The 10 most commonly asked questions about prostate cancer

One in eight men in the UK will be diagnosed with prostate cancer in their lifetime, making it the most commonly diagnosed cancer in men. Here, Dr Niaz Khan, GP at Roodlane Medical, part of HCA Healthcare UK, answers the top 10 questions he gets asked by patients about prostate cancer, including questions about risk factors, symptoms and the impact treatment can have.

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1. How often should I get checked?

If you’re a male aged over 45, then it’s recommended that you book to see your GP to discuss your prostate health and have a PSA test – a blood test that measures the amount of prostate specific antigen (PSA) in your blood. Prostate cancer is also more common in black men, so we would recommend PSA testing earlier in this group of patients.

Prostate cancer can be linked to familial risk, so if your father, brother or uncle has been diagnosed with prostate cancer, you should speak to your GP about your familial risk and how this can be managed.

A PSA test can also be used as part of a diagnostic work-up, so if you are experiencing symptoms of a possible prostate problem, your GP may carry out a physical examination and recommend a PSA test.

2. What is a PSA test?

A PSA test is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. A sample of blood is taken and sent to a laboratory to be tested. It is normal to have a small amount of PSA in your blood, and this amount rises slightly as you get older.

When you book your PSA test with your GP, they may also suggest that you have a 

physical prostate examination - also known as a digital rectal examination (DRE), and a urine test to rule out a urine infection.

3. Does a high PSA mean I have prostate cancer?

A raised PSA level can be caused by many things, including a urinary tract infection (UTI), an enlarged, inflamed or injured prostate or simply because you’re getting older (PSA levels rise naturally with age). However, in some cases, a raised PSA can mean that you have prostate cancer, so it’s important that you have annual PSA tests from the age of 50 (or earlier if you’re more at risk) to rule prostate cancer out.

4. What are the symptoms of prostate cancer?

Going for a regular PSA test is important as prostate cancer may not have symptoms. However, there are still some signs and symptoms you should be aware of, including:

  • Needing to urinate more frequently, often during the night
  • Needing to rush to the toilet
  • Difficulty in starting to urinate
  • Straining or taking a long time whilst urinating 
  • Weakened urinary flow
  • Feeling that your bladder has not emptied fully
  • Blood in your urine or semen

In most cases, having these symptoms won’t mean you have prostate cancer, but it’s important you visit your GP so that prostate cancer can be ruled out. 

5. Is prostate cancer curable?

The earlier prostate cancer is diagnosed, the more likely it is that your treatment will be successful. In the past 40 years, prostate cancer survival has more than tripled due to it being picked up early and improvements in the way it’s diagnosed and treated. If you have been diagnosed with prostate cancer, your consultant will be able to talk you through your treatment options.

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6. Is it only older men that get prostate cancer?

It’s not just older men who can develop prostate cancer, however it is much less common in younger men. Prostate cancer mainly affects men over 50, and your risk does increase as you get older.

The most common age for men to be diagnosed with prostate cancer is between 65-69 years, but it’s important to remember it can develop at a younger age, so always have any symptoms checked.

7. What is the familial risk associated to prostate cancer?

While most men who are diagnosed with prostate cancer do not have a family history of it, it is believed that around 5-10% of cases are linked to inherited gene changes. The risk of developing prostate cancer is higher if you have a father or brother who has had prostate cancer, or two or more close relatives on the same side of the family who had prostate cancer. These relatives include a father, brother, grandfather, half-brother or an uncle. 

If you have a strong family history of breast, ovarian or prostate cancer in your family, or you have the BRCA1 or BRCA2 gene mutation then you are also more at risk of developing prostate cancer.

If you think these risk factors apply to you then speak to your GP. They can discuss this with you and if clinically appropriate, refer you to a genetics counsellor, who can help you to decide if you would like to have a 

genetics test to understand your individual risk.

8. Why are black men more likely to get prostate cancer?

In the UK, around one in four black men will be diagnosed with prostate cancer in their lifetime – making them twice as likely to be diagnosed with prostate cancer as other men. If you are a black male, it’s also more likely you’ll be diagnosed with prostate cancer at a younger age. The reason for this isn’t yet clear, but it could be linked to genes.

If you would like to better understand your risk of prostate cancer, your GP will be able to advise whether they think you should undergo a PSA test and book you in for any other diagnostic tests.

9. Will treatment for prostate cancer end my sex life?

Treatment for prostate cancer can have an impact on your sex life – but this will vary depending on your individual diagnosis and treatment plan. When deciding your treatment plan, your consultant will talk you through your treatment options, and the impact that each treatment can have so you know what to expect.

Some treatments for prostate cancer can damage the nerves and blood supply needed to get and maintain an erection. Although this may sound daunting, there are many options post-treatment to reduce symptoms and allow you to maintain a healthy sex life. 

10. Will treatment for prostate cancer cause urinary incontinence?

Prostate cancer treatment can cause urinary problems for some men, but this will depend on the treatment you undergo and whether you had urinary problems before your treatment. This will be something your consultant will discuss with you before your treatment begins. 
Depending on the type of problems that you’re having, there are lots of ways you can manage urinary incontinence, including:

  • Making lifestyle changes e.g., cutting down on fizzy drinks, alcohol and caffeine
  • Completing pelvic floor muscle exercises to strengthen the muscles that control when you urinate
  • Maintaining a healthy weight to reduce the pressure on your bladder
  • If you smoke, try to cut down or stop – as smoking can cause coughing, which puts pressure on your pelvic floor muscles

If you’re concerned about your prostate health or your risk of being diagnosed with prostate cancer, book an appointment with your GP.