Prostate cancer

Friday 1 November, 2013

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On this page:  The prostateWhat is prostate cancerWhat are the symptoms?What are the causes?Are there screening programs for prostate cancer?How common is it?Tony's story

The prostate

The prostate is a small gland about the size of a walnut that sits below the bladder and is found only in men.

It produces most of the fluid that makes up semen. It surrounds a tube called the urethra, which carries urine (from the bladder) and semen (from the prostate and other sex glands) through the penis and out of the body.

The prostate gland is located near nerves, blood vessels and muscles that are needed to control bladder function and to achieve an erection.

The prostate normally gets bigger as a man gets older. The growth of the prostate depends on the male sex hormone, testosterone, which is made by the testicles (testes).

A growing prostate may narrow or block the urethra, which can change urinary patterns. This enlargement is called benign prostate enlargement − it is not cancer. Benign prostate enlargement usually begins around the urethra, deep inside the prostate.

It may cause symptoms such as:

  • weak urine flow
  • frequent urination, especially at night
  • an urgent need to urinate
  • difficulty starting to urinate
  • leaking or dribbling after urinating
  • bone pain in the lower back, upper thighs or hips
Diagram of the male reproductive system including the prostate

What is prostate cancer?

Prostate cancer develops when abnormal cells in the prostate gland grow more quickly than in a normal prostate, forming a malignant tumour. Most prostate cancers grow slower than other types of cancer.

Early (or localised) prostate cancer means cancer cells have grown, but they have not spread beyond the prostate. Some prostate cancers may spread to other parts of the body, such as the bladder, bones and lymph nodes. This is called advanced prostate cancer.

What are the symptoms?

Early prostate cancer rarely causes symptoms. This is because the cancer usually grows in the outer part of the gland and is not large enough to put pressure on the urethra. If the cancer grows and spreads beyond the prostate (advanced or metastatic cancer), it may cause:

  • pain or burning when urinating
  • increased frequency or difficulty urinating
  • blood in the urine or semen
  • pain in the lower back, hips or upper thighs
  • weight loss

These symptoms are common to other conditions, including benign prostate enlargement, and may not be a sign of advanced prostate cancer. If you are concerned and/or are experiencing any of these symptoms, speak to your doctor.

What are the causes?

While the causes of prostate cancer are unknown, the chance of developing prostate cancer increases:

  • as you get older – it mainly affects men over 65
  • if your father or brother has had prostate cancer
  • if you have a strong family history of breast or ovarian cancer
  • if you are of African descent – you have a higher risk than men of European descent.

Family medical history, such as inheriting the BRCA2 gene mutation, may increase the risk of prostate cancer in some men. However, this affects less than 10% of Australian men.

You may have an inherited gene that increases prostate cancer risk if you have multiple relatives with prostate cancer, breast cancer or ovarian cancer on the same side of the family (either the mother’s or father’s side) or younger male relatives (under 50) with prostate cancer.

If you are concerned about your family history of prostate cancer, you may wish to ask your doctor for a referral to a family cancer clinic or a urologist. They can advise you on suitable testing for you and your family. For more information call Cancer Council on 13 11 20.

Are there screening programs to detect prostate cancer?

Unlike bowel and breast cancer, there is no screening program available for prostate cancer. This is because there is not sufficient evidence at present that routine screening for prostate cancer (using a blood test and an examination) is beneficial.

However, as each person is different, talk to your general practitioner (GP) about the advantages and disadvantages of testing for prostate cancer. Your GP will advise you based on your particular circumstances.

How common is it?

Prostate cancer is the most common cancer in Australian men (apart from common skin cancers). There are about 20,000 new cases in Australia every year.

One in seven men in Australia are at risk of developing prostate cancer before age 75. It is less common in men under 50, unless they have a family history of prostate cancer.

Tony's Story 

"I had been going to my GP for several years. He did regular blood tests to monitor my PSA and when he saw it rising, he referred me to a specialist.

"The specialist diagnosed me with prostate cancer and recommended I have radiotherapy treatment. I got a second opinion from a surgeon who offered to do a radical prostatectomy. I didn’t want to have radiation – a couple of friends recommended surgery and I decided I wanted to get the cancer out.

"I suffered from incontinence after my operation. My surgeon gave me some exercises to improve my continence, but they weren’t effective.

"Some friends recommended I see a physiotherapist who specialises in pelvic floor exercises and I started to see her about 12 weeks after the operation.

"The physio gave me some exercises to do. They’re straightforward – you can even sit and watch TV when you do them – but they’ve worked! I’ve been doing them for over a year and my continence has improved at least 90%. On reflection, I wish I had seen the physio before my operation or very soon afterwards.

"I’m in a prostate cancer support group run by the hospital. I joined after treatment, but I would recommend that men join a group as early as possible after diagnosis.

"It’s great information, and it’s good to be with other people who have been through the same experience and can talk about it.

"It’s magic to get help and support from other people. I’ve gone every month since joining and it’s been of great benefit to me."

Click here to tell your cancer story.

Reviewed by: A/Prof Declan Murphy, Director of Robotic Surgery, Peter MacCallum Cancer Centre, VIC; Tony Davison, Consumer; Peter Dornan, Consumer; Duane Duncan, Australian Research Centre in Sex, Health and Society (ARCSHS), La Trobe University, VIC; Dr Farshad Foroudi, Radiation Oncologist; Peter MacCallum Cancer Centre, VIC; Virginia Ip, Urology Care Coordinator, Sydney Cancer Centre, Royal Prince Alfred Hospital, NSW; Judy Jeffery, Cancer Connect, Cancer Council NSW; David Smith, Research Fellow, Cancer Council NSW; and Robyn Tucker, Cancer Council Helpine, VIC.
Updated: 01 Nov, 2013