Five facts about prostate cancer for the men of Ireland

Raising awareness of men’s health issues – such as prostate cancer and testicular cancer – is hugely important so that men are encouraged to talk among themselves, with family members and with their doctor about their health and not ignore any symptoms.

With this in mind, here are some facts about prostate cancer.

1) Prostate cancer is very common. In Ireland more than 3,500 men are diagnosed with this form of cancer each year and it is the second most common cancer to affect men after skin cancer.

2) The majority of men with prostate cancer won't die from the disease. However, early detection is vital. Almost 90 per cent of newly diagnosed men will have prostate cancer contained within the prostate gland which can be successfully treated. Most prostate cancers are small and slow growing and may not be fatal. Some men may have a faster-growing prostate cancer and will benefit from early treatment.

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3) Older men and those at risk should get screened regularly. Most prostate cancers are found by screening. Screening or testing for prostate cancer involves a blood test called PSA (prostate specific antigen) and an examination of the prostate gland (digital rectal examination). Men over the age of 50 may decide to undergo these tests through their GP service.

Some men who are at higher risk of developing prostate cancer may decide to be tested at a younger age. In addition to older men, men who have a family history of prostate cancer and black men have a greater risk for developing prostate cancer. If you’re concerned, it’s important to talk to your GP first before considering screening.

Not all men should be routinely tested for prostate cancer. It’s very important to have a conversation with your GP to decide whether or not it is appropriate to undergo prostate cancer testing and then make an informed decision.

4) The majority of men with prostate cancer have no symptoms at diagnosis. While most men won't have symptoms, it is important for men not to ignore any urinary symptoms and seek advice and guidance from their GP if they have urinary problems. These may include: difficulty passing urine, going more frequently to pass urine during the day, getting up more than 1-2 times at night and/or straining to pass urine. These symptoms are common as men get older and may be a sign of prostatic enlargement which is not cancer related and very treatable.

Blood in the urine (haematuria) should never be ignored. Again, this is highly unlikely to be due to prostate cancer, but all men (and women) who pass blood in the urine should see their GP as these symptoms should always be investigated to make sure there is nothing else going on.

5) Treatment options for prostate cancer vary. Most men diagnosed with prostate cancer have more than one treatment option to choose from. Treatment for prostate cancer is based on patient age, other medical problems that the patient may have, type of prostate cancer, whether or not the prostate cancer is contained within the prostate and patient preference.

A urologist, radiation oncologist, and sometimes an oncologist may be involved in determining what different treatment options are suitable before a decision is made.

The most common types of treatment for prostate cancer

1) Active surveillance. Some prostate cancers are low risk which don't need treatment and can be closely monitored with blood tests, clinical examination, scans of the prostate and prostate biopsy.

2) Surgery – Which involves an operation to remove the prostate completely. This is now most commonly done though a keyhole approach using robotic assisted technology.

3) Radiotherapy – which can be given in two forms. The first is brachytherapy, which involves putting radioactive seeds into the prostate to kill cancer cells or secondly external beam radiotherapy, which involves giving X-rays to kill cancer cells.

– Mr Arun Thomas is a consultant urologist and robotic surgeon at Beacon Hospital. He has a special interest in treating men’s health issues, prostate cancer and other urological cancers