is the prostate gland located?
is a walnut shaped gland present only in men; it is located
just below the opening of the bladder and encircles the water
tube (urethra) that carries urine and semen.
does the prostate gland do?
job is to make some of the fluid that helps carry sperm when
have sex. You’re unlikely to be aware of your prostate until
it causes trouble.
The most common problem is prostate enlargement (called Benign
Prostatic Hypertrophy, or BPH), which can make it difficult
to pass urine. B: BPH is noncancerous and is not the same
as prostate cancer.
do we know about prostate cancer?
is Prostate Cancer?
Cancer is a condition of the prostate in which there is abnormal
growth of prostate cells. The growth is uncontrolled (compared
to growth of normal prostate tissue) and the cancer
cells have a tendency to spread (known as "metastasise")
outside the confines of the tissue to involve other parts
of the body.
causes prostate cancer?
causes of prostate cancer are unknown.
are some factors, which may be associated with an increase
in the likelihood of developing the disease:
relatives who have or have had cancer of the prostate. One
relative (father, brother, uncle) increases the risk twofold
ethnic groups have a higher incidence of prostate cancer
Research in north America has shown that African-Caribbean
African-American men are most likely to have this type of
men have the lowest incidence, but the risk rises somewhat
emigrate to the West.
a diet high in animal fat and protein.
are no known primary prevention measures which men can take
to minimise the risk of developing prostate cancer.
are the symptoms of prostate cancer?
early prostate cancer are unlikely to have any symptoms as
occur when the cancer is large enough to put pressure on the
urethra or disturb
bladder function. Many older men have enlargement of the prostate
to non-cancerous benign prostatic hypertrophy.
symptoms of benign prostatic hypertrophy and prostate cancer
are similar and
may include the following:
in passing urine
urine more frequently than usual, especially at night
blood in the urine
majority of men with these symptoms do not have prostate cancer.
cancer of the prostate is often a slow growing cancer and
not occur for many years even significant cancers may cause
no urinary symptoms
and the first symptoms may be pain in the back, hips or pelvis
by the cancer spreading to the bones.
prostate cancer is only detected following a prostate operation
- the tissue removed at operation is always sent for pathological
have shown that 10% of men undergoing a prostate operation
(known as a trans-urethral resection of the prostate, or TURP)
for urinary symptoms will subsequently be shown to have a
small area of cancer within the tissue removed
and early detection: three main tests
are three recognized methods of testing for prostate cancer;
of serum prostate specific antigen (PSA)
rectal examination (DRE)
Specific Antigen (PSA) is an enzyme produced
by the prostate gland, which helps in liquefying the semen
prostate cancer tend to have levels of PSA in their blood
that are higher than normal. However it is important to realize
that although PSA is prostate specific (produced by prostate
cells only) it is not prostate cancer specific. Conditions
such as benign enlargement of the prostate and urinary tract
infections will also result in an elevation of the levels
men who have prostate cancer, do not have raised levels
thirds of men who have raised levels of PSA, depending on
off level used, do not have prostate cancer.
uncertainties mean that at the present routine PSA testing
to screen for prostate cancer is not recommended
I have a PSA test, and what will it mean?
you have symptoms of difficulty passing urine, an abnormal-feeling
prostate gland, or a strong family history of prostate cancer
it is unlikely that your doctor will recommend that you have
a PSA test before the age of 50. This is partly because of
the uncertainties mentioned in the section above.
normal PSA test is not an absolute proof that you do not have
prostate cancer. If your prostate gland feels abnormal
on rectal examination your doctor may still advice a prostatic
biopsy. On the other hand a raised PSA result does not mean
that you definitely have a prostate cancer.
agree to have a PSA test you should be ready to undergo a
prostate biopsy, if your results demand that course of action.
require further details click on PSA
rectal examination (DRE)
stage prostate cancer is seldom detectable by digital examination
of the rectum,
and it is a raised serum PSA that triggers investigation.
DRE alone is less than 50% accurate in detecting prostate
is most valuable for detecting more advanced cancers, assessing
of a known cancer and for diagnosing non-malignant disorders
of the prostate.
of a palpable abnormality of the prostate with a raised PSA
the likelihood of cancer.
PSA levels are raised and I need a biopsy, so what happens
is carried out in a special clinic which is currently held
in ward 14 BRI. Even patients seen at the Yorkshire Clinic
come to BRI as we have the latest high quality equipment in
this clinic. You will be admitted to the
if you have been seen at the Yorkshire Clinic in the first
performed as an outpatient procedure. It does not require
an anaesthetic and you will be able to go home shortly after
the procedure is completed.
be asked to lie on the examination couch while the doctor
re-examines your prostate to assess it. The doctor will then
scan the prostate by inserting a small ultrasound probe into
the rectum. An ultrasound probe in the rectum enables the
specialist to 'see' the prostate in such a way that needle
biopsies may be taken with greater accuracy from different
parts of the prostate. The diagnosis of prostate cancer is
made by the histological examination of prostate tissue, and
the standard investigation for a man with a raised serum PSA
is the taking of several needle biopsies under transrectal
ultrasound (TRUS) control.
are taking Aspirin, Clopidrogel or Warfarin you should have
been advised about stopping the drugs. Please speak to Mr.
Puri or the specialist nurse for advice,
report that TRUS biopsies are moderately uncomfortable. As
there is a risk of infection, antibiotics are prescribed to
cover the procedure.
3 in 100 will require a second course of antibiotics,
- 1 in
100 will have to be admitted to hospital for intravenous
risk of death from TRUS biopsy is less than 1 in 10,000.
may have some bleeding in the urine or following sexual
intercourse for up to three weeks.
60-70% of men undergoing TRUS biopsy for a raised PSA are
to have cancer. This proportion differs according to the 'threshold'
PSA that is considered to be abnormal.
biopsy was negative, what happens now?
is very difficult to answer accurately, but the important
thing to note is that a negative biopsy result cannot exclude
completely the possibility of cancer within the prostate.
If the amount of cancer is very small it is difficult to hit
it with the biopsy needle.
practice is to keep you under review by regular visits to
the outpatient department and to repeat the PSA at intervals.
If the PSA continues to climb steadily upwards this would
be further evidence of possible cancer and it might be necessary
to repeat the biopsies. This would not be done within three
months because the act of taking a biopsy from the prostate
artificially raises the PSA level and this would confuse the
PSA levels remain stable it may be possible for your GP to
repeat the test
at regular interval.
this leaflet provides useful information that will help you
understand the reasons for the various tests. If you have
any questions, jot them down here and ask the nursing or medical
staff for answers.
here to go back to the Prostate Cancer Main Menu