What is prostate cancer? New screening trial to detect deadly disease unveiled

What is prostate cancer? New screening trial to detect deadly disease unveiled

On International Men's Day (November 19), the government and Prostate Cancer UK launched a £42 million screening experiment to investigate ways to identify the most common male cancer in the nation early on.

Hundreds of thousands of men will be involved in the groundbreaking trial known as TRANSFORM, which will identify prostate cancer using screening techniques such as MRI scans.

Prostate cancer is the most prevalent form of cancer among men, and there is currently no screening programme in place.

New screening techniques may provide more reliable results from the experiment than the existing blood tests, which frequently indicate prostate cancer when none is present and can miss some tumors.

So what is prostate cancer and what should men be on the lookout for? Find out what you need to know below.

What is the prostate?

The prostate is a part of the male reproductive system and is located in the pelvis, between the penis and the bladder.

It’s a small gland around the size of a walnut, and its function is to produce a white fluid that partly makes up semen.

Men, trans women, non-binary people who were assigned male at birth, and some intersex people have prostates.

What is prostate cancer?

Prostate cancer can develop “when cells in the prostate start to grow in an uncontrolled way,” according to Prostate Cancer UK.

It is the most common cancer in men, as one in eight men is diagnosed with it in their lifetime.

In the UK, around 400,000 men are living with prostate cancer or have had prostate cancer.

What are the symptoms of prostate cancer?

Prostate cancer typically develops slowly so men might not notice any signs for years.

Symptoms that do appear usually happen when the prostate becomes large enough to impact the urethra, which is the tube that carries urine from the bladder and out of the penis.

These symptoms include:

  • an increased need to pee

  • straining while you pee

  • a feeling that your bladder has not fully emptied

These symptoms can also be caused by prostate enlargement but should be checked by a doctor.

What are the causes of prostate cancer?

The causes of prostate cancer are unknown but some men are more at risk than others.

Men are more at risk of developing prostate cancer as they get older, with most cases developing after the age of 50.

According to the NHS, prostate cancer is more common in black men and less common in Asian men.

Additionally, men whose fathers or brothers were affected by prostate cancer are at slightly increased risk themselves.

Obesity may also increase the risk of prostate cancer.

What are the tests for prostate cancer?

While there is no single test for prostate cancer, commonly used tests include blood tests, a physical examination of the prostate, an MRI scan, and a biopsy.

Previously, a study found the diagnostic process for prostate cancer is now safer, which brought the UK a step closer to introducing a national rollout scheme.

Concerns regarding potential harm and side effects when being screened for the disease have been a hotly debated topic in the medical world.

This can include biopsies and unnecessary testing which could cause infections, as well as increasing unnecessary anxiety for men.

Now researchers from Prostate Cancer UK have further researched prostate screening using both clinical trials and real-world data to determine if the “seesaw has been tipped”.

Before 2019, men with a high level of PSA in their blood were sent straight for a biopsy, which could cause pain and bleeding, and came with a risk of serious infection. These biopsies could also sometimes miss the cancer, leading to repeated biopsies with further risks of infection and uncomfortable side effects.

According to their analysis, on average, 67 per cent fewer men experienced harm during the diagnostic process. Two new techniques have been crucial to this reduction in harm – multiparametric MRI scans (known as mpMRI) and transperineal guided biopsies.

Widespread screening can reduce deaths from prostate cancer by 20 per cent, but a national rollout has been impossible while the benefits have been outweighed by the drawbacks. The UK may now finally be in a position to roll out a screening programme for prostate cancer, according to Prostate Cancer UK research.

How is prostate cancer treated?

Some people in the early stages of prostate cancer may not get treatment. The NHS says that doctors may suggest either “watchful waiting” or “active surveillance”.

However, prostate cancer can sometimes be cured if treated in the early stages by surgically removing the prostate or radiotherapy, so it is important to persist if you have concerns. And a national rollout will help demystify the process and help diagnose more men in the early stages, so that lives can be saved.

If prostate cancer has been diagnosed at a later stage after it has spread, treatment will focus on prolonging life and relieving symptoms. Stage four cancer means it has metastasised - and has spread further than the prostate into the body. This often means it is terminal.

Treatment options can produce side effects, such as erectile dysfunction and urinary symptoms, so some people may choose to delay treatment until there’s a risk the cancer might spread, according to the NHS. However, the study has now shown that diagnosis safety has improved greatly.

There are newer treatments available at some hospitals, including high-intensity focused ultrasound (HIFU) and cryotherapy, but the long-term effectiveness of these treatments is not known yet.