Every year 3,000 NZ men will be diagnosed with prostate cancer.
all about prostate cancer
The prostate is a small gland, normally about the size of a walnut. It sits just below the bladder and surrounds the upper part of the urethra – the tube that carries urine from the bladder and semen from the testicles to the outside of the body through the penis. Prostate cancer is the presence of cancer cells or a cancerous growth in or on the gland.
In many cases, prostate cancer is slow growing, and having it won’t affect you. But in some cases, the cancer is more aggressive and can spread to your bones, liver and lungs.
It is common for our prostate to become enlarged as we age. But, this can also be a sign of prostate cancer.
The prostate is located under our bladder. If it is enlarged it puts pressure on the bladder, which can cause the following:
- Needing to pee more often, especially at night
- Having difficulty starting or stopping flow
- Dribbling or leaking when you urgently need to pee
Prostate cancer is most common in men over 40. It is very rare in younger men.
Chances of developing it increase as you get older. By the age of 60, one in 14 men will have prostate cancer.
Prostate cancer can be hereditary. If your father or brother has prostate cancer, you have a higher chance of developing it.
If you’re over 40, and your brother or father has had prostate cancer, then we recommend you get tested every year.
If you don’t have a family history of prostate cancer, we recommend you get tested from age 50. If your test results are normal, then you only need to get tested once every two years.
There are two initial tests for prostate cancer:
- Physical exam (finger test)
Your doctor will put their finger up your bottom to feel the prostate for roughness, size, and unusual lumps. The medical name for this is a Digital Rectum Exam, or DRE.
- PSA blood test
Prostate Specific Antigen (PSA) is a protein produced by your prostate. High levels in your blood might be caused by prostate cancer, but can be caused by other things as well. PSA levels can fluctuate, and some men have very low PSA levels, so the results aren’t clear cut.
It’s important to have BOTH tests, as neither test on it’s own can give an accurate indication of cancer.
If having your tests done on the same day, the PSA test should be done first. And you should wait a couple of days after ejaculating or cycling as these activities raise your PSA.
If you want to know what your PSA level is, then ask your doctor for the actual number. Here is a guide to PSA levels that are considered normal by age:
40s Average 0.65 Upper limit 2.0
50s Average 0.85 Upper limit 3.0
60s Average 1.39 Upper limit 4.0
70s Average 1.64 Upper limit 5.5
If the results of your tests show there are significant warning signs, your doctor will give you the option of having a biopsy, where a tissue sample of your prostate is taken. This will confirm if you have prostate cancer.
More recently, MRI scanning has also developed a role in the diagnosis of prostate cancer, and may be useful as well.
Depending on the size and stage of the cancer, you will be offered different treatment options. For some, the best option may be to monitor the cancer and not intervene if it isn’t having a negative impact on your health. For others, one or a combination of the following may be needed: medication, surgery, radiotherapy, or chemotherapy. Your doctor will help you choose the best treatment for you.
Strengthening your pelvic floor before (and continuing after) your surgery will improve your bladder control and your chances of being able to have erections after your surgery. Ask your doctor for a physiotherapist referral (specifically a pelvic health specialist if you can find one in your area) so that you can include a pelvic floor exercise prescription as part of your recovery plan.