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Be Prostate and Testis Aware this Movember and beyond

20 November 2017

Prostate cancer is the commonest cancer in men with 1 in 8 British males getting prostate cancer at some point in their lifetime. The good news is that there have been lots of advancements in the treatment of both early and advanced prostate cancer in recent times and over 330,000 British men are currently living with and after prostate cancer.

Signs and symptoms

Sometimes there are no signs of early prostate cancer. Many men have a change in their waterworks as the get older, such as slow flow or getting up at night to urinate. This is mostly due to a natural enlargement of the prostate, but it is important to look for a potential prostate cancer. It is worth an appointment with your GP or a specialist Urologist to assess urinary symptoms. Blood in the urine can be a sign of advanced prostate cancer and that certainly requires urgent assessment. A deterioration in urinary symptoms and back pain should also generate an urgent appointment for assessment as occasionally this can indicate prostate cancer that has spread to the bones.

Tests and diagnosis

An initial assessment can be done by your GP or by a Urologist. This would normally entail a blood test that is a marker for prostate cancer called PSA (prostate specific antigen).

Although screening for prostate cancer is not recommended, anyone over the age of 45 with a significant risk of prostate cancer should have an assessment with at least a PSA blood test and an examination of the prostate.  The major risk factor is a family history of prostate cancer particularly if a blood relative has prostate cancer, especially if  under the age of 70 when diagnosed.

The next step after this is either a MRI scan or for prostate biopsy. MRI scanning has become increasingly more useful in the diagnosis of prostate cancer and can mean that men can avoid a biopsy in certain circumstances. It can also help target a biopsy to an abnormal area. The 3T MRI scanner at HCA Healthcare UK’s The Wilmslow hospital has an excellent capability of doing this.

Treatment

There are many options for the treatment of prostate cancer. If it is a low risk disease a Urologist may just keep an eye on it. If it does require treatment then the prostate can be removed in some cases. Specialists can also deliver radiotherapy to the prostate. Hormone therapy can also suppress prostate cancer and chemotherapy has a role in more advanced cases. Of course, the earlier the disease is identified the better the outcome.

Testicular cancer

Testicular cancer is more common in younger men, with half of the men diagnosed under the age of 35 years old.

Signs and symptoms

Most commonly testis cancer presents with a lump on one of the testes. Many lumps in the scrotum are not due to cancer and maybe benign lumps, such as a cyst. A Urologist is best placed to examine the scrotum for a concerning lump and can often reassure and discharge based on examination alone.

Tests and diagnosis

The initial test is usually an Ultrasound scan if there is a concern based on the examination. This is done with a probe placed on the scrotum with some gel. The Urologist can get in-depth images of the testes doing this, and the state-of-the-art ultrasound machine at HCA The Wilmslow Hospital is excellent for this purpose. A specialist will also sometimes do blood tests and CT scans in the evaluation of testicular cancer.

Treatment

The outcome of treatment is extremely good for testicular cancer. It would normally involve removing the testis through a minor operation and a false one can be put in depending on patient choice. Chemotherapy is also often used.

Mr Stephen Bromage is Consultant Urological Surgeon at HCA The Wilmslow Hospital, for more information or to book an appointment please call 01625 545 036.

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