Prostate cancer testing

The prostate is a small walnut-shaped gland found only in men. It surrounds the urethra, which is the tube through which urine passes from the bladder to the penis. As men get older, the prostate may become larger. This benign growth can squeeze the urethra and cause men to have difficulties urinating.

Problems with urinating are common in men over 50
In Victoria, about one in three men over 50 have problems with urinating. These problems include:

Difficulty starting
Slow stream
Urinating more frequently than usual, especially at night
Dribbling of urine after urinating
Pain or a burning feeling when urinating
Appearance of blood in the urine.

If you have any of these symptoms, particularly blood in the urine, see your doctor. They are not necessarily signs of prostate cancer. They are most likely to be caused by:

A non-cancerous growth called benign prostate enlargement
A prostate infection.

Early prostate cancer does not normally cause symptoms.

The cause of prostate cancer is not known
It is not known why some men develop prostate cancer and others do not. It is known that the likelihood of prostate cancer increases with age. In early stages, the growth of the cancer is dependent on the male hormone.

Most prostate cancers are not life-threatening
Because most prostate cancers grow only slowly and occur in older men, they are often not a threat to life. Prostate cancer diagnosed in younger men (50–75 years) is more likely to threaten health.

There are two common tests for prostate cancer
One of the current tests for prostate cancer is a physical examination and the other is a blood test. Neither of these tests is 100 per cent accurate. If the tests suggest you may have a problem, your doctor will probably refer you to a specialist for further tests. Usually a biopsy (removal of some prostate tissue) is needed to confirm whether or not you have prostate cancer.

Treatment for early prostate cancer
There are currently three courses of action or treatment available for localised prostate cancer (where the cancer has not spread beyond the prostate gland). They are:

Watchful waiting (no immediate treatment, but can be offered if the cancer grows).
Radiation therapy (more than one type).
Surgery.

We are not certain which treatment is best; however, there is some evidence of benefits for men who have surgery. Men with early prostate cancer usually live for many years, regardless of treatment.

Radiation therapy and surgery can have side effects such as erectile dysfunction and incontinence that affect quality of life.

Treatment for advanced prostate cancer involves reducing the availability of the male hormone. This can be done with tablets, injections or surgery.

Discuss testing with your doctor
Medical authorities do not recommend that all men should be tested for prostate cancer. Some men prefer to have a test anyway, to reassure themselves. Men with a family history of prostate cancer (father or brother diagnosed at an early age) may also consider a test. Ultimately, it is a decision only you can make. If you are unsure, discuss it with your doctor.

Where to get help

Your local doctor
The Cancer Council Victoria’s Cancer Helpline Tel. 13 11 20
Lions Australian Prostate Cancer Website, www.prostatehealth.org.au

Things to remember

Prostate cancer generally occurs in men over 65.
Prostate cancer in men 50-75 years of age can be life-threatening.
Early prostate cancer does not usually cause symptoms.
Urinary symptoms are commonly due to benign prostate growth.
Related articles:

Cancer explained.
Men's health.
Prostate cancer.
Prostate checks.

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Article publication date: 25/05/1999
Last reviewed: 31/08/2007

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