Prostate Cancer Information
Information for Patients
Please visit the Clinical Trials section to see if the clinical trials currently available .
Information for the Public
Below you will find information about the prostate, prostate disorders and the range of support options available for people affected by prostate cancer. More information can be found on the Prostate Cancer Foundation of Australia and the USANZ websites.
What is the prostate?
The prostate is a gland that is part of the male urinary and reproductive systems. It is found below the bladder and in front of the bowel, and is a walnut shape, with two semi-circular lobes that encircle the urethra. The prostate is surrounded by layers of smooth muscle and is composed of thousands of small, fluid-producing glands interspersed within its blood vessels.
What is the function of the prostate gland?
The main function of the prostate is to produce seminal fluid that protects and enhances sperm, aiding the sperm's survival in the reproductive track. The prostate also functions to control urine flow and ejaculations via contractions of its smooth muscle layers.
Prostate Disorders
There are three main prostate disorders:
1. Prostate Cancer
2. Prostatitis
3. Benign Prostate Hyperplasia
Common Symptoms
While not exhaustive the following list details some common symptoms associated with a disordered prostate:
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difficulty in starting to urinate
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blood in the urine or semen
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discomfort when urinating
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a slow flow of urine that is difficult to stop, and a
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decreased libido.
While these symptoms can all be signs of other disorders like Prostatitis, prostate cancer is the only prostate-related disease that can be life-threatening. Men should be tested for it regularly from once over 50 years of age (over 40 if they have a family history of the disease).
Prostate Cancer
What is prostate cancer?
Prostate cancer occurs when some of the prostate cells reproduce more rapidly than is normal, resulting in swelling or a tumour. It is a slow-growing cancer, although it tends to be more aggressive in younger men.
Prostate cancer cells may invade other parts of the body, usually the bones and lymph nodes, producing secondary tumours ('metastasis'). Treatment is still possible after the cancer has metastasised, but currently there is no cure.
How prevalent is prostate cancer?
3,000 Australian men die from prostate cancer each year, making prostate cancer a leading cause of cancer incidence and the second leading cause of cancer mortality in Australian men. Early detection and treatment is essential for a good prognosis.
Since this disease mainly affects men in their early fifties, its incidence is expected to increase significantly over time as a result of Australia's ageing population. Evidence indicates that the economic and social burden of prostate cancer will rise extensively, unless there are significant scientific breakthroughs that are translated into alterations in clinical management.
What is involved in the diagnosis for prostate cancer?
Diagnosing prostate cancer includes digital rectal examinations of the prostate and testing for elevated levels of a protein called Prostate Specific Antigen (PSA). If either of these tests is abnormal, then a biopsy of the prostate will be performed. This biopsy is used to determine how aggressive the tumour is and what type of treatment is appropriate.
In countries with aggressive screening practices, approximately one in six men will be diagnosed with prostate cancer in their lifetimes, although autopsy studies indicate an even higher rate of prostate cancer in the population.
Screening is heavily reliant on the use of the serum test for PSA, which is prone to false positives, and thereby needs to be used in conjunction with a Digital Rectal Exam and biopsy.The prostate can be sampled for the presence of cancer by needle biopsy under ultrasound or CT guidance, but many cancers are missed by biopsy. For those cancers found, management is complicated by the fact that prostate tumours appear multi-focal within the gland and have markedly variable biology.
Some tumours are almost completely inactive and would require no therapy, whilst others are rapidly growing or metastatic and are thereby life-threatening. This is why better biomarkers are needed to help stratify the disease into the different types and to find the most appropriate treatment.
What are the treatments for prostate cancer?
Treatment options for prostate cancer are primarily:
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surgery
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radiation therapy
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hormonal therapy, and
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chemotherapy.
What are the chances of recovery?
If appropriate treatment is started while the cancer is still solely in the prostate gland, a cure is possible. This is why early diagnosis is critical. There are a wide range of programs and groups available to provide support and assistance to patients and their families.
Prostatitis
This is a benign, non-life threatening condition that is caused by inflammation of the prostate gland. This condition may cause the prostate to feel sore and irritated and may result in discomfort deep within the pelvis.
There are four types of Prostatitis: Acute prostatitis; Chronic bacterial prostatitis; Chronic prostatitis/chronic pelvic pain syndrome or chronic nonbacterial prostatitis; and asymptomatic inflammatory prostatitis.
Benign Prostatic Hyperplasia (BPH)
It is common for the prostate to enlarge as men age. Benign prostatic hyperplasia (BPH) results from an abnormal increase in the number of prostatic stromal and epithelial cells. This excessive cell division results in the formation of large cell clusters in the prostate. There are two main types of growth:
1. Prostatic cells multiply around the urethra. This type of growth causes the prostate to squeeze the urethra.
2. Middle-lobe prostate growth. Cells grow into the urethra and bladder outlet area. This type of growth generally requires surgery.
BPH is quite common in older men. The prostate starts to get bigger after age 30; this growth ultimately causes discomfort by placing pressure on the urethra and bladder. Symptoms of BHP include:
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blood in the urine (i.e., hematuria)
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dribbling after urination has been completed
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feeling that the bladder has not emptied completely after urination
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frequent urination
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hesitant, interrupted, or weak urine stream
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leakage of urine
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pushing or straining to begin urination
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recurrent, sudden, urgent need to urinate.
Treatment of BPH may include:
1. Medical treatment
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Alpha-blockers can be used to relax the smooth muscle surrounding the prostate and at the head of the bladder, decreasing the pressure on the bladder and urethra.
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5-alpha reductase inhibitors act to prevent the conversion of testosterone into the active form, stopping any further growth of the prostate gland.
2. Surgery
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Transurethral resection of the prostate (TURP) is where an instrument is inserted through the penis, into the urethra. This instrument is then used to shave away part of the urethra, relieving the flow of urine from the bladder.
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Laser procedures are less invasive than TURPs. These involve the removal of the obstructive tissue in the prostate by laser.
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Microwave procedures produce sufficient energy in the prostate to cause necrosis of the prostate tissue. This decreases the size of the prostate and removes obstructions from the urethra.
Prostate Cancer Support Groups
There are a variety of support groups available to assist anyone affected by prostate cancer, including:
The Prostate Cancer Foundation of Australia (PCFA) is Australia's peak national body for prostate cancer funding, support, information, and awareness. The PCFA has a national network of more than 80 Support Groups in every Australian State and Territory. The groups meet locally to provide personal support and to raise awareness of early detection.
The Cancer Council Helpline is a confidential telephone counselling service available to anyone affected by cancer-sufferers, health professionals, family, friends, students, and teachers. Phone 13 11 20, or visit the Council's website to find out more.
Cancer Australia is a section of the Australian Government that is committed to national cancer control, prevention, treatment, and care. The Cancer Australia site has useful resources related to setting up peer support groups.