|The prostate is a gland,
about the size of walnut, found only in men. It is located just
below the bladder and surrounds the tube known as the urethra
that carries urine from the bladder and out through the penis.
The function of the prostate is to manufacture the liquid component
of semen, which allows the sperm to move freely.
Normally cells grow and multiply only when the body needs them
to. Prostate cancer develops as a result of a breakdown in this
normal process leading to cells growing in an uncontrolled way.
The mass of excess cells forms a tumour, which may be benign or
malignant. The tumour is described as 'malignant' if it is able
to invade other healthy tissue. The peripheral (outer) zone of
the prostate is the area most susceptible to developing cancer.
Prostate cancer is rare in men under 50. However, the risk increases
steadily with age and by the time they are 80, more than half
of all men will have some cancerous growth, mostly without noticing
it. Prostate cancer is usually slow growing and often is not the
cause of death.
|Frequently, prostate cancer
produces no symptoms. Sometimes, even when symptoms are present,
men do not seek medical attention. If prostate cancer is detected
early then there is a good chance that the disease can be cured.
The symptoms are similar to those produced by another common disease
of the prostate, benign prostatic hypertrophy (BPH), and include:
- Difficulty in starting to pass urine
- Weak, sometimes intermittent flow
- Dribbling of urine before and after urination
- Frequent need to pass urine
- Urgent need to pass urine
- Need to get up several times in the night to urinate
- Feeling that the bladder is not completely empty
- Rarely, blood in the urine
|If you develop any symptoms
mentioned above, you should consult your GP (General Practitioner).
You may be then be referred to a hospital specialist (a urologist).
There are several tests that you may undergo as part of the diagnostic
process. Some of these tests may also be performed as part of
a routine health screening.
A simple urine test will be carried out to look for blood or infection.
PSA blood test
Testing a blood sample to determine the amount of prostate-specific
antigen (PSA) is central to the early detection of prostate cancer.
If an abnormally high level of PSA is detected in the blood then
prostate cancer is a possibility. However, a high PSA level does
not necessarily indicate cancer. It can be caused by other prostate
diseases such as BPH or prostatitis (inflamed prostate).
Digital rectal examination (DRE)
Your urologist will certainly carry out an examination of your
prostate by inserting a finger into your rectum. Although this
can be uncomfortable, it is not painful, and tumours can often
be felt by this method. Many men find this procedure embarrassing
but it should be remembered that urologists do this as an everyday
procedure and it may save your life.
If cancer is suspected, the urologist may perform a prostatic
biopsy (removal of a small piece of tissue). A biopsy involves
passing an ultrasound probe into the rectum to give an accurate
view of the prostate. Samples of the prostate are collected using
a needle. Biopsies can be uncomfortable but urologists will often
give you a mild sedative, or a local anaesthetic. The tissue is
then sent to a pathologist who will examine it under the microscope
and check whether or not the tissue sample is cancerous.
If cancer is found, the pathologist will 'grade' it, according
to the rate of growth. The grading system goes from 1-10, one
being the mildest and 10 being the most aggressive. This will
give the doctor an idea of how quickly your cancer is likely to
In order to ascertain whether the cancer has spread (metastasised)
to other parts of your body you may have a bone scan. Another
technique is an MRI scan which can look at the body in sections
using a strong magnetic field and radio signals. CT scanning is
similar to a MRI scan but uses X-rays to build up a picture. These
scans usually look for the spread of cancer to lymph nodes in
the pelvis. This helps the doctor to decide how far the cancer
has spread, if at all and therefore what is the best course of
treatment. This process is known as 'staging' the cancer.
|The most appropriate treatment
for you will depend on several factors: how aggressive your cancer
is and whether it has spread; your age; your general health.
Sometimes it is a better option, particularly for slow growing
tumours, if no treatment is undertaken. Your condition will be
monitored closely with routine check-ups. Some people, however,
find this approach causes too much anxiety and will prefer to
have active treatment.
Surgery - radical prostatectomy
Surgery is the main treatment for most prostate cancer. A radical
prostatectomy is the most common operation performed and involves
removing the prostate, seminal vesicles and nearby lymph nodes.
As it is a major operation, it is most suitable for otherwise
healthy men (usually under 70) whose cancer appears not to have
spread. The procedure takes place under a general anaesthetic.
About 80% of men who have this operation are still alive 10 years
afterwards. Possible side-effects of this procedure include some
degree of urinary incontinence, sterility and erectile dysfunction
(impotence), although modern surgical techniques can minimise
Hormone therapy successfully reduces the size of prostate tumours
in 80% of men but it does not kill cancer cells. It is sometimes
used prior to radiotherapy to reduce the size of the tumour. For
many men hormone therapy will be recommended in addition to surgery.
Testosterone, the male hormone produced by the testicles, stimulates
cancer growth. Hormone therapy is based on controlling the level
This is done either by 'switching off' the production of testosterone
or damping down the levels that circulate in the bloodsteam. This
can achieve by medicines, such as finasteride (Proscar) that block
the conversion of a natural chemical into active testosterone.
Alternatively orchidectomy, which involves surgical removal of
both testicles, stops the production of testosterone.
Radiotherapy is an alternative to radical prostatectomy. Currently
there is no conclusive evidence to show that one method is more
effective than the other. The treatment involves radiation being
applied to the affected area to destroy the cancer cells. This
is usually done as an out-patient procedure. The main side-effects
are bladder irritation and diarrhoea. Some men will become impotent
as a result.
This is a relatively new procedure which involves the implantation
of radioactive pellets into the prostate where they gradually
lose their radioactivity over the following months. The pellets
are inserted under general or spinal anaesthetic. Brachytherapy
is not recommended for men whose cancer has spread to other parts
of the body.
Cryosurgery, gene therapy and vaccines are other new therapies
currently under investigation.
|The reason why some men
develop prostate cancer is unknown, although some risk factors
have been identified. The most important risk factor is advancing
age. Other factors include family history. If a close relative
- father, brother, uncle - has developed the disease then your
own risk is likely to be increased. Ethnic origin also seems to
play a part. Afro-Caribbean men seem to be at highest risk and
men of Far Eastern descent the least.
You may be able to reduce your risk by limiting the amount of
fat in your diet, through cutting down on diary produce and red
|Hong Kong Cancer Fund
Tel: (852) 2868 0780
Fax: (852) 2524 9023
The HK Anti-Cancer Society
Tel: (852) 2814 0950 / (852) 2814 1232 / (852) 2814 0702
Fax: (852) 2873 1405
CANSURVIVE (English Speaking Support Group)
Tel : (852) 2868 0780 Fax : (852) 2524 9023
Hotline : (852) 2328 2202
The Prostate Cancer Charity
American Prostate Society
National Cancer Institute
American Cancer Society
The Cancer Council Victoria
|Healthwise (Health Information Resource
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : firstname.lastname@example.org
Homepage : http://www.healthwise.org.hk/
This leaflet is for information only. For a detailed
opinion or personal advice, please consult with your own