Prostate cancer is the most common cancer diagnosed in Australian men after skin cancer. About 17,000 men are diagnosed with prostate cancer each year.
The prostate gland is found only in men. It is a small gland between the penis and the bladder that wraps around the urethra, which is the tube that carries urine from the bladder to the penis. The main function of the prostate gland is to help produce sperm.
The exact cause of prostate cancer is unknown, but certain factors can increase the chances of developing it. The risk increases with age – prostate cancer mainly affects men aged 60 or older. Men who have a close relative (father or brother) with prostate cancer, particularly if they were diagnosed before age 65, are more likely to develop the disease than men with no family history. The risk is even higher for men with more than one close relative who has had prostate cancer.
Early prostate cancer doesn’t usually cause symptoms. Symptoms of later-stage prostate cancer include:
- feeling an urgent need to urinate
- difficulty starting to urinate
- a slow or intermittent stream of urine
- leaking or dribbling after urination
- blood in the urine
- pain when urinating
- pain in the lower back or pelvis.
These symptoms don’t necessarily mean you have prostate cancer. In many cases, they are caused by a non-cancerous growth called benign prostate enlargement or benign prostate hyperplasia. This is common in men over 50.
If you are experiencing symptoms and they are a concern for you, see your doctor.
Finding prostate cancer early
There is no national screening program for the early detection of prostate cancer. Doctors have different opinions about whether all men without symptoms of prostate cancer should be tested.
There is concern that testing healthy men will cause unnecessary harm and lead to treatments that may not offer long-term benefits. Treatment for prostate cancer can leave men with side effects such as erectile dysfunction and continence issues, which can affect their quality of life.
Testing may identify fast-growing or aggressive cancers that have the potential to spread to other parts of the body and would benefit from treatment. It may also detect very slow-growing cancers that are unlikely to be harmful.
Prostate cancer tests
If you decide to be tested for prostate cancer, the following tests are commonly used:
Prostate specific antigen (PSA) test – This blood test is used to measure the level of a protein called prostate specific antigen. This will show whether there might be a problem with the prostate gland. A high PSA level doesn’t necessarily mean you have prostate cancer. Two-thirds of men with elevated PSA levels don’t have prostate cancer, and some men with a normal PSA will have prostate cancer. For those who decide to have prostate cancer tests, the general recommendation is to have a PSA blood test every 2 years from age 50 to age 69. For men whose risk of prostate cancer is higher than average (e.g. with a brother diagnosed with prostate cancer), regular testing can start earlier.
Digital rectal examination (DRE) – This is when the doctor inserts a gloved finger into the rectum to check the prostate gland for abnormalities. To confirm a diagnosis of prostate cancer, the doctor will recommend a biopsy. A DRE is not recommended as a standard test for men who don’t have symptoms of prostate cancer.