Men's Health

Prostate Cancer


FACTS             OVERVIEW             TESTING             TREATMENT             RESOURCES AND SUPPORT GROUPS

THE HAIRY FACTS




OVERVIEW

What is the prostate?

Function

  • Gland producing fluid that protects and enriches sperm
Location
  • Immediately below the bladder, in front of the bowels. 
  • The prostate is doughnut shaped and surrounds the urethra, the tube that carries urine from the bladder out through the penis.
  • In younger men the prostate is about the size of a walnut. 
  • The nerves that control erections surround the prostate. 

What is prostate cancer?
  • Prostate cancer occurs when some of the cells in the prostate reproduce far more rapidly than normal, resulting in a tumour. 
  • If left untreated, prostate cancer cells may eventually spread from the prostate and invade distant parts of the body, particularly the lymph nodes and bones, producing secondary tumours in a process known as metastasis. 
  • One of the most worrying aspects of the disease is that most prostate cancers develop without men experiencing any symptoms in the early stages.

What are the risk factors?
  • Gender: prostate cancer only affects men, as women do not have a prostate gland
  • Age: the older a man, the more likely he is to be diagnosed with prostate cancer
  • Family History: a man with a father or brother who developed prostate cancer before 60 is twice as likely to develop the cancer
  • Ethnicity: increased occurrence in black African and Afro-Caribbean males
  • Lifestyle: poor diet and lack of exercise

What are possible symptoms?
Note: the majority of prostate cancers have no symptoms, and it is really only advanced cancers that have spread throughout the prostate (and beyond) that cause urinary symptoms such as:
  • Urinary issues (slow flow, hesitancy, frequency, urgency)
  • Blood in the urine or semen
  • Reduced ability to get an erection
  • Painful ejaculation
 
If you have any concerns and are experiencing any of the symptoms above it is important to contact your doctor and note that these symptoms are also common to many different conditions, not just prostate cancer.



TESTING

What tests are available?
The purpose of testing is to detect prostate cancer at its earliest stages, before the disease progresses. 
There are currently two common tests available for initial detection:
  • Physical Examination (DRE: Digital Rectal Exam)
  • Blood Test (PSA: Prostate Specific Antigen)


 
The PSA blood test (PSA)

The PSA blood test looks for the presence of a protein in the blood that is produced specifically by prostate cells called Prostate Specific Antigen (PSA). The presence of an elevated PSA does not necessarily mean prostate cancer is present as there are other medical conditions that can lead to a PSA result outside the normal range. These include enlargement of the prostate (Benign Prostatic Hyperplasia or BPH) and inflammation of the prostate (prostatitis).
 
The Digital Rectal Exam (DRE)

The DRE involves the doctor inserting a gloved finger in the anus, where it is possible to feel part of the surface of the prostate. Irregularities include swelling or hardening of the prostate, or lumps on the surface that may indicate development of a tumour or other problems. The drawback to this test is that the doctor can feel only part of the prostate during the examination, so some irregularities may be beyond reach and therefore missed.
 
Results
If the results of the test are abnormal, your GP would refer you to a specialist (i.e. Urologist) to take a tissue sample in the form of a biopsy. A biopsy is the only way to determine if cancer is present. A doctor typically diagnoses prostate cancer after closely examining biopsy cells through a microscope and will inform you of the results. 
 
To test or not to test?
Our recommendation is to discuss your situation with your doctor to decide if testing is right for you. Together, you can choose the best course of action. As an aid to having this conversation, we worked with the Société Internationale d'Urologie on a tool to help men and their families navigate the decision making process:
 



Download the PSA overview here.


TREATMENT

If you have been diagnosed with prostate cancer, the message is don’t panic. Many prostate cancers are slow growing and may not need surgery or other radical treatment. Active surveillance (regular monitoring) is now a common treatment option for men with low risk, low grade prostate cancer. Take the time to learn about the various treatment options mentioned below and make an informed decision about what to do by seeking advice from medical professionals and from reputable sources such as the IRISH CANCER SOCIETY (ICS).
 
Remember also that because a side effect of treatment includes erectile dysfunction, prostate cancer can have a serious impact on intimate relationships. As many people who have been through the journey will tell you, prostate cancer isn’t just a man’s disease, it’s a couple’s disease. Make sure you involve your partner as you think through the various treatment options.
 
If you or someone you know has just been diagnosed with prostate cancer you may be experiencing a number of feelings; disbelief, fear, anger, anxiety and depression are common. There are many treatment options and support resources that can help you and your family through this difficult time.

 
Treatment Options

Active Surveillance

  • Many prostate cancers are slow growing and may not need surgery or other radical treatment. 
  • Active surveillance (which is regular monitoring) is now a common treatment option for men with low risk, low grade prostate cancer.


  • During active surveillance, prostate cancer is carefully monitored for signs of progression. These tumours can be safely watched through regular PSA tests and biopsies to ensure that they do not progress. 
  • Click HERE for more information on active surveillance.


 

Prostatectomy

  • A surgical approach to treating prostate cancer is the removal of the prostate gland. 
  • Depending on the stage of cancer, typically, men with early-stage disease or cancer that’s confined to the prostate will undergo radical prostatectomy – removal of the entire prostate gland, plus some surrounding tissue. 
  • Advances in surgical technique allow men to stay in the hospital one to two nights on average. 
  • Other surgical procedures may be performed on men with advanced or recurrent disease. 
  • Click HERE for more information on prostatectomy.


Radiotherapy

  • Radiotherapy involves the use of various types of X-rays (radiation) to treat cancer.

 
  • Click HERE for more information on radiotherapy.


 

Hormone Therapy

  • Prostate cancer cells are like other living organisms, meaning they need fuel to grow and survive. 
  • The hormone testosterone serves as the main fuel for prostate cancer cell growth so it is a common target for therapeutic intervention in men with the disease.


  • Hormone therapy, also known as androgen-deprivation therapy or ADT, is designed to stop testosterone from being released or to prevent it from acting on the prostate cells. Although hormone therapy plays an important role in men with advancing prostate cancer, it is increasingly being used before, during, or after local treatment as well.


  • Click HERE for more information on hormone therapy.


 

Chemotherapy

  • Chemotherapy uses drugs via the bloodstream to destroy cancer cells that have spread from the prostate gland to other parts of the body. 
  • There are many different types of chemotherapy and combination therapies.


  • Chemotherapy may slow the cancer's growth and also reduce some symptoms.


  • Chemotherapy drugs are carefully controlled in both dosage and frequency so that cancer cells are destroyed while the toxicity to healthy cells is minimised.
  • There can be side effects when treated with chemotherapeutic drugs and these should be discussed in consultation with your doctor.
  • Click HERE for more information on chemotherapy.


 

 

Side Effects of Treatment

Most of the most common side effects of treatment for prostate cancer are manageable:
  • Incontinence (involuntary leakage of urine)
  • Erectile dysfunction (difficulty achieving or maintaining an erection). The prostate is situated just under the bladder and is surrounded by the nerves that control erections, which is why surgery, radiotherapy and other treatments commonly cause these side effects at least temporarily. 
  • Weight gain – due to hormone therapy 
If the problems don’t go away there are now many medical and surgical treatments available to cure incontinence and erectile dysfunction.
 



RESOURCES AND SUPPORT GROUPS

Many men and their partners find talking to someone who has already been on a similar cancer journey can be invaluable. The Irish Cancer Society is the peak national body for prostate cancer in Ireland. Their mission is to provide prompt access to high-quality, multidisciplinary care in eight designated specialist cancer centres, where the best, safest and most effective treatments are provided. The ICS also provides the best scope and quality of patient care, treatment and support services, ensure equity of access to everyone, regardless of geographic location, age, sex, social or ethnic background. They want ensure that everyone achieves the best possible outcomes regarding cancer survival and quality of life.
 
Visit WWW.CANCER.IE or call 1800 200 700 to speak to a specialist nurse near you.
 
 

RESOURCES 

The ICS publish a series of helpful guides and additional resources to help connect men and their loved ones to the latest prostate cancer research and survivorship information.
 
Click the links below for further information:
For Movember’s list of men's health sources, please email: INFO.IE@MOVEMBER.COM.
 
Click here to find out more on Movember’s funded programmes on prostate cancer.




To request a copy of our references, please contact references@movember.com.