Prostate cancer

The prostate gland is part of the male reproductive system. It produces some of the fluid that makes up semen. Prostate cancer affects one in 11 Australian men and is common in the over-65 age group. Around 3,000 Victorian men are diagnosed with prostate cancer every year. Many cases are not life threatening because the cancer may be slow growing and usually occurs in older men.

Symptoms
Early prostate cancer usually causes no symptoms. When symptoms do occur, they may include:

• Difficulties starting and stopping urination
• Pain or a burning sensation when passing urine
• Urinating more often than usual, particularly at night
• The feeling that the bladder can’t be fully emptied
• Dribbling urine
• Blood in the urine or semen
• Pain during ejaculation.

• As you get older
• If you have a father or brother who had prostate cancer. The risk becomes greater if they were diagnosed at an early age.

• PSA test - the prostate makes a protein called prostate specific antigen (PSA). Large quantities of PSA in the blood can indicate prostate cancer or other prostate problems.
• Digital rectal examination - using a gloved finger in the back passage, the doctor feels for enlargement and irregularities of the prostate.
• Biopsy - six to 12 tissue samples are taken from the prostate and examined in a laboratory for the presence of cancer cells.

• Watchful waiting - sometimes your doctor will advise that treatment is not needed. However, you will still need to be examined and have PSA tests regularly to monitor any changes.
• Surgery - removal of the prostate is called a radical prostatectomy and will involve a six to 10 day stay in hospital. If the prostate can’t be removed, other surgery may be performed to remove blockages in the prostate to relieve urination problems. This operation is called transurethral resection of the prostate (TURP).
• Radiotherapy - x-rays are used to target and destroy cancer cells. Treatment usually lasts a few weeks, although this depends on the cancer and the person’s general health.
• Brachytherapy - a radioactive implant is placed inside the prostate to target cancer cells. The implant may be temporary or permanent.
• Hormone therapy - prostate cancer relies on the hormone testosterone for growth. Hormone therapy reduces testosterone levels and ‘starves’ the tumour, this is given with either medication or hormone injections. Sometimes surgical removal of the testicles (orchidectomy) is suggested which has the same effect.

• Surgery - many men will have temporary urinary incontinence (loss of bladder control). Almost all men will have a change to their sexual function and most men will have erectile dysfunction (impotence).
• Radiotherapy - A small number of men will have bowel problems. Between 40 and 80 per cent of men who have radiotherapy will experience erectile dysfunction (impotence).
• Brachytherapy - erectile dysfunction (impotence) and bowel problems can occur. Some men may experience painful urination and irritation of the bladder for several months after therapy. Urinary incontinence is not usually a problem.
• Hormone therapy - side effects may include erectile dysfunction (impotence), tiredness, hot flushes and loss of sex drive.

• Your local doctor
• Urologist specialist
• Urology or continence nurse
• The Cancer Council Victoria’s Cancer Helpline Tel. 131 120
• Multilingual Cancer Information Line, Victoria - see the CCV website for contact details
• Lions Australian Prostate Cancer website at www.prostatehealth.org.au

• Prostate cancer affects one in 11 Australian men and is most common in men over 65.
• Prostate cancer can be treated in a variety of ways, including watchful waiting, surgery, radiotherapy and hormone therapy.
• Possible side effects of treatment include incontinence and impotence; treatment options should be discussed thoroughly with your doctor.

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