One in 9 Australian men will develop prostate cancer by the age of 75
The Prostate
The Prostate is an organ forming part of the male reproductive system. It is located immediately below the bladder and just in front of the rectum. Its main function is to produce fluid which protects and enriches sperm.
Background
- One in 9 Australian men will develop prostate cancer by the age of 75.1
- Prostate cancer is rare before the age of 45.
- Many prostate cancers will not progress sufficiently to cause harm in a man's lifetime while others can progress to more advanced stages. Currently there is no test to adequately differentiate between aggressive and non aggressive tumours.
Risk Factors
The causes of prostate cancer are not known. However there are certain risk factors that have been linked with the development of prostate cancer, including:
- Family history of prostate cancer – those men with a father or brother who has had prostate cancer;
- Age - men over the age of 50 years;
- Diet - a diet high in animal fat and protein.
Recommendations
The Department of Health and Human Services recommends that:
- Males over the age of 50 should discuss testing for prostate cancer with their GP.
- Early prostate cancer usually does not cause symptoms. If symptoms do occur they are indistinguishable from symptoms related to non-cancerous conditions.
- If you experience any of the following symptoms you should see your GP:
- Frequent need to urinate, especially at night;
- Difficulty starting the urine flow;
- Slow, interrupted flow with dribbling afterwards;
- Blood in urine or semen;
- Pain during urination.
- Decisions about treatment options should be made only after discussing with a specialist all possible benefits and side effects of treatment. Side effects can include erectile dysfunction, incontinence, bowel problems and loss of bone density.
Current Testing Methods
1. The PSA Test
The Serum Protein, Prostate Specific Antigen (PSA) test is a blood test to check for elevated levels of a protein produced by normal prostate cells. When a cancer is present the level of PSA rises. A higher than normal PSA reading does not necessarily mean you have cancer, but it can be a useful test to help guide your decision about whether or not to have further tests. The PSA test does not tell you with complete certainty that you do or do not have prostate cancer.
Only one in three men with a higher than expected result are found to have prostate cancer. However it can be useful, because it guides the decision about whether you should go on to have further tests.
2. Digital Rectal Examination (DRE)
Because the rectum is located just behind the prostate, and cancer most often grows on that side of the gland, a doctor can sometimes feel a cancer by placing a gloved finger inside the rectum. This test may be uncomfortable but is rarely painful. A rectal examination on its own is less likely to pick up early cancers than when combined with the PSA test. If a DRE is performed in conjunction with a PSA test the chance of picking up all cancers is better. However even if both tests are positive, you may not necessarily have prostate cancer and conversely if both tests are negative a cancer is not completely excluded.2
3. Biopsy
A biopsy is the only definitive way of telling whether you have prostate cancer. Unfortunately, there is not yet a test available that is very good at differentiating between aggressive cancers and those which could be left alone. That's why it's important for men who are thinking about being tested to be fully aware of the pros and cons of testing, and to make a decision they are comfortable with on that basis.
Why isn't there a population-based screening program for prostate cancer?
Population-based screening of asymptomatic men for prostate cancer cannot be supported until more information is available about the natural progression of the disease and there is direct evidence showing a net benefit of screening. PSA and DRE do not have appropriate sensitivity (the ability to detect most people with the disease) and specificity (be able to exclude most people without the disease) to be used on men with no symptoms or risk factors as screening tools for prostate cancer. Due to the significant gaps in evidence about the effectiveness of prostate cancer screening and early treatment, experts' advice is not to recommend population-based screening but to support patient-centred informed decision-making when individual decisions about prostate cancer testing need to be made.3
For further information
Talk to your GP
or visit:
- Prostate Cancer Foundation of Australia
- Cancer Council of Australia (Prostate Cancer)
- National Health Service UK
- Andrology Australia
or contact:
Population Screening and Cancer Prevention on (03) 6166 6910 or the Cancer Helpline on 13 1120
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