Am I At Risk Of Prostate Cancer
In the UK, about 1 in 8 men will be diagnosed with prostate cancer in their lifetime. We don’t know exactly what causes prostate cancer but there are some things that may mean you are more likely to get it these are called risk factors.
There are three main risk factors for getting prostate cancer, which are things you can’t change. These are:
If you have any of these risk factors or if you have any symptoms, speak to your GP. They can talk to you about your risk, and about the tests that are used to diagnose prostate cancer. You can also get in touch with our Specialist Nurses, who can help you understand your risk of prostate cancer.
How To Do Active Surveillance Right
After a diagnosis of low-risk prostate cancer, you may be presented with a range of treatment options. Considering the slow progress of most prostate cancer, active surveillance is a reasonable choice for many men. Even if you live a long time after your diagnosis, your cancer may neverbecome aggressive and cause harm. Often, low-risk prostate cancer hardly progresses at all, even over decades.
If you choose to go the active surveillance route, do it the smart way. Dr. Hu recommends that for the first two years after your diagnosis
- Get a PSA test every six months.
- Have an office visit that includes a digital exam every six months.
- Within the first two years after diagnosis, get at least one follow-up biopsy as well as magnetic resonance imaging and precision medicine tests to reduce the risk of missing more aggressive cancer.
What happens next depends on those first two years. If it looks like your cancer is stable and not progressing, your doctor may suggest less frequent follow-ups. But if there is evidence that the cancer is becoming more aggressive, then you can decide at that time whether radiation, surgery, hormone therapy or some combination of these treatments is right for you. You may never need treatment, but if you do, youll get it when its still highly effective.
Men: Cancer Screening Exams By Age
These exams are for men at average risk of cancer.
Take this checklist to your next doctors appointment. Your doctor can help you develop a more tailored screening plan if needed.
These exams are for men at average risk of cancer. If you believe you may be more likely to develop cancer because of your personal or family medical history, visit our screening guidelines page to learn about exams for men at increased risk.
Ages 40-49
- Beginning at age 40, you should speak with your doctor about the benefits and limitations of prostate screening.
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year starting at age 45 to check for prostate cancer if you are African American or have a family history of prostate cancer.
Ages 50-75
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year to check for prostate cancer
- Colonoscopy every 10 years or virtual colonoscopy every 5 years to check for colorectal cancer
Age 76 and older
If youre age 76 to 85, your doctor can help you decide if you should continue screening. MD Anderson does not recommend cancer screening for men age 85 and older.
All Ages
Speak with you doctor about cancer screening exams for lung and skin cancers. Exams are available for those at increased risk.
Regardless of your age, practice awareness. This means you should be familiar with your body so youll notice changes and report them to your doctor without delay.
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Dealing With A Growing Prostate
Some men notice no symptoms of prostate growth. For the many who do, though, treatments can ease the peeing process.
Lifestyle changes: Cut down on, or cut out, alcohol and coffee, and drink less fluid in the evening. Both strategies can lessen the number of trips to the toilet. Also, talk to your doctor about your current medications. Some drugs may worsen your symptoms.
Medications: The FDA has approved several medications for benign prostate growth, which help by slowing growth, shrinking the prostate, or relaxing the muscles that make urination easier. Some men may benefit from a combination of drugs.
Surgery: For men who donât benefit from medications, there are many types of surgery to offer relief. Some are minimally invasive, others are more involved. The most common, called TURP , removes the prostate tissue thatâs compressing the urethra. TURP may result in retrograde ejaculation, a condition in which semen enters the bladder rather than exiting the urethra. It is harmless, but can lead to male infertility.
Symptoms Of Prostate Cancer
Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis .
When this happens, you may notice things like:
- an increased need to pee
- straining while you pee
- a feeling that your bladder has not fully emptied
These symptoms should not be ignored, but they do not mean you have prostate cancer.
It’s more likely they’re caused by something else, such as prostate enlargement.
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What Is The Prognosis For People Who Have Prostate Cancer
Because prostate cancer tends to grow slowly, most men die from something other than the disease. Early detection is key to better outcomes. Almost all men 97% to 98% diagnosed with localized cancer that hasnt spread outside of the prostate live at least five years after diagnosis. When metastatic cancer has spread outside of the gland, one-third of men continue to survive after five years.
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How Prostate Cancer Is Diagnosed
Tests and investigations to diagnose prostate cancer include digital rectal examination and blood tests by your GP which will be repeated again if you are referred to a urologist . A rectal scan and a biopsy of the prostate may be necessary.
You can read more about the PSA test here.
You can read more about other tests for prostate cancer here.
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Prostate Cancer And Agent Orange
Certain unique factors may put veterans, especially those who served in the Vietnam or Korean wars, at increased risk for developing prostate cancer. A 1996 report published by the Health and Medicine Division of the National Academy of Sciences, Engineering, and Medicine concluded that there is a link between prostate cancer and exposure to herbicides such as Agent Orange, which was used during the Vietnam and Korean wars. Similarly, a 2013 study conducted at the Portland VA Medical Center and Oregon Health and Science University found that veterans exposed to Agent Orange were at an increased risk for both developing prostate cancer and developing more aggressive forms of the disease.
Veterans with prostate cancer who were exposed to herbicides during active service may be eligible for disability compensation through the VA. There are several eligibility requirements to receive these benefits, and it is important to contact the VA directly if you think you are eligible.
Does Overdiagnosis Lead To Overtreatment Of Older Men
The widespread use of PSA screening has led to an increase in the diagnosis and treatment of early localized prostate cancer. Data from the US Cancer of the Prostate Strategic Urological Research Endeavor database suggest a significant decrease in risk in the last 2 decades in the United States, with more patients being identified with low-risk disease at diagnosis, but the role of active treatment of low- and intermediate-risk disease in elderly men remains controversial.
The median time from diagnosis to death from prostate cancer for men with nonpalpable disease is approximately 17 years., Considering that the US male life expectancy at the age of 65 years is 16 years, aggressive therapy will hardly extend life expectancy of older men with no palpable prostate cancer at the time of diagnosis. Twenty to 30% of prostate cancers detected by PSA screening programs show Gleason scores of 6 or lower and, thus, are not poorly differentiated and have volumes smaller than 0.5 cm3.
Histologic evaluation of radical prostatectomy specimens demonstrated that about 20% to 30% of cancers are small volume, show low Gleason scores, and are consequently clinically harmless., Many of these cancers pose little threat to life, especially for older men. Has PSA screening resulted in prostate cancer overdiagnosis?
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What Causes Prostate Cancer
Prostate cancer forms when the DNA in prostate cells develops mutations that may disable their ability to control cell growth and division. In many cases, these mutated cells die or are attacked by the immune system. However, some mutated cells may escape the immune system and grow out of control, forming a prostate tumor.
Understanding the risk factors may help men take preventive measures to reduce the likelihood of developing this disease.
Should You Know Your Psa Level
Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.
If you’re a man aged 50 or over and decide to have your PSA levels tested after talking to your GP, they can arrange for it to be carried out free on the NHS.
If results show you have a raised level of PSA, your GP may suggest further tests.
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What You Can Do Now
Sexual side effects from prostate cancer treatment are often temporary, especially if your doctor used nerve-sparing surgery. While your body recovers, you can try a few things to maintain your sex life:
- Let your doctor know about any sexual problems youre having right away. Although it can be hard to talk about sex, being open and honest will help you get the treatment you need.
- See a therapist. Couples therapy can help you and your partner understand and deal with sexual issues.
- Take care of yourself by exercising, eating a well-balanced diet, reducing stress, and getting enough sleep. Looking and feeling your best will give your self-esteem and mood a boost.
Will Treatment Cause Erectile Dysfunction
When youre sexually excited, nerves cause tissues in your penis to relax, allowing blood to flow into the organ. The nerves that control erection are very delicate. Surgery or radiation for prostate cancer may damage them enough to cause ED. When you have ED, you cant get or keep an erection.
Radical prostatectomy is a surgery to remove the prostate gland. When your surgeon removes the gland, they may damage the nerves and blood vessels that run along it. If theyre damaged enough, you wont be able to get an erection following the procedure.
Today, doctors can do nerve-sparing surgery, which helps prevent permanent ED. Your surgeon can still touch those nerves and blood vessels, causing ED as a temporary side effect. Many men have trouble getting an erection for a few weeks, months, or even years after their procedure.
Radiation therapy also damages blood vessels and the nerves that control erection. Up to half of men who have radiation for prostate cancer experience ED afterward. In some men, this symptom will improve with time. Sometimes radiation side effects dont appear until a few months after the treatment. If ED starts late, it may not be as likely to go away.
A few treatments can help with ED until youre able to have erections on your own again.
Additional treatments include the following:
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Is Prostate Cancer Different In Older Vs Younger Men
A recent review in the Lancet of five main cancer types concluded that yes, it is, and this needs to be better understood to develop more personalised care to patients.
To conclude, although most tumour subtypes and molecular alterations seem to be present in all age categories, there are clear shifts in the distribution of these characteristics with increasing age. The biological explanation as to why some subtypes and alternations are more frequent in older people has yet to be elucidated. Cumulative DNA damage with increasing age and immunosenescence might play a role, but are insufficient to explain all the observations summarised in this Review. A better understanding of these biological processes is needed and might help to better understand cancer biology globally, and as such improve personalised cancer care in both young and old people with cancer.
What Does It Mean To Get Prostate Cancer As A Younger Man
Early-onset prostate cancer is currently being investigated in order to better understand this group and their case presentations. Typically, those who are diagnosed at a younger age have been found to possess more genetic variants, or mutations that can contribute to cancer.
These individuals also typically have a familial history of the condition, with the greatest risk in those who have one or more close relative with early-onset prostate cancer. Findings like these suggest that early-onset prostate cancer is tied more to genetic factors that to environmental factors, such as smoking or diet.
General findings for those with high grade or stage early-onset prostate cancer trend towards a higher cause-specific mortality than their older counterparts. This means that individuals with aggressive early-onset prostate cancer are typically more likely to die from prostate cancer. This could be because they are less likely to die from conditions more present in older men. For example, a male at age 90 might have a heart condition in addition to his prostate cancer that may threaten his life more than a slow-spreading cancer.
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Craig Melvin And Al Roker Premiere ‘get Checked’ Psa
Dr. Matthew Rettig, the medical director of the Prostate Cancer Program at the Institute of Urologic Oncology at UCLA in California, said that even if screenings aren’t performed right away, men should at least start talking about them with their doctors early in life.
“I think I would have that conversation fairly early on in life, maybe even in 30s or 40s, about when to initiate screening,” said Retting. “I think that would be most important for patients who are at high risk for prostate cancer and high risk for early onset of prostate cancer. Those are the types of patients that probably ought to have the discussion and make a decision about when to start screening at a relatively young age.”
Four Questions On The Implications Of Age In Developing Prostate Cancer
Ageing is the highest risk factor in developing prostate cancer, and its commonly accepted inevitability is often encapsulated in the comment you dont die of it, you die with it.
So entrenched is this mentality that it drives attitudes, behaviours and practices around the management of prostate cancer, to the point where we have seen blatant age discrimination in patient care.
In an attempt to address this age discrimination, we produced a series of podcasts and blogs based on interviews with both patients and clinicians about their experience. In addition, we encourage all men and their loved ones to consider four key questions about age-related implications of developing prostate cancer.
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African Americans And Prostate Cancer
African American men are at an increased risk for developing prostate cancer over white men and other men of color. One in seven African American men will develop prostate cancer in his lifetime. Overall, African American men are 1.8 times more likely to be diagnosed withand 2.2 times more likely to die fromprostate cancer than white men. African American men are also slightly more likely than white men to be diagnosed with advanced disease.
Fortunately, the racial divide for prostate cancer outcomes is narrowing. Overall, the five-year relative survival rate for African American men diagnosed with prostate cancer is 97%, which means that if an African American man is diagnosed with prostate cancer today, at any stage, there is a 97% chance he will be alive in five years. When the disease is caught early, this rate increases to nearly 100%.
When Is A Psa Test Needed
If you are age 50 to 74, you should discuss the PSA test with your doctor. Ask about the possible risks and benefits.
Men under 50 or over 75 rarely need a PSA test, unless they have a high risk for prostate cancer.
- You are more likely to get prostate cancer if you have a family history of prostate cancer, especially in a close relative such as a parent or sibling.
- Your risks are higher if your relative got prostate cancer before age 60 or died from it before age 75. These early cancers are more likely to grow faster.
- If you have these risks, you may want to ask your doctor about getting the PSA test before age 50.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
04/2014
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Yes Or No For A Psa Test For Men Over Age 70
We all know that aging is a recognized risk factor for prostate cancer, that it can be cured, but you still need to be screened early to put the odds in your favor. But what about older men? Should men be screened for prostate cancer and have a PSA test past 70 years of age?
The prostate-specific antigen test, or PSA test, makes it possible to detect the disease at an early stage, often in the absence of symptoms, thereby preventing many deaths related to advanced and aggressive cancers. When its level is high, this antigen indicates that there is a problem with the prostate, but it is not necessarily prostate cancer. Blood levels can go up as a result of various prostate disorders, such as infection, benign enlargement or cancer, or sometimes for no apparent reason.
While this test is currently the best for screening for prostate cancer, it is not perfect. It does not on its own indicate whether it is necessary to treat a patient or how to treat.
It is true that age greatly increases the risk of prostate cancer. However, most prostate tumors, especially in older men, remain small, grow very slowly or not at all, do not spread, and do not cause any symptoms. Many men die with prostate cancer rather than from the disease. In fact, autopsy studies show that three-quarters of men over the age of 75 had prostate cancer – usually small and harmless – and that the vast majority had never known it and had died of something else.
Men 70 and over
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