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In the UK, about 1 in 8 men will get prostate cancer at some point in their lives. It is the most common cancer in men in the UK with over 40,000 new cases diagnosed each year. It can develop slowly over many years with no obvious symptoms. Men often only realise that something has changed when the prostate has grown large enough to put pressure on the urethra and cause a more frequent need to urinate (pee).
What is the Prostate?
The prostate is a gland that sits underneath the bladder and around the uretha- the tube men urinate and ejaculate through. The prostates main purpose is to make semen.
The most common prostate problems are:
An enlarged prostate- the most common reason for symptoms
Prostatitus – an inflammation or infection of the prostate
How does prostate cancer develop?
The causes of prostate cancer are largely unknown. Prostate cancer can develop when cells in the prostate start to grow in an uncontrolled way. Prostate cancer often grows slowly to start with and may never cause any problems but some men have prostate cancer that is more likely to spread. This needs treatment to stop it spreading outside the prostate.
Who is most at risk?
- The chances of developing prostate cancer increase as you grow older. Men aged 50 and over are more likely to develop it with the average age for diagnosis between 65 and 69 years
- Men with a family history such as a brother or father who had prostate cancer have a slightly higher risk of getting it themselves
- For reasons that are not yet understood men of African-Caribbean or African descent are at a higher risk of prostate cancer and men of Asian descent a lower risk
- Overweight or obese men
Signs and symptoms to look out for
Most men with early prostate cancer don't have any symptoms. If you are experiencing any of the symptoms below it doesn’t mean that you definitely have prostate cancer but they shouldn’t be ignored.
- Needing to urinate more often than usual, including at night–for example if you often need to go again after two hours
- Difficulty starting to urinate
- Straining or taking a long time to finish urinating
- A weak flow when you urinate
- A feeling that you’re not emptying your bladder fully
- Needing to rush to the toilet – sometimes leaking before you get there
- Dribbling urine after you finish
- New pain in the back, hips or pelvis
Less common symptoms include:
- Pain when urinating
- Pain when ejaculating
Urinary problems are common in older men and are not always a sign of a prostate problem. They can be caused by a urine infection or another health problem, such as diabetes, or by some medicines. You should see your GP for a urine test.
Your lifestyle can also trigger changes in the way you urinate – for example, drinking too much will make you urinate more often, while alcohol, caffeine and fizzy drinks can irritate the bladder.
If you're worried about your risk or are experiencing any of these symptoms, visit your GP or speak to your pharmacist to arrange a PSA test
Pharmacists can support patients in making an informed decision about having a PSA test; counsel patients on the signs and symptoms of prostate cancer; offer PSA testing; and refer patients for further investigation, if necessary.
Tests for prostate cancer
There is no single test for prostate cancer. All the tests used to help diagnose the condition have benefits and risks, which should be discussed with you.
The most commonly used tests for prostate cancer are:
- A blood test known as a prostate-specific antigen (PSA) test, measures the level of PSA and may help detect early prostate cancer. Men are not routinely offered PSA tests to screen for prostate cancer in the UK.
- A physical examination of your prostate (known as a digital rectal examination or DRE)
- A biopsy
- A urine test to eliminate infection as the cause of your symptoms.
Understanding PSA Tests
Ask your pharmacist about a PSA test. Early detection of prostate cancer may lead to better treatment outcomes. Further tests will be needed for an accurate diagnosis but a PSA test can give you an idea about whether you may have prostate cancer, before any symptoms develop. Cancer may be detected at an early stage when it could be cured or even before it has developed, and treatment given that extends life
PSA is a protein found in the prostate. When there is a problem with the prostate, such as cancer, the PSA can leak out in to the bloodstream.
High PSA is not specific to prostate cancer and can be due to a non-cancerous growth of the prostate, a urinary tract infection or inflammation of the prostate, as well as prostate cancer. Raised PSA levels also cannot tell a doctor whether a man has life-threatening prostate cancer or not. Equally PSA is not always raised in a person who has prostate cancer and so the test can provide false reassurance. Results can also be affected by certain medications and obesity.
It is important to have a discussion with your Pharmacist or GP in order to make an informed decision about having the PSA test and to understand how to interpret the results. GPs do not routinely offer PSA testing to men without symptoms, unless they ask for a test. You can discuss this test with your pharmacist and have it at the pharmacy.
How is a PSA test done at the pharmacy?
Firstly the pharmacist will explain the benefits and risks or limitations of the PSA test and what the results may mean. Your pharmacist will help you make an informed decision about whether to have the test.
To have a PSA test you should not have:
• A current urine infection
• Ejaculated in the last 48 hours
• Heavily exercised in the last 48 hours
• Had a prostate biopsy in the last six weeks.
A sample of blood will be taken in a finger-prick test and the pharmacist will test to see if there is PSA present in the blood. After ten minutes the test will tell you whether PSA is present in your blood or not.
If PSA is detected during the test the pharmacist will refer you to your GP for further investigation.
If PSA is not detected in your blood there is no reason to visit your GP unless you have any symptoms of concern. In this case you could have another pharmacy PSA test 12 months later to check there has been no change in your PSA levels.
NHS Choices. Prostate cancer. http://www.nhs.uk/conditions/cancer-of-the-prostate
Prostate Cancer UK - http://prostatecanceruk.org/
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