Prostate cancer, which can often be treated successfully when caught early, is being missed by thousands of men because it often produces no symptoms. Although four out of five people who develop the disease survive for 10 years or longer, it still kills 12,300 men in the UK every year.
Around 68,000 men are diagnosed with prostate cancer in the UK each year, making it the most common cancer affecting men. Many may be unaware they are at increased risk until the disease is detected. Latest Cancer Research UK figures show it is the second most common cause of cancer death nationally, killing 33 men every day. Each year around three-quarters (76%) of prostate cancer deaths in the UK are in people aged 75 and over.
Risk factors men should know
Dr Jiri Kubes, medical director at the Proton Therapy Centre in Prague, said: "One of the biggest challenges with prostate cancer is that men can feel perfectly well while the disease is developing. Waiting until something feels wrong is not necessarily the best approach, particularly for men who already have recognised risk factors."
Dr Kubes highlights three particularly important risk factors: age, ethnicity and family history. The risk rises significantly after the age of 50. Men of Black African or Black Caribbean heritage are at higher risk and are more likely to develop the disease at a younger age. Having a close relative, such as a father or brother, who has had prostate cancer also increases the chances of developing it.
A family history of certain other cancers, including breast and ovarian cancer, may also be relevant because of inherited genetic changes. Around one in eight men will develop the disease during their lifetime, a risk factor that increases to one in four for Black men, according to Prostate Cancer UK.
"Knowing your family history is particularly important. If your father or brother has had prostate cancer, or there is a history of certain cancers in your family, it is worth discussing this with your doctor, even if you have no symptoms yourself," Dr Kubes says.
Symptoms to watch for
According to the NHS, prostate cancer often has no symptoms at first. It explained: "Prostate cancer usually starts to grow on the outer part of the prostate. This means it does not press on the tube that carries urine from the bladder to the penis (urethra) and cause symptoms, until the cancer has grown or spread."
If this happens, it can cause changes to the way you pee, such as difficulty starting to pee or straining to pee, a weak flow of urine, "stop start" peeing, needing to pee urgently or often (or both), feeling like you still need to pee when you've just finished, and peeing during the night.
Other symptoms can include erectile dysfunction, blood in the urine or semen, and lower back pain and losing weight without trying to, which may be symptoms of advanced prostate cancer. Dr Kubes added that symptoms such as difficulty passing urine, a more frequent need to urinate or blood in the urine should always be investigated. However, he warned these symptoms can also be caused by non-cancerous conditions, and their absence does not rule out prostate cancer.
When to talk to a GP
For men concerned about their risk, a conversation with a GP can help establish whether a prostate-specific antigen (PSA) blood test is appropriate. The test measures a protein produced by the prostate gland. An elevated result does not automatically mean cancer is present, but it may prompt further assessment, potentially including an MRI scan or biopsy.
Dr Kubes says: "The important thing is for men to be informed, rather than frightened. Understanding your personal risk and discussing the options with a medical professional gives you the opportunity to make decisions about your health based on evidence, rather than waiting for symptoms to appear."
Awareness cannot prevent every case of prostate cancer, nor does having a risk factor mean a man will inevitably develop the disease. But understanding who is more vulnerable can help men make informed decisions about testing and ensure that concerns are addressed before symptoms become the trigger for seeking medical advice.
