As March marks Prostate Cancer Awareness Month, Philip Charlesworth - Consultant Urological Surgeon at GenesisCare – explains how men should be aware of the disease and be familiar with the signs and symptoms, as well as the risks and understanding your PSA test.

Have you been avoiding you check-up? Photo credit: Unsplash
Have you been avoiding you check-up? Photo credit: Unsplash

According to statistics, a potential 14,000 men have missed a diagnosis of prostate cancer during the pandemic. Now, more than ever, it is essential men are getting checked and protecting themselves. Although, this may be dauting for some, Phillip shares his knowledge to provide security and confidence.

Knowing the signs and symptoms 

I’ve treated prostate cancer patients for a number of years, and over that time have seen a significant lack of understanding of the disease which can lead to a delay in getting help. Previous research conducted by GenesisCare and Prostate Cancer Research has shown that nearly a fifth (19%) of people surveyed were not able to identify any of the symptoms of prostate cancer. Although Prostate Cancer is generally detected at an early point just through a PSA blood test, ensuring people are aware of the main symptoms and therefore able to raise any concerns with a healthcare professional is really important. The symptoms could be a sign of something else, however if it is cancer then an early diagnosis can lead to greater treatment options and improved outcomes

The main symptoms for men to be aware of are:  

  • Difficulty in starting urination
  • Finding it hard to fully empty your bladder or feeling like your bladder hasn’t emptied properly
  • Weak urine flow
  • Leaking of urine - this might be just before or after you go to the toilet
  • Needing to urinate more often, particularly during the night
  • Sudden urges to urinate

Risk Factors 

Alongside knowing the signs and symptoms, it’s also vitally important for men to know if they are in a high-risk group – these are based on five main factors:  

  • Age; most cases are diagnosed in men over the age of 50
  • A family history of prostate cancer
  • Being overweight or obese
  • Different hormone levels – research shows men with higher levels of insulin-like growth factor 1 (IGF-1) have a higher risk of developing prostate cancer
  • Ethnicity - one in four black men will be diagnosed with prostate cancer compared to one in eight men of other ethnicities

Prostate cancer is more common amongst older men, especially those aged over 50. Heightened risks also come with genetics, so if there’s a family history of prostate cancer or breast cancer it’s worth flagging this with your GP.

About PSA Tests 

If you report any concerns to a GP they’ll often council you about the pros and cons of having a PSA blood test done.  A PSA test is a simple blood test used to help detect prostate cancer – specifically it measures the level of prostate-specific antigen (PSA) in your blood.

If you are found to have a PSA above the age-specific range, then it’s likely you’ll need further tests such as an MRI scan in the first instance to confirm whether there is cancer presence and depending on the outcome of the MRI, a biopsy may then be necessary.  It’s important to know that if you have a raised PSA reading then it doesn’t necessarily mean you have prostate cancer and could be an indicator of another condition such as an enlarged prostate – further tests will therefore help provide an exact diagnosis.

If you do have a PSA test it is very straightforward and can be done with your GP or a nurse. Alternatively, if you have concerns there are a number of specialist centres where you can be seen by someone like myself for assessment and any necessary tests and scans.

Treatments and Innovation 

We see patients come to us with no knowledge of the different treatments that are now available. Not having that knowledge can make a diagnosis even more frightening, but the truth is that treatment advances mean there are several options that may be available – particularly if diagnosed an at an early stage.

An example of recent innovations is MRI-guided radiotherapy which is exclusively available in the UK from GenesisCare using an innovative machine known as the MRIdian. Treatment combines high-resolution magnetic resonance imaging (MRI) techniques with extremely precise radiotherapy beams that can treat tumours more accurately than conventional radiotherapy. The MRIdian is considered ground-breaking because it is able to turn on the radiation beam only when the tumour is positioned precisely in the treatment window and turn off the beam in an instant if the tumour moves even by a fraction – helping to protect healthy tissue from unnecessary radiation exposure. This helps to greatly reduce side effects and treatment can be delivered in as few as five sessions. 

The technology also means that the 15-40% of men who have locally recurrent prostate cancer after initial external beam radiotherapy, can now safely and effectively undergo repeat radiotherapy to treat the cancer or control the disease and delay the need for hormone therapy.

Additionally, there is now a highly innovative and personalised approach to prostate cancer treatment called Theranostics that combines diagnostic imaging and radionuclide therapy to destroy advanced cancers without damaging healthy tissue.  This is a particularly effective treatment for men with advanced prostate cancer that is difficult to treat and isn’t responding to conventional therapies.  

I would always encourage anyone who does receive a prostate cancer diagnosis to not be afraid to ask their doctor about all the treatment options available to them or conduct their own research.  It’s never a one size fits all approach to cancer and it’s important to find the right treatment for you and your circumstances.

 If you are concerned or need help and advice, contact your local GP. 


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