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How to check for prostate cancer

Because the main symptom is incontinence, prostate cancer tends to go undetected, which may help explain why it is still one of the main killers in men over the age of 45. Just under 35,000 new cases are diagnosed in the UK each year ? accounting for a quarter of all new male cancers. Difficulty urinating, more frequent urination and occasionally blood in the urine are important symptoms of the disease, but many men have no symptoms until the disease is advanced.

What is the prostate?
The prostrate is a walnut-sized gland below the bladder that produces the fluid that nourishes and protects sperm. Its position, wrapped round the urethra, means any growth can affect urinary flow.

What are the symptoms?
A need to pass urine frequently, as well as having to wake up in the night to urinate, are common signs - although these symptoms are more often due to benign prostatic hyperplasia, a non-cancerous enlargement of the prostate gland. Other less common signs include pain when passing urine, blood in the urine, impotence and hip or lower back pain.

Who is at risk?
If your father or brother have had the disease, or if you're a meat eater, there is a higher chance of developing prostate cancer.

How do I get tested?
The prostate makes an enzyme called PSA (prostate specific antigen) which helps to thin male fluids so sperm can swim through more easily. As PSA is only produced in the prostate gland, it is a useful marker for detecting prostate cancer when measured in a simple blood test . A number of other factors can also raise the PSA level including, in some cases, having benign prostate enlargement. PSA does not diagnose whether or not prostate cancer is present, but does give an estimate of the risk that prostate cancer is present.

• If PSA is normal there is only a 2.5% chance that a man has prostate cancer.
• If it is moderately raised there is a 20% chance of prostate cancer
• If the blood level is very raised there is a greater than 50% chance that cancer of the prostate gland is present.

It has been estimated that PSA testing plus examination by a doctor can increase the detection of prostate cancer by 32% over having an examination alone. When PSA levels rise by more than 20% per year, referral for prostate biopsy is usually recommended. There is currently much controversy over whether annual screening for prostate cancer is justified on the NHS in the UK, although it is available in other countries such as the US. Your doctor will usually arrange the test if it is clinically indicated. The blood test is also available privately for those who wish to pay for it.

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