Monday, 12 December 2016

Cancer Types - Prostate

Hello everyone, 

This post is dedicated to my maternal Buppou, George, who survived a battle with prostate cancer.  

The Prostate:
The prostate is a gland found only in males. It surrounds the urethra, the tube that carries urine from the bladder to the penis. It also carries semen. The prostate is responsible for creating the fluid part of semen. The prostate needs testosterone (the male sex hormone) to grow and function.

Symptoms of Prostate Cancer:
Having to rush to the toilet to pass urine
Difficulty in passing urine
Passing more urine than normal, especially at night
Pain when passing urine
Blood in urine or semen (very rare)

These symptoms are the same for prostate cancer and an enlarged prostate so it is important to go to the GP as soon as they appear. The symptoms are usually caused because the growth is pressing on the urethra and is blocking the flow of urine. It is important to remember that early prostate cancer does not usually cause any symptoms because the growth is too small to affect the flow of urine.  Prostate cancer usually grows quite slowly, especially in older gentleman. They may only suffer mild symptoms and they may occur over a number of years.

Causes and Risks:
Prostate cancer is the most common cancer for UK men (not counting non melanoma). There are some risk factors:
* Age is the most significant of these risk factors. Prostate cancer is quite rare in men younger than fifty – in fact more than half of all prostate cancer cases are found in men aged seventy plus.
* Having a family history of breast cancer or prostate cancer will also heighten your risk of developing this type of cancer
* If you are of African ancestry then your risk is also higher as this type of cancer is more common in men of black or mixed race descent then white or Asian men

The aim of screening for prostate cancer is to diagnose the disease in the early stages when it is usually easier to treat and most likely to be curable. At the moment a national screening test is not available but research is being carried out and trials are taking place all the time.

Diagnosing Prostate Cancer
If your GP suspects prostate cancer then they will:
* Examine your prostate by placing a gloved finger into your back passage
* Get you to have a blood test to check your PSA levels (PSA = Prostate Specific Antigen)

This is not as painful or as embarrassing as it sounds. GP’s do this all the time and although having a finger inserted into your bottom may sound horrific, I am told by reliable sources that is really isn’t as bad as it sounds. Please don’t let the fear or embarrassment stop you getting this test if you feel you have a problem with your prostate – it could save your life.

With PSA levels, it is usually the higher the level, the more likely you are to have cancer. However, don’t be too alarmed by this fact – there could be another reason, for example an enlarged prostate or an infection. In fact, two out of three men with a raised PSA level do not have prostate cancer. It is possible for a man to have prostate cancer but not a high PSA level – this is where the gloved finger comes in handy.

Treating Prostate Cancer:
This is where my post will get complicated so I will try and keep it as clear and concise as possible!

Prostate cancer is divided up into stages. These stages will inform the doctor of how developed the cancer is and this information will help them decide on the best treatment plan for the patient in question. The stages are numbered 1-4 and your doctor will talk to you about your “TNM” which stands for Tumour, Nodes and Metastases. Basically this means they will discuss the size of the tumour, whether is has spread to any nearby lymph nodes and whether it has spread (metastasised) to anywhere else in your body.

Prostate cancer tends to spread to your bones rather than other organs. It is possible for it to metastasise even when the original prostate tumour is very small. This means early diagnosis is key to treating it and controlling it.

There are several factors doctors consider before deciding a treatment plan. These factors are:
* The stage of the cancer
* The grade of the cells (how they look under a microscope)
* Your Gleason score
* Your PSA levels
* Your age
* Your general health

Once these factors have been considered, your treatment options will become clearer and your doctor will discuss them with you. Please ask questions and make sure you feel comfortable with the treatment plan you are offered. Don’t be afraid to get a second opinion.

If the cancer is low risk and is localised to the prostate area only, then active monitoring is likely to be your treatment option. This means the cancer will be monitored and the doctors will wait to see if it develops. If it does start to develop then surgery may be an option and the prostate gland could be removed. Radiotherapy is also an option at this stage.

If the cancer is classed as an intermediate risk but is localised to the prostate area then surgery to remove the prostate gland may be an option. Radiotherapy may also be considered.

A high risk, localised tumour will usually be treated with surgery and external radiotherapy.

If the cancer has broken through the capsule that surround the prostate gland then this is known as locally advanced prostate cancer. This will usually involve surgery or radiotherapy which will be combined with hormone treatments.

If you are concerned by anything you have read today please contact your GP as soon as possible


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