Island Life Magazine Ltd February/March 2011 | Page 116

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Island Life - February/March 2011

Surgeon: Dr Vaughan Daniels

Disorders of the Prostate
Prostate Cancer and Benign Enlargement
of the Prostate

The prostate is an organ which sits at the
base of the bladder, deep in the pelvis, in
men. Its role is to produce fluid, which
contributes to the ejaculation, which creates
a healthy environment for sperm. The
urethra, the tube which takes urine from
the bladder down the penis to the outside,
passes through the prostate.
The most feared disorder of the prostate
is prostate cancer. This is the commonest
cancer affecting men, and accounts for
a quarter of all cancers in men. In 2008,
approximately 36,000 new cases were
diagnosed in the United Kingdom and
annually approximately 10,000 men die from
prostate cancer(1). Unfortunately, prostate
cancer tends not to cause symptoms until at
a relatively late stage. Some prostate cancers
are detected on examination of the prostate,
but the majority are found as a result of a
blood test called PSA (Prostate Specific
Antigen). This measures a protein in the
bloodstream produced by the prostate, which
is elevated in prostate cancer. Unfortunately,
PSA is not a perfect test, as other conditions
such as benign enlargement of the prostate
and urinary infections can also produce
increases in PSA. Men with a raised PSA and
abnormal prostate examination usually need
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to undergo a prostate biopsy.
Not all prostate cancer requires treatment,
particularly as the rate of growth of these
tumours can be very slow, often taking ten
years or more before the cancer causes
significant health problems. In older men,
with slow growing cancers, often the PSA
is simply monitored to establish the rate of
growth. Similarly in younger men with small
volume disease, active surveillance is often
an appropriate option. In those with prostate
cancer confined to the prostate, surgery to
remove the prostate, or radiotherapy, can
be curative. Because prostate cancer relies
on hormones for its growth factors, even
in those with advanced prostate cancer
which has spread to other areas of the body,
hormonal blocking treatment can be used to
control the disease and prevent progression,
often for many years. The available treatment
options can seem confusing, and individual
treatment decisions are based on detailed
analysis of the likely aggressiveness of the
cancer; whether it is localised or has spread
elsewhere; as well as general fitness, age and
individual patient preference. These decisions
are usually made after full counseling both
by a urological surgeon and by an oncologist.
With increasing age, the prostate tends
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