Around 48,000 British men are diagnosed with prostate cancer each year, with one man dying every 45 minutes from the disease. The illness – the third biggest cancer killer in the UK – was brought into sharp focus last month when Oscar-winning Hollywood actor William Hurt died four years after a terminal prostate cancer diagnosis.
According to expert Dr Jiri Kubes it’s vital men are aware of precisely when, and at what age, they are eligible to get checked by their GP. And there are some symptoms to watch out for. Dr Kubes is Medical Director at the Proton Therapy Center
in Prague, Czech Republic – a facility that treats many UK prostate cancer patients with pioneering proton beam therapy radiation.
He said: “There’s been a huge attempt to raise awareness about the disease in the past few years. But men need to know what these checks actually entail and at what age they should be approaching their GP asking for a test.”
What is the test for prostate cancer?
Dr Kubes said: “While there’s no national screening programme for prostate cancer, a prostate speciﬁc antigen (PSA) blood test is used as a diagnostic tool in the UK. PSA is a protein often produced by prostate cancer cells. Raised levels, discovered through a simple blood test, can indicate a tumour.
“According to NHS guidelines, if you’re aged 50 to 69, a PSA reading of 3ng/ml or higher represents a ‘raised’ level and cause for concern. If the PSA test indicates a problem, you’re likely to have a digital rectal examination as well as an MRI scan of the prostate.”
When can you ask for a PSA test?
“According to NHS guidelines, if you’re 50 years old or over, you can ask your GP for a PSA test. However – and this is crucial – if there’s any family history of prostate cancer, you can demand a PSA test five to ten years sooner, at the age of 40-45.
“That also goes for black men. They too can request a PSA test at 45 years old due to the fact that studies have shown they’re genetically more at risk of contracting the disease. It’s also important to stress that you should be looking out for the early warning signs of the disease as soon as you hit your 40s. And that’s important.
“Research has found that around a third of men have no idea what to look out for when it comes to prostate cancer.”
What are the early symptoms?
“The main indicator that something is wrong is in your toilet habits. If you’re finding you need to wee more frequently, or you’re getting up often during the night, then you need to investigate the cause. You may also notice a hesitancy when you try to pee, or straining and taking a lot of time, as well as a weak flow.
“Some sufferers notice that their bladder feels like it’s not been fully emptied. Meanwhile, blood in your urine or semen is another obvious warning sign. But men also need to be aware that prostate cancer can be symptomless until the tumour has grown large enough to pose a real problem.
“We see many patients – in fact the majority – who’ve been diagnosed with prostate cancer having had absolutely no symptoms whatsoever.”
What happens next?
“The good news is that the chances of surviving the disease is good if you catch it early enough. Most patients will undergo a biopsy of the tumour, with samples of tissue studied in a lab to see how quickly the cancer will spread. What happens next will depend on the result of those tests.”
What treatments are available?
Prostate cancer can be slow growing. Your GP may not feel that any invasive surgery or treatment is necessary. It’s not uncommon, particularly among older men, for a ‘watchful waiting’ approach to be adopted, where a patient simply begins active surveillance on the tumour – having regular tests – to see if it gets worse and starts to cause symptoms.
“Some patients will opt for a prostatectomy – the surgical removal of your prostate gland. But that surgery comes with certain risks, particularly incontinence and the loss of sexual function.
“Surgery does not guarantee all the cancerous cells will be removed. Another common treatment is radiotherapy, or a mixture of radiotherapy and hormone therapy, to halt the spread of the cancer and to stop cells regrowing.
“As with a prostatectomy, standard radiotherapy can see ‘collateral damage’ where organs close to the tumour are damaged by the radiation. Meanwhile, a growing number of people are seeking newer, alternative treatments, unlikely to be available on the NHS.
“Proton beam therapy is an alternative to standard radiotherapy and is increasingly being used to treat some of the deadliest and hardest to reach cancers – including those of the central nervous system, head and neck, breast, prostate and lymphomas. Unlike traditional X-ray radiation, proton beam therapy particles stop at the tumour, reducing damage to surrounding tissue and organs, and future ‘secondary’ cancers.
“For prostate cancer patients it can also radically reduce the chances of incontinence and impotence. Crucially, a prostate cancer patient can be treated with protons in around five days, with good clinical results, providing treatment begins in the early stages of the disease.”