Prostate cancer is the most common form of cancer in men, with one in eight men experiencing it in England at some point. It’s more common in men over the age of 50, black men, and men with a family history of the disease. The earlier the condition is caught, the easier it is to treat, so it’s important to be aware of the risk factors and symptoms.
Risks and symptoms of prostate cancer
As we’ve already mentioned, the biggest risk factors for prostate cancer are age, ethnicity, and family history. Being overweight may increase the risk of getting more aggressive or advanced forms of prostate cancer. However, doctors do not fully understand what causes it or why some people are more susceptible.
Prostate cancer in the earlier stages often does not have any signs and symptoms because it grows slowly and may be contained within the prostate, so it’s important to understand your level of risk. Some men may experience urinary problems such as blood in the urine, needing to urinate more often, or finding it more difficult to urinate.
In advanced prostate cancer that has spread to other parts of the body, signs may include back pain, bone pain, fatigue, weight loss, weakness in the limbs, urinary incontinence, and erectile dysfunction (ED).
How is prostate cancer treated?
Prostate cancer treatment depends on the stage and grade of the cancer, and the overall state of health of the patient. There are many different options, including active monitoring, surgery, radiation therapy and medicines.
Surgery is carried out when the cancer hasn’t spread outside the prostate, and the patient is otherwise generally fit and well. It may also be used if the cancer has just started to spread to other areas of the body, or has come back after radiotherapy.
Prostate cancer surgery is known as radical prostatectomy, and is a major operation with several risks and side effects. The risks include bleeding, infection, blood clots, and injury to nearby tissue. Side effects may include urinary difficulties and ED, even if the surgery is ‘nerve sparing’ (removing the diseased parts while leaving the nerves intact).
Men who experience ED as a result of prostate cancer should not suffer in silence however, because their medical team will be able to offer advice. The first line of treatment is usually PDE5 inhibitors such as sildenafil, which can be bought online after a short consultation with a pharmacist to check that you are a suitable candidate.
Technological advancements, including robotic assisted surgery, have made the procedure more accurate and effective in recent years. However, most men still experience temporary or long term ED after prostate cancer surgery.
A breakthrough for more accurate surgery
The Guardian reports that a breakthrough has been made for a more precise form of prostate cancer surgery that almost doubles the chances of men retaining erectile function compared to standard surgery. The procedure is known as NeuroSafe, and it enables doctors to remove the prostate while preserving the surrounding nerve tissue.
A clinical trial has taken place across five hospitals in England, and involved 344 men undergoing surgery with no previous history of ED. Half of the men received the NeuroSafe procedure, while half had standard surgery. A year later, 56 per cent of the men who had standard surgery had severe ED, compared to 38 per cent who had the NeuroSafe option.
Furthermore, 23 per cent of men who had the standard procedure reported no or only mild ED, compared with 39 per cent of men who had the NeuroSafe procedure. The results of the trial are published in the Lancet Oncology.
Prof Greg Shaw, the trial lead and a consultant urologist at University College London hospitals said: “This procedure gives surgeons feedback during the surgery to give them the certainty they need to spare as many nerves as possible and give men increased hope of recovering their sexual potency after their cancer is surgically removed.”
Dr Matthew Hobbs, the director of research at Prostate Cancer UK, said: “Prostate cancer surgery is a life-saving option for lots of men, but it’s a major procedure that can cause side-effects like erection problems. A major challenge we face is how to cure men but also ensure they can live life to the full afterwards.”
“This study is promising and provides evidence that innovative types of surgery can reduce erectile dysfunction in some men. However, more research is needed to prove whether NeuroSafe is as effective as traditional techniques at delivering a complete cure.”
“We also need to understand exactly which men could benefit from this new technique and, crucially, whether this technique could be delivered at scale across the NHS to make it accessible to men across the UK.”
More effective detection for prostate cancer
There is an ongoing debate about how prostate cancer should be best detected. Men’s health campaigners and some healthcare professionals want prostate specific antigen (PSA) tests to become part of a national screening programme. Currently, they are only offered to men with symptoms, although men in high risk groups do have the right to request one.
However, some healthcare professionals argue that the test is not 100 per cent accurate and can give false positives. This may result in men undergoing invasive and unnecessary procedures.
A new study led by Oxford University has found a new and more accurate method of carrying out prostate biopsies, which could lead to more accurate diagnosis.
Professor Richard Bryant, the study’s Chief Investigator from the University of Oxford’s Nuffield Department of Surgical Sciences, said “Almost 100,000 men are investigated for prostate cancer every year in the UK, and it is extremely important that we get this right.”
“The results from the trial now provide the evidence necessary to help urologists, and their patients, decide how best to perform prostate biopsy. There have been several excellent trials in this space over the past year with inconclusive results. We have now conducted the largest trial in this field, and are excited to provide definitive results.”
However, it is reported that the new method is more painful for patients, and it also takes longer to carry out. Research remains ongoing into less invasive methods of diagnosing prostate cancer.
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