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Urological Conditions

Prostate Cancer

What is Cancer?

Your body is made up of millions of cells which continuously renew themselves to replace old or damaged tissue. When the renewal process gets out of control whereby more cells grow than die they begin to form growths or tumours.

These tumours can either be benign (non cancerous) or malignant which are cancerous and can invade and damage healthy tissue.

Sometimes cancer cells can break away from the original site and settle in other parts of the body causing further damage. When this happens the cancers that have spread are called 'metastases', 'mets' or 'secondaries'.

About Prostate Cancer

The cause of prostate cancer is unknown, although it is more common in some ethnic groups than others and diet may be involved. There is some evidence that it runs in families. You have a slightly higher chance of developing it if you have a father or brother with prostate cancer. The more aggressive the cancer is, the greater the threat it poses to your life-expectancy.

Prostate cancer can present with a whole range of diverse symptoms, not all related to the waterworks. Men’s concerns, however, regarding the presence of this tumour are mostly raised if they start to develop bothersome urinary symptoms (link to LUTS above)Investigations into these symptoms will include examination of the prostate gland as well as measurement of PSA. Should you have concerns regarding prostate cancer for other reasons, it is perfectly reasonable to ask your doctor for a PSA (link to: What is PSA? In FAQ’s)

Diagnosing prostate cancer

Simon Bott talks about diagnosing prostate cancer

Prostate cancer is a very common condition. It can be found in 50% of men in their 50s and almost all men by the time they reach their 9th decade. However, most men who get prostate cancer will be unaware of it and live a normal, full, healthy life.  A significant proportion, 14-17% of all men, will develop symptoms and some will unfortunately die due to the disease. Currently prostate cancer is the most common cause of cancer death in men, killing over 10,000 men in England and Wales each year. It is therefore important to correctly identify whether a man has prostate cancer, but perhaps more importantly to identify men with prostate cancer that matters. This is done by prostate scans (MRI scans) and by taking small pieces from the prostate (a prostate biopsy).

At Urology Partners we are at the forefront of developing improved ways to diagnose and correctly categorise prostate cancer. We were the first surgeons to describe the template prostate biopsy (Bott 2003 British Journal of Urology), a tool now used around the world, which allows a more thorough prostate examination. We use state of the art MRI scans (3T-multiparametric MRI) to reduce the need for unnecessary biopsies and also enable us to target suspicious areas in the prostate. We are also now able to fuse together the MRI scan pictures with the pictures we obtain at the time of the biopsy (Fusion targeted prostate biopsies) to increase the accuracy of the biopsy. The first step in the diagnosis of prostate cancer is a blood test called the PSA. This test is not specific to prostate cancer but is specific to any process going on in the prostate. This means that a raised PSA blood test does not necessarily mean you have prostate cancer but it does mean further investigation is required.

At Urology Partners we first assess you by asking questions about your waterworks, whether anyone in the family has prostate problems and about your general health. We will then examine you and perform a digital rectal examination. We will discuss with you the next step which may be an MRI scan of your prostate.   

Stages of prostate cancer

When Prostate cancer is diagnosed it can be described as 'early', locally advanced or 'late'. It starts with changes in the cells of the prostate. The cells form a lump which may eventually be felt in a physical examination. When prostate biopsies are taken they are examined by a pathologist who will report the grade of cancer present in the cells. The Gleason system is used to grade prostate cancer and describe how aggressive the cancer is.

A Gleason score of 2 - 4 is least aggressive, a score of 5 - 7 is moderately aggressive and a score of 8 - 10 is the most aggressive.

If you have been diagnosed with prostate cancer, the Predict Prostate tool from the NHS may help you with deciding how to manage your diagnosis and the options of treatment available. Click here to use this tool 

Further Information on Diagnostics:

3T mpMRI
Transperineal Template Biopsy