Understanding Prostate Cancer: Key Facts for Early Detection and Prevention

TOPICS:

Prostate cancer, causes, signs, detection & testing

Understanding Prostate Cancer: Key Facts for Early Detection and Prevention

Prostate cancer is a significant health concern affecting millions of men globally, with over 50,000 new cases diagnosed annually in the UK alone 9 15. While the disease can be life-threatening, early detection and informed lifestyle choices greatly improve outcomes. This article addresses common questions about prostate cancer, providing clear, actionable information to empower individuals and promote proactive health management.

What Is Prostate Cancer?

Prostate cancer develops when cells in the prostate gland—a small, walnut-sized organ below the bladder that produces seminal fluid—grow uncontrollably 2 14. Most prostate cancers grow slowly and remain confined to the gland, posing minimal immediate threat. However, aggressive forms can spread to bones, lymph nodes, and other organs, becoming life-threatening 2 10. Age is a primary risk factor, with most cases diagnosed in men over 50 3 15. Other risk factors include a first or second degree relative woth prostate cancer and a African ethnicity. Importantly, early-stage prostate cancer often presents with no symptoms 15 17.

What Causes Prostate Cancer?

While the exact cause remains unclear, several factors elevate risk:

Age: Risk increases significantly after 50, peaking between 75–79 3 14.

Ethnicity: Black men face higher incidence rates compared to White or Asian men 3 14.

Genetics: A family history of prostate cancer, particularly in fathers or brothers, doubles risk. Inherited mutations in BRCA2, HOXB13, or Lynch syndrome genes also heighten susceptibility 3 7 14.

Lifestyle: Obesity and diets high in animal fats correlate with aggressive prostate cancer 2 8. Exposure to pesticides or cadmium may contribute, though evidence is inconclusive 3 14.

Unlike smoking-related cancers, prostate cancer lacks a single preventable cause, making awareness and early detection critical 3 14.

Can You Check for Prostate Cancer at Home?

While no home test can definitively diagnose prostate cancer, at-home PSA (prostate-specific antigen) kits allow preliminary testing. These finger-prick blood tests measure PSA levels, which often rise due to prostate abnormalities 4 12. For example, the SELFCheck Prostate Test detects elevated PSA, prompting users to consult a GP for further evaluation 4 12. However, PSA levels can also increase from non-cancerous conditions like prostatitis, so abnormal results require clinical confirmation 2 11. Although home test kits are available, not all are validated and it is always more accurate to have a PSA blood tests after discussion with a healthcare professional in a validated lab.

How to Check for Prostate Cancer at Home

At-home PSA tests involve collecting a small blood sample via finger prick and mailing it to a lab. Results typically return within 48 hours, with elevated PSA warranting a GP visit12. While convenient, these tests have limitations:

They cannot distinguish between cancer and benign prostate issues.

False positives/negatives may occur, necessitating follow-up tests like a digital rectal exam (DRE), MRI scan or biopsy 11 17.

Men over 40, particularly those with risk factors, should discuss regular PSA testing with their doctor, even if using home kits 12 15.

Warning Signs of Prostate Cancer

Symptoms often appear in advanced stages and include:

Urinary changes: Frequent urination, difficulty starting/stopping urine flow, or pain during urination 5 14.
Blood in urine or semen 5 14.
Erectile dysfunction or discomfort sitting due to an enlarged prostate 5 9.
Systemic effects: Unexplained weight loss, bone pain (especially in the spine or pelvis), and fatigue 5 14.
Notably, early-stage prostate cancer is typically asymptomatic, reinforcing the importance of early testing in men with a high risk of developing prostate cancer 15 17.

The Most Accurate Tests for Prostate Cancer

PSA Blood Test: Measures prostate-specific antigen levels. While not definitive, consistently elevated PSA prompts further investigation 2 11.
Digital Rectal Exam (DRE): A doctor physically checks the prostate for lumps or irregularities 2 17.
MRI scan of the prostate: These tests have become standard of care for the initial evaluation of the prostate in men with an elevated PSA or with suspicion of prostate cancer on examination. There is very good evidence for their use in deciding whether a further prostate biopsy is necessary or not. These tests are non invasive and have minimal associated risk.
Biopsy: The gold standard for diagnosis, where prostate tissue samples are analyzed for cancer cells. This is an invasive test. Not all men with an elevated PSA need a biopsy 10 17. Decision for a biopsy is made after discussin the pros and cons with a urology specialist.
Advanced Biomarker Tests: Newer tools like the MPS2 urine test assess genetic markers and clinical factors to predict cancer risk, reducing unnecessary biopsies 6.

Men at high risk should consider getting a PSA test at 40–45, while average-risk individuals should start discussions by age 50 2 9.

Is Prostate Cancer Genetic?

Approximately 5–9% of prostate cancers are hereditary, linked to gene mutations like BRCA2, HOXB13, and those causing Lynch syndrome 7 14. Men with these mutations face up to double the risk of developing prostate cancer and often at younger ages 3 7. Genetic testing is recommended for those with a strong family history, as it guides personalized screening plans 7 14.

Does Exercise Help Prevent Prostate Cancer?

There is no absolute evidence that regular physical activity reduces prostate cancer risk. However it improves outcomes for diagnosed individuals. Studies show Regular exercise and Weight management mitigates obesity-related risks and active men experience fewer side effects and from treatment.

Conclusion: Empowerment Through Awareness

Prostate cancer’s slow progression and high treatability in early stages make education and proactive testing in those at high risk of developing prostate cancer essential. Men over 50—and those with risk factors—should prioritize annual PSA tests and open dialogues with healthcare providers. Lifestyle adjustments, including a balanced diet and regular exercise, further reduce risk. By demystifying prostate cancer and promoting early action, we can significantly curb its impact and save lives.

"When it comes to cancer, knowing is better than not knowing." 11

Citations:

Dr Ashwin Sridhar

FRCS (Urol), MSc, PGDME

Consultant Urologist

Urology & Andrology