Prostate Cancer: Case To Test Men In Their 40s
Health editor, BBC News online
Men could be offered a screening test for prostate cancer in their late 40s, a study suggests.
The idea is controversial as prostate specific antigen testing can be unreliable, throwing up false positive results that can cause undue worry and even treatment over something benign.
Swedish researchers say checking every man aged 45-49 would predict nearly half of all prostate cancer deaths.
Their findings, in The BMJ, come from a study of more than 21,000 men.
Do All Men Who Are Treated For Prostate Cancer Lose Sexual And Urinary Function
Its definitely not true that all men are incontinent and impotent after treatment for prostate cancer. Urinary incontinence is usually temporary.
There can be a sexual impact for guys who have normal function. If the cancer is near their nerve bundle, theyre going to have a decrease in sexual function. If its not, and we can do bilateral nerve sparing surgery, studies show 70 percent can get back their normal sexual function. It all depends on where the cancer is. But the truth is that we cant predict very well who will be the 30 percent who will haveor still haveED some already do have ED because of age, diabetes, hypertension or renal failure.
How To Keep Your Prostate Healthy
A key part of keeping your prostate in good health is to be aware of any changes when you urinate or any discomfort in your lower abdomen, pelvis and anal area. If you notice anything that concerns you, visit a doctor. At Spire Healthcare, you can get the help you need with our mens health services, which provides specialist care for men with prostate, penile, testicular and bladder problems.
You can also take steps to prevent prostate issues by making changes to your lifestyle that promote good general health, which is thought to have a knock-on effect on promoting good prostate health. There are three main approaches:
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How Often Do I Need To Get A Prostate Exam
A prostate exam is a common examination that is used to check on the current condition of the prostate. As men age, the need to monitor prostate health becomes more of a necessity. Unfortunately, many men neglect the task of having periodic examinations of the prostate. Often, this is due to a misunderstanding about the mechanics of the exam, as well as a lack of information about prostate cancer and what the disease can do if left unchecked.
Prostate exams do not require much, other than a visit to the family physician or urologist. The exam takes place in the doctors office, and involves nothing more than a lubricant and a rubber glove. The physician dons the glove, lubricates the index finger, and inserts the finger into the anus. The prostate can be easily examined through the thin walls of the rectum, allowing the physician to check for growths, texture, and any other abnormalities. Generally, the examination takes only a moment or two and is relatively painless.
Why Does Prostate Cancer Happen
The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.
The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.
For reasons not yet understood, prostate cancer is more common in men of African-Caribbean or African descent, and less common in Asian men.
Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.
Recent research also suggests that obesity increases the risk of prostate cancer.
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Questions To Think About Before Having A Psa Test
To help you make your decision, you could think about the following questions:
- What would you do if your PSA level is high?
- What would you do if further tests find that you have an early prostate cancer?
- What difference will it make for you to know about an early prostate cancer?
Before you decide whether to have the PSA test, you may want to talk to your GP about it. You can also call our cancer support specialists on 0808 808 00 00. They can discuss the options with you and send you more information.
When To Get Your Prostate Checked: Warning Signs And Advice
A healthy prostate plays a vital role in male fertility, producing fluid that helps keep sperm alive. But as you get older, particularly after the age of 40, you may find that your prostate starts to cause you problems. One reason for this is that the prostate continues to grow as you age. This is a normal process but for many men, an enlarged prostate can cause symptoms that affect their quality of life. This isnt the only problem that affects the prostate, there are several other prostate issues, which can produce similar symptoms to each other. A prostate exam can help you find out whats going on with your prostate so your doctor can then help you get relief from any symptoms you may be experiencing.
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Guideline : In The Future Health Professionals Should Look At A Mans Psa Level Alongside Other Known Risk Factors As Part Of A Risk Assessment Tool When One Becomes Available
We are currently working to develop a simple and reliable risk assessment tool, which will show whether a man is at risk of getting prostate cancer. This will help health professionals to support men at risk and talk to them about possible further tests.
When Should You Get Tested
Prostate Cancer UK recommend PSA blood testing from age 45 and up for men who are at higher risk, and from 50 upward for men at normal levels of risk
Dr Rodgers said: Risk of prostate cancer is increased for people of African Carribean ethnicity and those with a family history of prostate cancer.
If you develop symptoms that suggest prostate enlargement, or your symptoms change over time then you should be discussing this with your doctor.
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How To Check Your Balls
Figures show that 44% of men dont know how to check their balls properly, but early detection is key for a good prognosis. Here are our top tips:
- The best conditions for checking your balls are in a warm shower
- Roll one testicle between your fingers at a time, feeling for any swelling or pain points
- Remember that its normal for your testicles to be different sizes
- Any lumps or swellings are abnormal. Any pain or changes in weight can indicate problems
- If you notice anything that youre worried about, make an appointment with your GP as soon as possible
When Should You Get Your First Prostate Exam
In 30 seconds
The answer to when you should get your first prostate exam depends on your medical history and genetic predisposition.
Your prostate grows throughout your life, which means youre more likely to experience problems as you age.
Prostate cancer is often symptomless, but if you feel unwell, consult a doctor: identifying whats wrong will help you get the right treatment.
First off, what is a prostate? This is a walnut-sized gland located below the bladder, near your rectum. It secretes fluid that becomes part of semen, helping to carry sperm. has two main growth phases first in puberty, and the second from around age 25, continuing at a rate of 14% increase each decade.
Sometimes the prostate can become enlarged enough to cause problems or as a result of related health issues. The most common prostate problems are:
- Prostatitis: when your prostate becomes inflamed as a result of an infection
- Benign prostatic hyperplasia : an overly enlarged prostate
- Prostate cancer
The recommended age for a prostate exam takes into account the fact the prostate grows throughout adulthood, but BPH, prostatitis and prostate cancer can affect you at any age. Below, well outline what to look out for, when to get a prostate exam, and what that entails.
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Whats The Best Treatment For Prostate Symptoms
Treatments for prostate cancer include surgery to remove the prostate, radiation therapy, and ablation therapies, as well as active surveillance. Some treatments are better for some men and some prostates than others. There are side effects for each, so it really requires an informed discussion to help each man make an educated decision.
One thing we do at Yale is use an MRI of the prostate to evaluate the location of the prostate cancer for surgical planning. Ive found it to be quite helpful. Its not done everywhere.
When To Get Checked For Prostate Cancer
Establish a routine. As you enter middle age, be proactive and ask your doctor for their recommendations on establishing a prostate cancer screening schedule that makes sense for you, given your risk factors and your family history. Exactly when you begin screening depends on a lot of factors, based on incidence rates among different populations. These are questions to consider in setting up a proactive prostate cancer screening regimen that works for you:
- Do you have a family history of prostate, ovarian, breast, colon, or pancreatic cancers among your male and female relatives?
- Do you have African ancestry?
- How old are you?
- Where do you live?
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What Is A Normal Psa Level
Your doctor may talk about a normal PSA level. Unlike some other blood tests, there is not one normal PSA level for everyone. The PSA level naturally gets higher as you get older and varies depending on the size of your prostate. The size of the prostate is different for each individual and the prostate gets bigger with age.
Your doctor will tell you what they think the normal level of PSA should be for you. They generally use these levels:
- A PSA level of up to 3 nanograms per millilitre of blood if you are in your 50s.
- A PSA level of up to 4ng/ml if you are in your 60s.
- A PSA level of up to 5ng/ml if you are in your 70s.
- There are no PSA level limits if you are aged 80 and over.
Are You Seeing Prostate Cancer Becoming More Prevalent In Younger Patients
Its pretty rare. Its less common that men in their 40s have prostate cancer, but, we also are very rarely screening them. The young men who come in to be screened tend to have one of those high-risk features. They most likely had a father who had prostate cancer, so theyre nervous about it. Or theyre African-American, and theyve been flagged by their health care providers.
If youre young, your quality of life is even more important to you right now. We know that, if diagnosed with low-grade prostate cancer, a person will need treatment at some time in life. If we can delay treatmentwhich could negatively impact urinary or sexual functionby several years, then we should do that and obviously discuss that there is a low but possible chance of metastasis developing during that time.
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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.
What Would You Say To Men Who Dont Want To Get A Prostate Check
A rectal exam is recommended but optional. We recommend both, but if theyll just let you do a blood test, thats better than not doing anything at all.
If concern about the rectal exam is the only reason youre not getting screened, talk to your doctor about it. We can discuss the risks and benefits. None of the evaluation tests are mandatory, but the reason we do that is that it improves our ability to detect cancer. So, if thats why youre not being evaluated, we can talk and decide if we can do other tests.
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How Is Prostate Cancer Treated
For many men with prostate cancer, treatment is not immediately necessary.
If the cancer is at an early stage and not causing symptoms, your doctor may suggest either “watchful waiting” or “active surveillance”.
The best option depends on your age and overall health. Both options involve carefully monitoring your condition.
Some cases of prostate cancer can be cured if treated in the early stages.
- radiotherapy either on its own or alongside hormone therapy
Some cases are only diagnosed at a later stage, when the cancer has spread.
If the cancer spreads to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms.
All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary symptoms, such as needing to use the toilet more urgently or more often.
For this reason, some men choose to delay treatment until there’s a risk the cancer might spread.
Newer treatments, such as high-intensity focused ultrasound and cryotherapy, aim to reduce these side effects.
Some hospitals may offer them as an alternative to surgery, radiotherapy or hormone therapy.
But the long-term effectiveness of these treatments is not known yet.
Checking For Psa At Home
Itâs best to look for prostate symptoms and then screen using a Prostate Specific Antigen blood test. While there is no physical way for you to check for prostate cancer at home, there are at-home screening options for PSA. imawareâ¢ at-home test for PSA can help screen you for prostate issues.
What Is Prostate Cancer
The prostate is a gland that is usually the size and shape of a walnut. It sits under the bladder and surrounds the urethra . It’s main job is to help make semen. It grows as you get older.
Prostate cancer causes abnormal cells to develop in the prostate gland which creates a tumour and can sometimes spread to other parts of the body.
Sometimes the cancer will grow too slowly to cause any problems or affect how long you live. You may never need any treatment.
However, some types of prostate cancer are very aggressive and are more likely to grow and spread quickly. This seems to be even more likely in black men. This will require treatment to stop it spreading.
Most men with early prostate cancer don’t have symptoms. You can check your risk using the Prostate Cancer UK Risk Checker.
If you notice changes in how you urinate, it might not be prostate cancer, but it’s best to get it checked out. Early symptoms could be:
difficulty starting to urinate or emptying your bladder
a weak flow when you urinate
a feeling that your bladder hasnt emptied properly
dribbling urine after you finish urinating
needing to urinate more often than usual, especially at night
a sudden need to urinate you may sometimes leak urine before you get to the toilet.
More advanced symptoms or signs that the cancer has spread could be:
back pain, hip pain or pelvis pain
problems getting or keeping an erection
blood in the urine or semen
unexplained weight loss.
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.
- 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.
- 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.
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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