At Home with Dr Christian Jessen - 165

CANCER R EPO R T
| SLUG|

often than usual, especially at night,
pain on passing urine and blood in
the urine or semen. It can also cause
weight loss, particularly in the elderly.
These symptoms do not necessarily
conﬁrm it is cancer, as there is a
variety of reasons for a change in
the pressure of urine ﬂow, such as
an overactive bladder, enlargement
of the prostate (benign prostatic
hyperplasia or BPH) or prostatitis
- an infection of the prostate gland.

'PROSTATE CANCER USUALLY
AFFECTS MEN OVER 50
- BUT, ONCE DIAGNOSED,
THE PROGNOSIS IS GOOD'

WORDS: GEORGINA MARIC | PHOTOGRAPHS: GETTY IMAGES, SHUTTERSTOCK | SOURCES: CANCER RESEARCH UK, PROSTATE CANCER UK

Who's at risk?

Prostate cancer usually affects men
over 50, and approximately half of
this age group also shows signs of
prostate enlargement. According
to Cancer Research UK (www.
cancerresearchuk.org), the largest
number of cases is diagnosed in
those aged 70 to 74, and one-in-25
men over 70 will die from the disease.
Prostatitis can affect men of any age,
but it is treatable with antibiotics.

How to ﬁnd out

If your GP wants to rule out prostate
cancer he will probably recommend
a prostate-speciﬁc antigen (PSA) test
- a blood test that measures the level
of PSA (a protein). PSA is produced
in the prostate gland and found in
small amounts in the blood. A raised
PSA level can be a warning sign of
the presence of prostate cancer. It
can also indicate other problems
- three out of four men with a raised
PSA level will not have prostate
cancer. However, the higher the PSA,
the greater the likelihood of cancer.
There is a strong genetic link with
prostate cancer, so your man needs
to ﬁnd out if his father, grandfather,
uncle or brother had prostate cancer
because, if this is the case, he has a
greater risk of developing the disease.
He needs to tell his doctor so he can
have regular blood tests to monitor
his PSA levels. His GP may also
perform a digital rectal examination
(DRE) to check for abnormal signs
such as a lumpy prostate gland.

Diagnose it

If your man is referred to the urology
department in the hospital, he may
have a rectal ultrasound scan to
examine the prostate gland. Called
a transrectal ultrasound (TRUS), a
small device is put into the back

BEING INFORMED IS
KEY TO FIGHTING
PROSTATE CANCER

passage. It produces sound waves to
create a clear picture of the prostate
gland. He may also have a biopsy
(tissue sample) taken through the skin
behind the testicles (the perineum).
A biopsy can also be performed
during a cystoscopy investigation
(an examination inside the bladder).
One cutting-edge diagnostic tool
being used in some hospitals is a
template-guided biopsy, sometimes
known as a transperineal template
biopsy or prostate-mapping biopsy.
Developed in the UK by leading
urology and radiology consultants,
this new method can be much more
accurate than traditional prostate
biopsies. The National Institute for
Health and Care Excellence (NICE,
www.nice.org.uk) says: 'There is
evidence that some men with
suspected prostate cancer who have
had negative or inconclusive results
from other biopsy methods will be
more effectively diagnosed with
prostate cancer using this procedure.'
Performed under general anaesthetic,
a prostate-mapping biopsy involves

inserting many ﬁne needles though
the skin between the scrotum and the
anus in order to obtain tissue samples
from the prostate for testing. Where
possible, it is usually preceded by
magnetic resonance imaging (MRI)
scanning. This allows the consultant
to speciﬁcally target the location
of the cancer cells that have been
identiﬁed by the MRI scan.
The procedure is used speciﬁcally
for men who have raised PSA levels,
and may be followed by a prostate
biopsy if necessary. Alternatively, it
may be recommended for a patient
who has a raised PSA or other risk
factors for prostate cancer, but a
biopsy has not detected any cancer.

Treat it

Depending on what stage the cancer
has reached, the doctor will discuss
the best course of treatment and the
possible side effects. For some men,
it may be an option to have no
treatment but to monitor the cancer
closely. Doctors call this 'active
surveillance' or 'watchful waiting'. >
www.athomemagazine.co.uk MARCH 2015 | 165

http://www.cancerresearchuk.org http://www.nice.org.uk http://www.athomemagazine.co.uk

At Home with Dr Christian Jessen

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