1: What exactly is the prostate?
Mark Matfield: The prostate is a small gland located underneath the bladder in men. It is shaped like a doughnut and fits around the tube (called the urethra) which carries urine out of the bladder. The prostate produces part of the fluid that mixes with sperm when a man ejaculates.
2: What are the main symptoms of prostate cancer?
Mark Matfield: Some of the main symptoms of prostate cancer are linked to problems while passing urine, whether it’s going too often, difficulty going or pain or even noticing some blood. Pain in the lower back, hips and upper thighs can also be indicators. However, all of these symptoms are more often caused by other less serious conditions, so please don’t panic, but it is good idea to consult your doctor.
3: How common is prostate cancer?
Mark Matfield: Prostate cancer is now the most commonly diagnosed cancer in men in many western countries, with 36,000 new cases diagnosed in the UK a year. The number of recorded cases has increased a lot in recent years, partly because of the use of the PSA test in detecting the disease, but also because men are living longer. Like most cancers, prostate cancer is more common in the elderly.
4: Which men are at risk?
Mark Matfield: Prostate cancer is very rare in men under 50. The risk increases after the age of 50 with half of all cases occurring in men over 70. Men from families with a history of prostate cancer are at higher risk.
5: What is a PSA test?
Mark Matfield: A PSA test is basically a blood test. If the level of Prostate Specific Antigen (PSA) in your blood is too high, it is an indicator of prostate problems and one of these problems can be prostate cancer. There are several other conditions which cause an increase in blood PSA levels and only around one in three men found to have a raised PSA will have prostate cancer.
6: Who should have a PSA test?
Mark Matfield: We believe that, for men over 50, it is worth having a PSA test every few years. This is available on the NHS for every man over 50 who wants one, after his doctor has explained the benefits and risks involved in this and further tests.
7. How successful is treatment for prostate cancer?
Mark Matfield: Thanks to scientific advances in detecting and treating prostate cancer, survival rates are good. Early detection is the key though. Currently the cancer is detected at an early stage in around fifty percent of patients and treatment is successful for nine out of ten of these men.
8: What treatments are available for prostate cancer?
Mark Matfield: Sometimes prostate cancers are so slow growing that no treatment is needed. What’s known as ‘watchful waiting’ is used in these cases, with regular monitoring of the patient to find out if the cancer changes. However, when treatment is necessary, there are four main types used – surgery, radiotherapy, brachytherapy and hormone therapy.
9: What are the side-effects of prostate cancer treatment?
Mark Matfield: Most men being treated for prostate cancer are well past the age when they want to start a family, but all treatments carry a high risk of infertility. There is a low risk of short or long-term incontinence as a major side-effect of surgery, radiotherapy and brachytherapy treatments. Most prostate cancer patients experience impotence during the course of the treatments, and, in some cases, afterwards. Hormone therapy can cause hot flushes, tiredness and weight gain, but all side-effects cease when the treatment stops.
10: What newer treatments are available?
Mark Matfield: Two promising new treatments for prostate cancer are Cryotherapy and High Intensity Focussed Ultrasound [HIFU]. Cryotherapy uses extreme cold to freeze and destroy cancer cells. HIFU, on the other hand, causes localised heat inside the tumour that kills the cells. Both of these treatments appear to be as effective as surgery or radiotherapy in the short term, but their long-term effectiveness is not yet known.
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Disclaimer: Please be aware that Dr Matfield is a cancer scientist, not a medical doctor. Whilst he is very happy to provide information about prostate cancer diagnosis and treatment in general – including any specific aspects of it you have in mind – he is not able to offer diagnoses or comment on any individual case. The best person to diagnose and treat any individual is their own doctor – it would be wrong for anyone to offer individual medical advice by email.