Age and genetic factors contribute to the development of this cancer, to the extent that most men in their eighties, will have a small prostate cancer that they will not know about, which is also unlikely to cause them harm. However, a few of these cancers are aggressive and lethal, and worth finding to allow early successful treatment and cure. Usually, early prostate cancer carries no symptoms. Prostate disease is also very common in ageing men, and needs to be distinguished from cancer at an early stage. Because the majority of cancers found do not cause harm, there are no formal national systematic screening programmes anywhere in the world, but men can request testing as long as they are well informed about the implications of testing.
Prostate cancer is common and in some cases, early detection may be an important tool in getting appropriate and timely treatment.
So, what will happen in the clinic when you visit?
- You will be seen, examined and counseled by an expert doctor. He/she will decide with you whether you need a PSA blood test (see below) or other investigations.
- Basic investigations include a series of blood tests, as well as more sophisticated tests as necessary, to check your potential risk of having prostate cancer. This could include the genetic composition of your normal cells from blood samples to find out whether you have any susceptibility for prostate cancer. It will be particularly relevant if you have a family history of cancer.
- If you have an initial PSA blood test and it is abnormal, you will receive sophisticated imaging, in the form of multiparametric Magnetic Resonance Imaging to the prostate, which will determine whether there are any visible abnormalities in the prostate, to allow targeted biopsies.
- Depending on the results of the investigations, you will be referred to a prostate cancer specialist for further discussion, and possibly advised to receive prostate biopsies, to determine whether you have prostate cancer or not.
- Should you be found to have prostate cancer, the Prostate expert will discuss with you and advise on the best course of action, and most appropriate treatment. He may suggest additional tests and more sophisticated imaging investigations.
- If prostate cancer is excluded, and you have an enlarged prostate with resulting symptoms, you will be referred to an expert doctor also for further investigations and treatment as necessary.
The PSA test (Prostate Specific Antigen)
This is the blood test that we may use as an initial screen for prostate cancer. PSA is not a cancer substance, it is an enzyme produced normally by prostate cells, and some of it leaks into the blood where it is measured. If the level is high it could indicate prostate cancer or other benign enlargement of the prostate. The levels can go up also if you have an infection in the urine, if you cycled for a long distance, or if you have ejaculated recently before the test. The test alone is insufficient to detect prostate cancer. If the level is high, it needs to be followed by a multiparametric Magnetic Resonance Imaging scan which we can provide, and this will determine whether you need to be referred for further tests to a prostate expert. A nurse or medical technician will draw blood from a vein, most likely in your arm.
If you have any questions please let us know at any point and we will help you find the answer you need.