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Introduction to prostate cancer

In this section, you can find information on:

  • The prostate and prostate cancer
  • The treatment options available
  • Specific information on brachytherapy and the procedure
  • Potential benefits of brachytherapy
  • Potential side effects to consider
  • The healthcare professionals involved in delivering brachytherapy
  • Potential side effects to consider
  • Frequently asked questions
  • Useful questions to ask your doctor

About the prostate gland

The prostate is a gland found in men which is about the size of a walnut.1

It sits just below the bladder. Its main purpose is to produce fluid that forms part of a man’s semen, which is used to protect and transport sperm as it travels out of the penis.

What is prostate cancer?

Prostate cancer occurs when abnormal cells develop within the prostate tissue.2

Prostate cancer occurs when abnormal cells develop in the prostate gland, usually after the age of about 45, although this can vary from individual to individual. West Indian and African men are more likely to develop this disease compared to Caucasian (white) and Asian men.

What are the typical symptoms of prostate cancer?

In prostate cancer, the cancerous tumor can enlarge the prostate, putting pressure on the urethra.3

The urethra is the tube that carries urine out from the bladder.

Patients may find:

  • Passing urine is difficult and/or painful
  • A need to get up more often in the night to pass urine
  • Greater urgency in passing urine
  • Passing blood while urinating


If you experience any of the above symptoms, you should contact your healthcare professional.

Risk factors

There are several explanations that can make some men more likely to develop prostate cancer compared to others.
These risk factors include:4

  • Age – men are more likely to develop prostate cancer if they are over 45 years old
  • Genetics – there is an increased risk of developing prostate cancer if another male member of your family has suffered from it
  • Ethnicity – West Indian and African men have a higher risk compared to Caucasian (white) and Asian men
  • Physical exercise – studies have shown that taking regular exercise can protect against developing prostate cancer
  • Diabetes Mellitus – there is some clinical evidence suggesting that diabetes may protect men from developing prostate cancer. Other studies state the opposite. The results are unfortunately, still inconclusive.

 

What tests are used to confirm a diagnosis?

The three main tests which doctors use to confirm a suspected prostate cancer diagnosis are shown in the table below:4

Test

What's being tested?

What happens after

PSA level

A simple blood test. PSA stands for Prostate Specific Antigen – a protein which the prostate produces and releases into the bloodstream. This test checks the levels of PSA which are raised in patients with prostate cancer. The results of the test are used to grade the extent of prostate cancer (see below).

Digital rectal examination (DRE)

A doctor will insert a finger into the back passage (rectum), to check the prostate. The presence of a tumor within the prostate causes changes in the size and shape of the prostate gland and the doctor will be able to feel this. The doctor will send the patient for additional tests if anything unusual is discovered.

Biopsy

A small sample of cells are taken from the prostate using a needle. Abnormal cancerous cells. The cells are examined under a microscope to identify if any cancer is present, and inform the best treatment options.

How do I know how advanced the cancer is?

Terms such as ‘staging’ or ‘grading’ are used by healthcare professionals to describe the level of progression of the cancer and help inform which treatment options might be best.5

The various stages of prostate cancer are summarized below:

Type Stage Description
Early prostate cancer 1 Cancer remains contained within only part of the prostate gland.
Locally advanced prostate cancer 2 Cancer is still in the prostate gland but it is becoming large.
3 Cancer may have spread out of the prostate gland and into the surrounding tissues.
Advanced prostate cancer 4 The tumor has spread into nearby organs such as the bladder and/or into bones.

A scoring system called the 'Gleason score' may also be used – the score is determined by examining a sample of the prostate cells under a microscope. The score can range from 2 to 10. A low score indicates that the cancer is unlikely to spread and is low risk. A high score indicates that the cancer is more aggressive, more likely to spread to surrounding tissues and is high risk.

 

References
1. National Cancer Institute. Available at: www.cancer.gov/cancertopics/wyntk/prostate/page2. Accessed 2 February 2011.
2. National Cancer Institute. Available at: www.cancer.gov/cancertopics/wyntk/prostate/page3. Accessed 2 February 2011.
3. National Cancer Institute. Available at: www.cancer.gov/cancertopics/wyntk/prostate/page5. Accessed 2 February 2011.
3. National Cancer Institute. Available at: www.cancer.gov/cancertopics/wyntk/prostate/page4. Accessed 2 February 2011.
4. National Cancer Institute. Available at: www.cancer.gov/cancertopics/wyntk/prostate/page7. Accessed 2 February 2011.