Public understanding of prostate cancer is very poor, yet the condition is increasing in prevalence

Prostate cancer is predicated to become the most common cancer in the UK by 2030, according to a recent report – Prostate cancer: Britain’s growing problem – by leading men’s cancer charity Orchid. This is a frightening prospect, considering the disease already takes 31 lives every day.

While steps have been taken in both diagnosis and treatment, and mortality rates are set to fall by 16 per cent by 2035, much more needs to be done to improve the outlook for prostate cancer patients. Orchid’s report urges the Government to provide more funding and support to continue combatting the disease.

A lack of knowledge about the prostate – only 43 per cent of men know where the prostate is and less than 15 per cent know what it does – coupled with men’s reluctance to visit a GP are the main barriers to improving prostate cancer diagnosis. As with other cancers, the mortality risk from prostate cancer is greatly increased the later it is diagnosed. Therefore, it is vital to ensure men can identify the symptoms and know when to seek help. Orchid hopes that increased knowledge can go some way to reducing the 23 per cent of cases that are diagnosed in A&E at the point when patients are unlikely to survive another year.

Alongside the report, Orchid also commissioned a survey to gauge the public’s knowledge of the disease. Rebecca Porta, Orchid’s chief executive, voiced her concern that the survey found “men knew far more about women’s cancers and were encouraging their partners to check regularly for lumps, but were not doing it for themselves.”

Identifying symptoms

The prostate gland is found only in men. Usually the size and shape of a walnut, it sits underneath the bladder and surrounds the urethra. Its function is to help make the fluid that mixes with sperm to create semen. Prostate cancer occurs when cells start to grow in an uncontrolled way, which can put pressure on the urethra. It does not cause symptoms until it has progressed far enough to put pressure on the urethra. This makes it important to refer men to a GP if they:

• Need to urinate more frequently, often at night
• Have difficulty starting to urinate
• Have a weak urinary flow
• Feel like the bladder is not emptied fully.

It should be noted that these symptoms can also be caused by other conditions, such as prostatitis or diabetes, and may not indicate cancer. Unexplained weight loss, a loss of appetite and pain in the testicles, bones or back can be red flags that the cancer has spread. It is therefore important for men to get any symptoms or concerns checked out by a GP.

At risk groups

Providing important information to men who are at a greater risk of prostate cancer can help to improve early diagnosis. Rebecca Porta highlights Orchid’s ‘FACE up to prostate cancer’ campaign as the best way for pharmacy teams to help identify those at risk:

• Family history – men with a family history of prostate cancer have a risk that’s two to three times higher than those without.
• Age – the risk of prostate cancer is much higher in men over 50.
• Changes in urine habits – the symptoms of prostate cancer mostly affect the urinary system.
• Ethnicity – men from black African or Caribbean communities are at a much higher risk, especially once thay are over the age of 45. Identifying men who fall within these categories and having conversations about prostate cancer can give men the confidence and encouragement to visit a GP to check any symptoms.

Patient care

If a tumour is not life threatening, patients with prostate cancer are put on an active surveillance scheme, which means their condition is monitored. Regular tests and biopsies help to discover any signs of advancement as early as possible. However, for many men, repeat visits to the doctor to determine the progression of their cancer can be very distressing, so it is important to provide as much support as possible.

Although surgery, radiotherapy and cryotherapy are all effective at combatting prostate cancer that has not spread to other areas of the body, they each come with a high risk of side effects, such as urinary incontinence or erectile dysfunction, which can have a significant lifestyle and emotional impact. This is why Orchid is campaigning for more trained specialist nurses who can help answer concerns and provide support through the whole process, from diagnosis until after treatment. Rebecca commented that “the services that women get during a breast cancer clinic are absolutely excellent and we would like to see that in prostate cancer”.

The side effects that can be caused by prostate cancer treatments are well catered for in pharmacy. Advising men on products to help with urinary incontinence for example, can help to diminish the emotional stress of these conditions. Equally, monitoring the wellbeing of patients and answering any concerns can reassure and support men during a worrying time.

To find out more about pancreatic cancer, read TM's interview with Orchid's chief executive Rebecca Porta.

Prostate cancer is predicated to become the most common cancer in the UK by 2030