Transcriber: Ayyappadas Vijayakumar Reviewer: David DeRuwe
Hello, I’m Andrew Gabriel,
and today I’m going to talk to you about prostate cancer,
and in particular prostate cancer awareness.
And this is what you need to know to look after your health
or the health of a man in your life.
So I am a prostate cancer patient myself.
I actually run several prostate cancer support groups,
and I do one-to-one support for patients.
I give presentations to patients
and also to clinicians from a patient’s perspective.
However, I am a patient, and I’m not a clinician myself.
So let’s start with What is the prostate?
Well, the prostate is a male sex organ.
It’s situated right in the middle of your abdomen, just below your bladder.
Your urethra, which is your pee pipe, goes through the middle of the prostate,
and the prostate contributes about 40% of your semen volume,
mainly a chemical called prostate-specific antigen or PSA,
We’ll come upon PSA later.
So your prostate is required for procreation.
What’s prostate cancer?
Well, prostate cancer
is when some of the cells in your prostate start growing uncontrollably,
and initially, this happens in the prostate,
but when this happens, the cells can start proliferating outside the prostate
and can start growing in other areas of your body.
And that's a really serious condition. And it can be fatal.
So ideally you want to stop this from happening.
Now, this is what I’m going to talk about.
So prostate cancer is the most commonly diagnosed cancer in the UK
with around about 50,000 cases a year.
Unfortunately, this leads on to nearly 12,000 deaths per year.
That's one death every 45 minutes.
One in eight men in the UK will be diagnosed
with significant prostate cancer at some point in their lives.
Unfortunately, if you’re a Black African or Black Caribbean man,
that figure rises to one in four men who will be diagnosed with prostate cancer
that’s significant at some point in their lives.
There are a few other things that raise your risk of prostate cancer.
So if your father or brother had prostate cancer,
your risk is raised by two and a half times,
and if your mother or sister had breast cancer below the age of 60,
your risk is also increased.
But the main factor is the risk factor for prostate cancer is actually your age.
So as you get older, your risk of prostate cancer increases,
and this starts to become significant at about age 50.
However, if you had any of the higher risk factors -
you’re a Black man,
father or brother with prostate cancer, or mother or sister with breast cancer -
then the risk starts to increase at a younger age.
So you need to bear that in mind, possibly from about age 40 or age 45.
So what are the symptoms of prostate cancer?
Well, the most common symptom of prostate cancer is nothing.
That makes it quite hard to find.
So prostate cancer in the early stages usually doesn't cause symptoms
and even in later stages often doesn’t cause any symptoms.
But there are some symptoms that you should be aware of
because these could be an indication of prostate cancer.
So just to run through these quickly:
If you notice your flow rate when you’re peeing has slowed down.
If you notice you’re peeing more frequently,
particularly more than once at night.
If you find it difficult to start peeing
or it takes you a long time to stop peeing at the end.
Urgency - so that’s where you get a sudden need to pee and you can’t hold on.
If you see any blood in your urine or semen.
If you lose your semen or you notice a reduction
in the strength of your erections,
these are all things that could be prostate cancer
and so you need to investigate it.
But let me reiterate -
most people diagnosed with prostate cancer don’t have any symptoms,
and in fact, most people with any of these symptoms I’ve listed
have other conditions, not prostate cancer.
But it is a risk for prostate cancer, so you should go and get checked out.
And even if it’s not prostate cancer,
most of those symptoms are actually easily resolvable,
so it’s worth going to get checked out anyway.
So I talk about getting checked out.
Now, early diagnosis tends to be more curable with fewer ongoing side effects,
whereas if you're diagnosed later,
then you can end up with more long-term side effects as a result of treatment,
and it can even be a fatal disease.
So there's no screening programme in the UK.
It’s very much up to you to go along to your doctor
and to ask to be checked out.
Now, we talked about PSA at the beginning; that’s the chemical the prostate makes.
So there's a simple blood test,
which is to measure how much PSA leaks into your blood
because PSA isn’t really intended to get into your blood.
But if you've got prostate cancer cells,
that is one route by which PSA can leak into your blood.
There are other causes, so the PSA test,
which measures the level of PSA in your blood,
is not a test for prostate cancer.
It's a test which can give an indication that further testing is required.
So ask your doctor for a PSA test; in the UK, you can do that from age 50.
But if you have any of the additional risk factors I mentioned - you’re a Black man,
brother and father with prostate cancer, or mother or sister with breast cancer -
then you need to ask for that at an earlier age from age 40 or 45.
It's also important that you get tested if you've got no symptoms.
Remember I said the most common symptom of prostate cancer is nothing.
That’s the point where you want to catch it.
So that’s the point where you need to have
a PSA test in order to check that your PSA level is OK.
You might get talked out of that by your doctor,
but if you do, push back and say,
“No, I want to have a PSA test even though I don’t have any symptoms.”
That's really quite important.
Now PSA increases gradually with age anyway,
so if you have multiple PSA tests over a period of time,
you'll see your PSA gradually creeps up.
But actually, a good indication of something needs sorting out
or further investigations,
if your PSA suddenly starts increasing more rapidly,
that’s actually more useful than the individual PSA readings.
So you should try and have PSA tests periodically
so that you can graph your PSA.
Unfortunately, about 15% of prostate cancer doesn’t increase PSA at all,
so you may need to ask for another test from your doctor,
or your doctor may offer it, and that’s called the digital rectal exam.
So that’s where the doctor will feel the surface of your prostate
through your back passage,
and the doctor can tell by how soft or by how hard or lumpy the prostate is,
whether there’s any cause for concern that needs some further investigation.
And if any of these things throw up any questionable results,
you’ll be referred to the urology department at the hospital,
who will do further investigations
to decide whether or not you need any treatment
and then go ahead and you would start treatment if you do
or be discharged if you don’t.
Now, there is a small risk of overdiagnosis and overtreatment.
And a lot of doctors refer to this
because this was actually quite a big issue 10 to 15 years ago.
It’s a much smaller issue now,
and due to changes in the diagnostic pathway
and changes in the way prostate cancer is treated,
the incidence of overdiagnosis and overtreatment is very small.
But as someone who has prostate cancer myself,
I would say you definitely want to go and get checked out and not leave it
because you can end up with prostate cancer that’s incurable
if that happens.
So just to give you some more links
where you can go and find out some more information:
“Prostate Cancer UK” is one of the main charities
in the UK that’s involved with prostate cancer
and provides a lot of information for people concerned about prostate cancer
or who have actually been diagnosed with prostate cancers.
There’s an enormous amount of information available for them,
and they have a set of specialist nurses who you can call up and talk with.
So if you search for “Prostate Cancer UK”, you will find that information.
And if you live in Wales,
“Prostate Cymru” is an organisation in Wales that also supports
prostate cancer patients and those concerned about prostate cancer.
So thank you for listening and do go off and get yourself a PSA check
or ensure that the man in your life goes and gets a PSA.