Lions Prostate Cancer Research & Treatment Project
What is Prostate Cancer from Cancer Australia
What is Prostate cancer?
Prostate cancer occurs when abnormal cells in the prostate grow in an uncontrolled way.
The prostate is a gland in the male reproductive system. It makes a fluid that forms part of semen. The prostate is located just below the bladder and in front of the rectum.
Prostate cancer can press on or block the bladder or the urethra (the tube that allows urine to be released from the bladder) and cause problems with urination and sexual function. In advanced disease, the cancer can spread to other parts of the body to form secondary cancers (known as metastasis).
Prostate cancer is the most common cancer in men in Australia (apart from common skin cancers)
What are the risk factors for prostate cancer?
A risk factor is any factor that is associated with increasing someone’s chances of developing a certain condition, such as cancer. Some risk factors are modifiable, such as lifestyle or environmental risk factors. Others cannot be modified, such as inherited factors or whether someone in the family has had cancer.
Having one or more risk factors does not mean that you will develop cancer. Many people have at least one risk factor but will never develop cancer, while others with cancer may have had no known risk factors.
Even if a person with cancer has a risk factor, it is usually hard to know how much that risk factor contributed to the development of their disease.
Prostate cancer risk factors
Factors that are associated with a higher risk of developing prostate cancer include:
- age: the risk of developing prostate cancer increases rapidly from age 50; it is most commonly diagnosed in people aged between 60 and 79
- family history: those who have a father or brother with prostate cancer who were diagnosed before the age of 60, or who have a family history of breast or ovarian cancer, are more likely to develop prostate cancer
- changes in certain genes that can be carried in families: inherited mutations in certain genes, such as the BRCA1 or BRCA2 genes, may increase the risk of developing prostate cancer in some people. People with a genetic condition called Lynch syndrome (also called hereditary nonpolyposis colorectal cancer or HNPCC) also have a higher risk of developing prostate cancer.
What are the symptoms of prostate cancer?
Prostate cancer may cause no symptoms, even in the advanced stage.
Symptoms of advanced prostate cancer can include:
- problems urinating, including weak flow, a flow that stops and starts, needing to urinate urgently or frequently, difficulty starting the flow of urine, or feeling like you haven’t completely emptied your bladder
- pain or burning when urinating
- blood in the urine or semen
- pain in the back, hips, pelvis or chest
- weak or numb legs or feet
- unexplained weight loss
- tiredness, shortness of breath, dizziness, fast heartbeat or pale skin.
Many conditions can cause these symptoms, not just prostate cancer. If you have any of these symptoms, talk to your doctor. Blood in the urine should never be ignored.
How is prostate cancer diagnosed?
A number of tests may be performed to investigate symptoms of prostate cancer and confirm a diagnosis. Some of the more common tests include:
- medical history, family history and physical examination
- digital rectal examination – where the doctor inserts a gloved finger into your rectum to feel the prostate through the rectal wall
- blood test to check for prostate-specific antigen (PSA), a protein produced by the prostate; the level of PSA can be higher than normal in people with prostate cancer (but also in people with other prostate conditions that are not cancer)
- genetic tests that look for inherited gene changes
- transrectal ultrasound – where a probe is inserted into the rectum that uses sound waves to create a picture of the prostate inside the body
- imaging tests such as a CT scan and a bone scan to look at whether the cancer has spread beyond the prostate gland and help to guide management.
- multiparametric magnetic resonance imaging (mpMRI), a specialised type of medical scan that combines three MRI images for greater detail
- Nuclear medicine imaging such as a PET scan or a bone scan. A PET-scan – a specialised type of scan which involves injecting a weak radioactive substance into the body to allow the cancer cells to show up on the scan. Prostate cancer often does not show up on standard PET scans, and a PSMA-PET scan may be done to specifically look for prostate cancer activity. PSMA stands for prostate specific membrane antigen, a protein found on the surface of prostate cells.
- biopsy (usually after having an MRI scan) – where a small sample of tissue is removed using a special needle guided by transrectal ultrasound and examined under a microscope; the needle is commonly inserted through the skin between the anus and scrotum (called a transperineal biopsy) but can also be inserted through the rectum (transrectal biopsy).
The tissue taken during a biopsy will be given a score that indicates how quickly the cancer may grow or spread. This may be done using the Gleason scoring system, where a score is given to the types of cancer seen under the microscope. These are given a low score meaning that the cancer is less likely to spread or a high score meaning it is most likely to spread.
The two most common types of cancer found in the sample are given scores up to 5 and these are added together to give the Gleason Score (up to 10). The cancer may also be scored using the International Society of Urological Pathologists (ISUP) Grade Group system, which grades prostate cancer from 1 (least aggressive) to 5 (most aggressive).
Lions Prostate Cancer Research & Treatment Project 