Prostate cancer

Prostate cancer is the most commonly diagnosed cancer in Australian males, with 3,500 Aussie men dying from it each year.

What is it?

Prostate cancer occurs in the prostate—a small gland located below the bladder—when abnormal cells develop. These cells can multiply and spread throughout the body. However, prostate cancer is usually quite slow growing and men can live with low-grade prostate cancer without symptoms or without it spreading for many years.

In saying this, high-grade cancers that require more urgent attention can also exist within the prostate and it is these cancers that Urologists are trying to diagnose early so that effective treatments can be initiated to cure patients.

How common is it?

In 2015, prostate cancer made up 26% of all cancers for men, and accounted for over 4,000 cases of cancer diagnosis. This type of cancer is age-dependent, and the risk of getting it increases as people age. From age 75 to age 85, the risk increases by approximately 6%.

Symptoms and risk factors

Besides age, family history is the other factor associated with an increased risk of developing prostate cancer. If there is a male with a first degree male relative with prostate cancer, there is a higher chance of developing it than those with no such history. This risk increases for those with multiple relatives with the disease, and increases again if these men were diagnosed when they were young.

Other risk factors include: family history (genetics), lifestyle and diet.

In the early stages of prostate cancer, there might be no symptoms. In the later stages, symptoms might include:

• Blood in urine or semen
• Discomfort when urinating
• Finding it difficult to urinate
• Pain in the lower back, hips or upper thighs
• Feeling the sudden need to urinate

Diagnosis

To diagnose prostate cancer, a doctor will first complete a blood test and sometimes a physical examination (it is optional). The blood test—Prostate Specific Antigen (PSA) test—and the physical examination—Digital Rectal Examination—are not 100% accurate in diagnosing prostate cancer. However, if the tests indicate something unusual, the next step is a Magnetic Resonance Imaging study or MRI.

Once information is collated only then would a biopsy be performed which involves the removal of a very small sample of the prostate. This is sent to a pathologist and remains the only way to confirm whether the cells are malignant or benign.

Reducing the risk

While nothing has been shown to stop prostate cancer in its tracks, diet (Mediterranean diet) and physical activity have been proven to improve overall health and potentially reduce the risk of disease. Current Australian guidelines recommend a discussion with your GP as to whether you are tested at age 50 or at age 40 if you have a family history.

Treatments & medical breakthroughs

Surgeons are now able to remove prostate cancer without removing the prostate, resulting in minimising potential side-effects. Epworth is also at the forefront of medtech, including the da Vinci robot-assisted surgical suites to aid in surgery and research.

The E.J. Whitten Foundation Prostate Cancer Research Centre at Epworth is led by Epworth Urologist Associate Professor Nathan Lawrentschuk, and manages over 2,300 patients. The research centre is based at Epworth Freemasons in East Melbourne and it was built as a resource to inspire men to take charge of their own health.

Epworth also provides Urology services at Epworth’s Richmond, Eastern and Geelong Hospitals.