Prostate cancer: risks, symptoms, diagnosis and treatment

Prostate cancer affects many Australian men and is most common in men over 65¹. Many cases are not life-threatening because the cancer can be slow growing and usually occurs in older men.

Who is most at risk of getting prostate cancer?

There are some factors that can increase a man’s chance of getting prostate cancer. This includes things you can’t change, such as:

• Getting older. One in 5 men will be diagnosed with prostate cancer by the age of 85. It is more common in older men, with 63% of cases diagnosed in men over 65 years of age.²
• Your family history. If you have a first degree male relative with prostate cancer, you have a higher chance of developing it than men with no such history.

But there are also things you can change, like diet, lifestyle and talking to your GP about your prostate health.

The Prostate Foundation of Australia encourage all men over 50 – or over 40 if they have a family history– to talk with their GP about your prostate health. According the Foundation, there is also some evidence to suggest that eating a lot of processed meat or food that is high in fat can increase the risk of developing prostate cancer.

What are the symptoms of prostate cancer?

According to the Cancer Council Australia, in its early stages, prostate cancer may not show any symptoms. But if there are symptoms, these can include:

• difficulty passing urine
• a slow, interrupted flow of urine
• frequent passing of urine, including at night
• incontinence.

Symptoms associated with advanced prostate cancer include blood in urine, pain during urination and lower back or pelvic pain. Remember, all of these symptoms can also be caused by conditions usually less serious than prostate cancer. If you have any questions or concerns about any symptoms you may have, talk to your GP.

Screening for prostate cancer

Early detection and treatment can significantly improve prostate cancer survival². There are, however, no tests available with sufficient accuracy to screen populations of men for early signs of prostate cancer.

The tests most commonly used to help detect of prostate cancer are the prostate specific antigen (PSA) blood test and digital rectal examination explained below.

Diagnosing prostate cancer

Prostate cancer is diagnosed using a number of tests, which may include:

• A prostate-specific antigen (PSA) test –to test for large quantities of PSA in the blood.
• A digital rectal examination–so the doctor can feel for enlargement and irregularities of the prostate.
• A biopsy –to look for the presence of cancer cells.

If prostate cancer is diagnosed, more tests may be needed – such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans and bone scans.

Treatment for prostate cancer

Grading and staging

How the cancer is treated will depend on its grade and stage. The grade gives an idea of how quickly the cancer may develop and the stage describes how far the cancer has spread.

Types of treatment

Prostate cancer can be treated in a variety of ways, and it depends on a number of factors. Some treatment options may include:

• Watchful waiting – sometimes you will not need treatment, but you’ll still need to be examined and have tests regularly to monitor any changes.
• Active surveillance–this involves very close monitoring.
• Surgery–The removal of the prostate is called a radical prostatectomy and might be performed by open surgery, or by a ‘keyhole’ approach.
• Transurethral resection of the prostate (TURP)–If the prostate can’t be removed, this surgery may be performed to remove blockages in the prostate to relieve urination problems.
• External radiotherapy.
• Internal radiotherapy (brachytherapy)–this involves a radioactive implant placed inside the prostate.
• Hormone therapy–given either by medication (tablets) or hormone injections.

Palliative care

In some cases of prostate cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer. As well as slowing the spread of cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.

Do you have more questions?

If you have been diagnosed with cancer and have questions about your diagnoses or treatment plan, talk to your health care team and ask them to explain anything you don’t understand.

Medibank members with hospital cover can also call a nurse with any health question, 24 hours a day, seven days a week. To speak to a Medibank Nurse call 1800 644 325.