Prostate Cancer

What is the Prostate?

WHAT IS THE PROSTATE? 

Only men have a prostate. The prostate is a gland located in the lower urinary tract beneath the bladder, which surrounds the urethra in men (the passage in the penis through which urine and semen pass). The prostate gland forms part of the male reproductive system. It produces the fluid component of semen which enriches sperm and aids in its transport. It consists of smooth muscle which helps to propel semen out during ejaculation. The prostate requires the male hormone, testosterone to grown and develop.

A healthy prostate is the size of a large walnut and has a volume of 15-25 milliliters, however as aging occurs, the prostate slowly increases in size. Occasionally, this growth can cause problems, such as difficulty urinating. These problems are common in older men.

What is Prostate Cancer? 

Prostate cancer is the uncontrolled growth of cells of the prostate gland. The prostate gland is present in males only. It is the second most common cancer among Australian men. Prostate cancer is rarely seen in men under the age of 50 and is more common in older men.

Symptoms

In the early stages of prostate cancer, you may not have any symptoms. In the later stages, some symptoms may include:

  • A frequent or sudden urge to urinate
  • Difficulty urinating 
  • Discomfort when urinating
  • Haematuria (blood in the urine) 
  • Blood in the semen
  • Lower back pain, upper thighs or hips. 

These symptoms may not mean you have prostate cancer, however you should see your doctor if they do occur.

Risk Factors

Factors strongly linked to an increased possibility of developing prostate cancer may include: 

  • Age: Prostate cancer is an age-dependent disease, which means the chance of developing it, increases with age. The risk of developing prostate cancer by the age of 75 is 1 in 7 men. By the aged of 85, this increases to 1 in 5. 
  • Family History: If you have a first degree male relative with prostate cancer, you will have a higher chance of developing prostate cancer. The risk increases again if more than one male relative has prostate cancer. Risks are also higher for men whose male relatives were diagnosed at a young age. 

Other factors strongly linked to an increased chance of developing prostate cancer:

  • Genetics: Genes are found in every cell of the body. They control the way the cells in the body grow and behave. Each person has a set of many thousands of genes inherited from both parents. Changes to genes can increase the risk of prostate cancer being passed from parent to child. Although prostate cancer is not inherited, a man can inherit genes that can increase the risk. 
  • Diet: There is some evidence to suggest that eating lots of processed meat or food high in fat can increase the risk of developing prostate cancer. 
  • Lifestyle: There is evidence to show that environment and lifestyle can affect the risk of developing prostate cancer. 

How is prostate cancer detected and diagnosed? 

Usually, a blood test and/or physical examination will be conducted to assess the health of the prostate. 

  • Blood Test (PSA - Prostate Specific Antigen Test): The result of this shows whether there is an increase in this specific protein. Depending on the result, you may need further investigation by a specialist. A high PSA test result does not necessarily mean cancer. Prostate diseases other than cancer can also cause a higher than normal PSA level. 
  • Digital Rectal Examination (DRE): Because of where the prostate is located, the doctor inserts a gloved, lubricated finger in to the rectum to check the size of the prostate and assess if there are any abnormalities. A normal DRE result does not rule out prostate cancer. 

Diagnosis

If your tests show you may be at risk of prostate cancer, the next step is a biopsy. A biopsy is the only way a firm diagnosis of prostate cancer can be made. A urologist removes small samples of tissue from your prostate, using very thin, hollow needles guided by an ultrasound. The prostate is either accessed through the rectum (transrectal) or the perineum (transperineal), which is the area between the anus and the scrotum. The doctor will likely advise a course of antibiotics afterwards to reduce the chance of infection. The tissue is sent to a pathologist to identify whether the cells are malignant (cancerous) or benign (not cancerous). For more information on a transrectal biopsy, please see our TRUSS Biopsy information page.