Black men are three times more at risk of prostate cancer than white men

Mr Alan Doherty

So what can you do to protect yourself against prostate cancer – the most common type of cancer in men?

What symptoms should I look out for?

The prostate is located just below the bladder within your pelvis. If your prostate becomes enlarged as a result of disease, it can squeeze the urethra, the tube which carries urine out of your bladder and to the penis. So sometimes, difficulties going to the toilet can be early symptoms of prostate cancer. Look out for:

Frequency – do you need to urinate more often than before?

Urgency – do you have to get to the toilet very quickly?

Nocturia – are you getting up three or more times at night to urinate?

Hesitancy – do you feel the need to urinate but can’t empty your bladder?

If the answer is ‘yes’ to any of the questions above, you should see your GP. However many men who have prostate cancer do not have any symptoms. Equally, it is more common for these sorts of symptoms to be due to a non-cancerous condition called Benign Prostatic Hyperplasia (BPH), when the prostate becomes enlarged.

Family history is very important

Prostate cancer can run in families. We know that if you have a first degree relative (father or brother) who is diagnosed with prostate cancer before the age of 60, this means your risk of developing the disease increases fourfold. Your risk also increases four times if more than one of your relatives develops prostate cancer, regardless of their age. The Birmingham Prostate Clinic advises that in either of these situations, you should visit your GP and discuss having a PSA test.

Why are black men at greater risk of prostate cancer than white men?

This is not fully understood. It is believed to be in part due to genetics and although diet may also be a factor, there is no clear link between diet, ethnicity and prostate cancer risk.

What is the PSA test for prostate cancer?

PSA stands for the prostate specific antigen, a protein which can be detected in a blood test. If the levels of this protein are high, this may indicate that you are at risk of prostate cancer. Your age will also be considered when assessing your PSA result, because older men tend to have larger prostates and therefore slightly higher readings. The PSA test does not tell us whether or not you have prostate cancer – only whether you may be at risk. Your doctor will also consider your family history and your ethnicity.

What happens if my PSA test is high?

If your PSA result is considered to be high, you will need to have some further assessments. Your GP may carry out a digital rectal examination (DRE) to examine your prostate. If it feels abnormal and hard, this is a sign that you may have prostate cancer. You may be referred to a specialist called a urologist who may carry out a scan of your prostate. A biopsy – when samples of your prostate tissue are taken and examined in a laboratory – is the test which will tell the urologist whether or not you have prostate cancer. It will also help the urologist to know how far the disease has spread and how aggressive it is.

What if I do have prostate cancer?

There is wide variation in the outlook and treatment for men who are diagnosed with prostate cancer. It is a type of cancer which can be very slow growing and if you are elderly, your doctor may recommend ‘active monitoring’ with regular assessments rather than treatment. If your prostate cancer is diagnosed early, the chances of having successful treatment and a full recovery are very good. There are many different types of treatments for prostate cancer, including surgery (called a prostatectomy), radiotherapy, brachytherapy and treatment with hormones.

How do I decide what is the right treatment for me?

The best treatment for you will depend upon how the sort of prostate cancer you have and your own personal preferences. Many men find the choice of different prostate cancer treatments quite bewildering. It is best to ask your consultant about his or her experience of carrying out the procedure they offer. There can be side-effects of prostate cancer treatment including incontinence and impotence. You can ask your doctor for their results, not only in terms of treating cancer but also how well their patients get on in terms of erectile function and continence.