www.nhs.uk/conditions/prostate-cancer/symptoms/> [Accessed 28 September 2021]. 
6. About prostate cancer (no date) Prostate Cancer UK. Available at: https://prostatecanceruk.org/prostate-information/about-prostate-cancer#:~:text=In%20the%20UK%2C%20about%201,out%20more%20about%20your%20risk (Accessed: October 31, 2022).
7. Prostate Cancer UK. Introduction to tests. [online] Available at: <https://prostatecanceruk.org/prostate-information/prostate-tests/introduction-to-prostate-tests> [Accessed 28 September 2021]. 
8. Cancer Research UK. Tests | Prostate cancer | Cancer Research UK. [online] Available at: <https://about-cancer.cancerresearchuk.org/about-cancer/prostate-cancer/getting-diagnosed/tests> [Accessed 28 September 2021].