Over 35,000 men in the UK are cases diagnosed with prostate cancer every year in the UK. It is the most common cancer in men over the age of 55 years, and an estimated 1 in 14 men will develop the condition.
WHO IS AT RISK?
There are a number of risk factors for prostate cancer:
Prostate cancer mainly affects men over the age of 65. It is rare in men under the age of 40 years, but more than 1,000 men under the age of 55 years are diagnosed with prostate cancer each year in the UK. Up to 40% of these "early-onset" cases of prostate cancer are thought to be caused by inherited forms of the condition.
Afro-Caribbean men have relatively high rates of prostate cancer. The lowest rates are found in Asian men.
Family history of prostate cancer
Having a brother or father with prostate cancer increases your risk compared to men with no family history of the disease. If a close member of your family was diagnosed with prostate cancer under the age of 40, you are at a higher risk of developing the condition.
Family history of breast cancer
The risk of prostate cancer increases slightly in men who have a strong family history of female breast cancer and vice versa (National Cancer Institute). This is thought to be because two genes carried by both men and women (called BRCA1 and BRCA2) increase the risk of breast cancer in women and prostate cancer in men (Cancer Research UK).
A diet high in saturated fats and red meat may lead to an increased risk of developing cancer including prostate cancer.
WHAT IS THE PROSTATE GLAND?
The prostate gland is located just below the bladder. It is only found in men and is responsible for helping to produce the fluid in semen. The gland is tiny at birth but grows in size after puberty due to rising levels of the male hormone, testosterone.
WHAT CAUSES PROSTATE CANCER?
Prostate cancer occurs when normal, healthy cells, which are carefully regulated in the body, begin to reproduce uncontrollably in the prostate gland. In most cases the growth is slow and the cancer can go undetected for many years because it causes very few symptoms. In some cases, however, prostate cancer grows quickly and may spread to other parts of the body, such as the lymph nodes or bones.
SIGNS AND SYMPTOMS
There is no single symptom to indicate the presence of prostate cancer. Problems with the prostate are common; they may not necessarily be caused by cancer, and may result in slowly developing symptoms that can easily be confused with "getting older".
Because the prostate gland surrounds the tube known as the urethra, which passes urine from the bladder to the outside of the body, any prostate disease or growth (benign or malignant) is likely to cause problems with urination.
Common symptoms include the following:
Slow or weak flow of urine
Urinating more frequently or urgently than usual
Difficulty starting to urinate
Pain or burning sensation when urinating
Difficulty getting or maintaining an erection or pain during ejaculation
Constipation, altered bowel habit, or not feeling the bladder is completely empty.
Less common symptoms include the following:
Unexplained urinary infection or pain in the groin, back or hips
Blood in the urine or semen
Testicular cancer, the most common cancer in younger men aged between 15 and 45, and it's increasing. There are nearly 2,000 cases per year. The most common way this cancer is identified is by finding a lump in the testicle. Therefore, men falling into this age group should be encouraged to examine their testicles for lumps on a regular basis. Recent surveys suggest that many men are unaware of testicular cancer or prefer to ignore it, and that few men check their testicles.
In over 25% of cases, the cancer has already spread by the time of diagnosis. Despite this, today more than 95% of patients are cured with chemotherapy. If caught at an early stage, the probability of a successful cure is more than 98% with the treatment being much simpler and may only require surgery to the diseased testicle.
POSSIBLE RISK FACTORS
Unlike many cancers, there are few known strong risk factors for testicular cancer, and we cannot currently predict who is likely to get the disease. While most of these cancers occur in unsuspecting individuals, some risk factors can be traced in a minority of cases. These include:
Men born with an undescended testicle or where the testicle fails to descend into the scrotum. Research has shown the risk of testicular cancer increases dramatically if this is not corrected by the age of 11
A brother/father with testicular cancer
A previous history of testicular cancer
A sedentary life style increases, the risk but regular exercise reduces risk
Mumps (a rare complication called mumps orchitis) may have an increased risk
Repeated trauma (rather than inevitable knocks) increases risk
Men with HIV have a slightly higher incidence of testicular cancer, for more information please follow this link.
A recent study has shown a correlation between smoking marijuana and an increased risk of testicular cancer
SIGNS AND SYMPTOMS
Most testicular cancer cases are diagnosed because of changes to the testis such as:
- A painless lump or hardening in either testicle
- A feeling of heaviness in the scrotum
- Swelling or enlargement of either testicle
- An unusual collection of fluid in the scrotum
Occasionally, patients may be diagnosed because they become generally unwell (e.g. with night sweats, loss of appetite and weight loss or persistent backache, aching in the lower abdomen, back or groin) due to tumour spread outside the testicle, or develop tenderness in the breast. Some patients will experience no symptoms at all, especially in the early stages.
From puberty onwards, it is important that all men are aware of what is normal for themselves (there are slight differences in everybody). One testicle may hang lower than the other and be different in size.
The critical issue is looking for changes. These changes can be caused by a number of other conditions and are not always cancerous. In fact, as most lumps are benign, most patients with testicular discomfort don't have cancer. But it is important to visit your doctor if symptoms do persist for more than a week.If you do notice any changes, particularly hardening or heaviness, you should not allow your natural embarrassment to delay discussing this with your doctor as soon as possible.
TESTICULAR SELF EXAMINATION PROCESS
A massive 98% of testicular cancer cases can be treated if caught earlier enough. So come on boys 'check yourself out'!
The TSE process itself takes only a few minutes and should be done on a monthly basis.The best time to perform TSE is during or after a warm bath or shower when the scrotal sac is warm and relaxed.
1. Check each testicle separately using one or two hands.
2. Roll each testicle between the thumb and forefinger checking that the entire surface is free of lumps (Fig 1).
3. Become familiar with the feel of the epididymis collecting tube, which runs behind the testicle. This is normal and is often mistaken for new growth. Lumps in the epididymis are more common and almost invariably benign (Fig. 2).
4. Men should be encouraged to see their doctor immediately if they find any new lumps
The entire surface of both
testes is felt carefully
Be aware of the epididymis, the long narrow tube,
behind each testicle that matures and stores sperm
Cancer of the penis is very rare in the Western world; it is most often diagnosed in men over the age of 60 years, though can occur in younger men too. There are about 400 cases in the UK every year.
It is usually a slow growing cancer and if caught early, before spreading further the chances of survival are high. Cancer can develop anywhere in the penis, but the most common places are under the foreskin and on the head (the glans).
The exact cause of penile cancer is not known - however:
Infection with a type of virus that causes penile warts, HPV (human papilloma virus) also increases the risk of cancer of the penis. Practicing safe sex is therefore thought to reduce the risk.
Skin diseases that are associated with cancer of the penis include Lichen Planus, Lichen Sclerosus (also known as Balanitis xerotica obliterans) and the precancerous conditions Bowen's Disease and Erythroplasia of Queyrat (collectively called "Carcinoma-in-Situ"). If left untreated these could lead to cancer, so it is important to see your doctor and receive the necessary treatment.
It is much less common in men who have been circumcised soon after birth. This is because men who have not been circumcised may find it more difficult to pull back the foreskin enough to clean thoroughly underneath.
Your risk of developing cancer of the penis is greater if you smoke or you have a weakened immune system.
As with all cancers a healthy balanced diet, regular exercise and adequate sunshine are important.
WHAT TO LOOK OUT FOR?
It is important - as with any cancer - to get to know what feels normal, and watch out for any changes that don't go away:
A painless lump or ulcer on the penis that doesn't heal
A red rash under the foreskin
Flat growths of bluish brown colour
Difficulty in drawing back the foreskin (phimosis)
Unusual smelling discharge
Unexplained change in colour of the skin
Swollen lymph nodes in your groin area
Advanced cancer of the penis could lead to fatigue, stomach pains, aching bones and weight loss. Any of the above symptoms could be the cause of a number of other conditions, requiring their own treatment plan, and still need to be checked out by your GP.
WHAT TO DO IF YOU ARE WORRIED
Like most cancers, cancer of the penis is easiest to treat if it is diagnosed early, so if you have any worries, it is best to go to your doctor straight away.
You should not let your natural embarrassment get in the way - this visit could save your life!
Your doctor will inspect the penis, then as with all cancers, if he is worried he will refer you to a specialist who will take a sample (biopsy) of the abnormal area, usually under anaesthetic. The sample will be examined under a microscope to identify whether or not it is cancerous. The results are normally available within one to two days. If the biopsy confirms that it is cancer, further tests may be carried out to determine whether the cancer has spread to other parts of the body. These tests could include the removal of a gland or glands from the groin (called a lymph node biopsy), a CT scan (like a three-dimensional X-ray of the whole body), an MRI scan (similar to a CT scan), Ultrasound or a chest x-ray.
The extent to which the cancer has spread is divided into a number of stages, which are important to determine the treatment right for you and your prognosis:
1 Cancer is found only on the surface of the penis
2 Cancer has spread deeper into the penis tissue
3 Cancer has spread to the lymph nodes of the groin
4 Cancer has spread to the lymph nodes of the groin
5 Cancer has spread to other parts of the body