Prostate cancer

Friday 1 April, 2016

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On this page:  The prostateWhat is prostate cancer | How common is it? | What are the symptoms?What are the risk factors? 

The prostate

The prostate is a small gland that sits below the bladder. The gland, which is about the size of a walnut, is part of the reproductive system. Only men have a prostate gland.

The prostate gland produces fluid that helps to feed and protect sperm. This fluid is the main component of semen.

The urethra runs through the prostate gland. The urethra is a thin tube that carries urine from the bladder through the penis. It also carries semen from the prostate and testicles out of the body during orgasm.

The prostate gland is surrounded by muscle, which enables it to contract and produce ejaculate. It is located near nerves, blood vessels and muscles that are needed to control bladder function and to achieve an erection.

The growth of the prostate depends on the male sex hormone, testosterone, which is made by the testicles (testes). It is normal for the prostate to increase in size as men age. Sometimes this can cause problems, especially with urination.

The prostate

What is prostate cancer?

Prostate cancer develops when abnormal cells in the prostate gland start to grow more rapidly than normal cells, and in an uncontrolled way. Most prostate cancers grow more slowly than other types of cancer, although this is not always the case.

Early (or localised) prostate cancer means cancer cells have grown but, as far as it is possible to tell, have not spread beyond the prostate.

There are two stages of advanced prostate cancer. If the cancer grows and spreads outside the prostate gland into the seminal vesicles (glands that lie close to the prostate) or nearby parts of the body, such as the bladder or rectum, it is called locally advanced prostate cancer. Metastatic prostate cancer is when the cancer has spread to distant parts of the body such as the lymph glands or bones.

How common is it?

Prostate cancer is the most common cancer in Australian men (apart from common skin cancers). There are about 17,000 new cases in Australia every year.

One in five men in Australia are at risk of developing prostate cancer before the age of 85. The risk of prostate cancer increases with age, with the majority of cases diagnosed in men aged 60–79 years of age. It is uncommon in men younger than 50, although risk increases in younger men with a strong family history of prostate cancer, breast cancer or ovarian cancer.

What are the symptoms?

Early prostate cancer rarely causes symptoms. Even with advanced prostate cancer there may be no symptoms. Where symptoms do occur, they are often due to non-cancerous conditions, such as benign prostate hyperplasia (BPH).

Symptoms of advanced prostate cancer may include unexplained weight loss, feeling the frequent or sudden need to urinate, or pain in the lower back/pelvic area or sciatica.

These are not always a sign of prostate cancer, but you should speak with a doctor if you have any of these symptoms.

Benign Prostate Hyperplasia (BPH)

Men over the age of 50 often experience urinary problems. An otherwise normal prostate may grow, which can change patterns of urine flow. This enlargement is called benign prostate hyperplasia (BPH) and is generally a normal part of ageing − it is not cancer.

BPH may cause the following Lower Urinary Tract Symptoms (LUTS): 

  • weak urine flow
  • frequent urination, especially at night
  • an urgent need to urinate
  • difficulty starting to urinate
  • leakage after urinating
  • incomplete emptying of the bladder.

These symptoms may also occur in locally advanced prostate cancer. If you are concerned and/or are experiencing any of these symptoms, speak to your doctor.

What are the risk factors?

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

  • as you get older – prostate cancer is mainly diagnosed in men aged 60–79
  • if your father or brother has had prostate cancer – your risk is twice that of other men
  • if you have a strong family history of breast or ovarian cancer, particularly BRCA1 and BRCA2 gene mutations.

While prostate cancer is rare in men under 50, men aged 45–55 are at particular risk of developing significant prostate cancer later in life if their prostate specific antigen (PSA) test results are above the 95th percentile. This means that PSA levels are higher than 95% of men in the same age range.

You may have an inherited gene that increases your risk of prostate cancer if you have:

  • multiple relatives on the same side of the family (either your mother’s or father’s side) with prostate, breast and/or ovarian cancers
  • a male relative under the age of 50 with prostate cancer.

If you are concerned about your family history, your GP can advise you on the suitability of PSA testing for you and your family. For more information call Cancer Council 13 11 20.

Reviewed by: A/Prof Nicholas Brook, Consultant Urological Surgeon, Royal Adelaide Hospital and Clinical Associate Professor in Surgery, University of Adelaide, SA; Prof Ian Davis, Professor of Medicine and Head of Eastern Health Clinical School, Monash University and Senior Oncologist, Eastern Health, VIC; A/Prof David Smith, Senior Research Fellow and Cancer Epidemiologist, Cancer Council NSW, NSW; A/Prof Peter Reaburn, Associate Professor in Exercise and Sport Sciences, CQU, QLD; Sylvia Burns, Senior Cancer Specialist, Cancer Council Queensland, QLD; Robyn Tucker, Clinical Nurse Specialist, Cancer Information and Support, Cancer Council Victoria, VIC.

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