There are many reasons why you may need to speak to an Urologist, but one of the most common reasons is because the man is suffering with problems with their prostate. Below Jon has answered some of the most frequently asked questions:
What is the prostate?
The prostate is a small organ in men which sits underneath the bladder. It wraps around the urethra, which is the tube coming out of the bladder that you pee through. The prostate is important for a man’s fertility and sexual function.
What sort of problems can the prostate gland cause?
There are a few things that can go wrong with the prostate, but the two common problems are prostate enlargement and prostate cancer. For reasons we don’t fully understand, the prostate gland slowly grows bigger throughout a man’s life. Eventually if it gets large enough it starts to block the flow of urine. This causes symptoms such as a weak stream, not fully emptying the bladder, peeing more often or urgently, and having to get up at night. Prostate cancer usually develops after the age of 50, although it can on a rare occasion affect the younger man.
Prostate cancer can cause similar symptoms to an enlarged prostate, but often in the early stages it produces no symptoms at all and can only be picked up with blood tests (for example the PSA test) or scans.
What is the PSA blood test?
PSA stands for “prostate specific antigen”. It’s a substance produced by the prostate gland. Some of the PSA leaks out into the bloodstream, allowing us to measure the level. PSA is useful to doctors because it is only produced in the prostate gland. So, if the PSA level in the blood is high, this tells us there is something happening in the prostate.
The commonest cause of a high PSA level is having an enlarged prostate; the bigger the gland is, the more PSA it produces, and so the higher the blood level. Prostate cancer cells also produce a lot of PSA, and even a small cancer can push the level up. This makes PSA useful as a test for prostate cancer, as the level often increases before the cancer produces any symptoms, and this allows us to diagnose the cancer at an early stage when it is easier to treat.
I am worried I may have a prostate problem - what should I do?
Go and talk to someone about it! Sometimes making the decision to do this is the most difficult thing to do, but it’s easy to get it checked out and most men will not have a serious problem. You could see your GP or book in with a specialist directly.
What will happen at the appointment?
If you have a problem, we need to check whether your prostate is just enlarged, or if there is any risk of prostate cancer. We will go over your symptoms and medical history, and you will have a physical examination. Your risk factors for prostate cancer will be checked, and blood and urine tests will be taken, including a PSA. If you just have an enlarged prostate, then options for treating this will be discussed with you. If the assessment raises concerns about prostate cancer, then further tests will be needed, with an MRI scan and possibly a small procedure to take a sample from the prostate gland (a biopsy).
How is an enlarged prostate treated?
If prostate cancer is ruled out, then it’s likely that the prostate is just enlarged. Often, this does not need any treatment, particularly if the symptoms it causes are minor. Otherwise, drug treatment or surgery can be used, and are usually very successful.
How is prostate cancer diagnosed?
If there is a concern about possible prostate cancer, a detailed MRI scan of the gland is performed. If this is normal, then no further action is needed. If the scan shows a problem, this does not necessarily mean that prostate cancer is present, but it increases the risk. Most men with an abnormal MRI scan undergo a small procedure called a prostate biopsy, where a needle is placed into the prostate to remove a small sample. The sample is then analysed to see if cancer cells are present.
How is prostate cancer treated?
There are many ways of treating prostate cancer. Fortunately, the disease is often quite slow growing, and if this is the case it can be carefully monitored rather than undergo treatment and risk any side effects from treatment. Other options include surgery to remove the prostate, radiotherapy, focal treatments such as high-intensity focused ultrasound (HIFU), and drug treatments such as hormonal therapy or even chemotherapy. Treatment is usually successful, particularly when the cancer is caught at an early stage.
How can I find out more?
The UK Prostate website is a good starting point. Speak with a GP or you can book an appointment with Mr McFarlane.
