Prostate cancer

Prostate cancer is the most common type of cancer for New Zealand men. Some prostate cancers are slow growing and will never cause problems. Others are faster growing, can cause serious symptoms or even be life threatening.

Key points

  1. Prostate cancer is more common in men aged over 50, but is more likely to cause problems if you get it when you are younger.
  2. If caught early, prostate cancer can be managed well and can usually be cured. However, not all prostate cancer needs to be treated.
  3. If you have no symptoms, your doctor can help you decide whether a prostate test is right for you, by assessing your risk factors such as your age and family history.
  4. If you’re 50 years or older, tell your doctor if you have any lower urinary tract symptoms such as poor flow of urine (pee), trouble starting or stopping peeing, needing to pee more often and urgently, or incontinence.
  5. You can reduce your risk of prostate cancer by finding the cancer early and by having a healthy lifestyle.

What is the prostate?

The prostate gland is only found in men. It is a small walnut-shaped gland that surrounds the opening of your bladder. It helps make semen.

As men age, the prostate gland increases in size and can cause prostate enlargement, known as benign prostatic hyperplasia or BPH. From 50 years’ old, men often experience problems with urination (peeing) due to this. 

What is prostate cancer?

Prostate cancer is caused when some of the cells within your prostate gland start to grow out of control, invading and destroying healthy cells. Most commonly, prostate cancer grows slowly, but sometimes it can grow rapidly and spread to other areas, such as your bones, liver and lungs.

How common is prostate cancer?

In New Zealand, about 3500 men are diagnosed with prostate cancer every year and more than 600 die from the condition. Prostate cancer is also the third most common cause of cancer death in New Zealand men.

Māori men are more likely than non-Māori men to die of prostate cancer because it is often found too late to cure. Men who live in rural areas are at greater risk than those who live in urban areas because they have less access to health services. 

What are the symptoms of prostate cancer?

Early prostate cancer causes no symptoms. As the cancer grows, it can cause urinary symptoms such as problems with flow or irritation of your bladder. These include:

  • poor flow of urine
  • trouble stopping
  • dribbling after you have finished peeing
  • needing to pee more often, at night or urgently
  • trouble starting to pee
  • incontinence (not being able to control when you pee)
  • pain when peeing
  • blood in your pee.

Most of the time these symptoms are due to other common prostate problems such as benign enlargement of the prostate gland or urinary tract infection (UTI). However, if you have any symptoms let your doctor know so they can assess your risk of getting prostate cancer and provide advice on whether or not to do prostate testing.

In the late stage of prostate cancer, the cancer cells might spread to other parts of your body and cause symptoms such as:

  • new bone or back pain
  • both legs swelling
  • numbness or weakness in both legs
  • nausea or vomiting
  • breathlessness
  • visible blood in your urine
  • inability to urinate
  • loss of appetite
  • weight loss
  • fatigue or extreme tiredness.

See a doctor without delay if you have the above symptoms.

What are the risk factors for prostate cancer?

The risk of prostate cancer increases as you age and also if your brother or father has it.

  • Age – the risk of prostate cancer increases as you age. It is rare in men under 50. Men under the age of 70 who get prostate cancer are more likely to need treatment. This is because younger men live longer with their cancer so it has more time to progress and cause problems.
  • Family history – you have double the chance of getting prostate cancer if your father or brother has had prostate cancer. The risk is less if your grandfather or uncle has had prostate cancer.
  • Genetics – your risk of prostate cancer is higher if you have the BRCA gene.
  • Abnormal prostate testing – if you have done a PSA test and a digital rectal examination before and been told that the results are abnormal, your risk of getting prostate cancer is higher.

If I have no symptoms, should I get checked for prostate cancer?

The following people who have no symptoms are recommended to get checked for prostate cancer:

  • you are a man aged 50–70 years old but don’t have any family history of prostate cancer
  • you are a man aged 40–70 years old and your father or brother has had prostate cancer
  • you are a man aged more than 70 years old and you have family history of prostate cancer or you have had an abnormal PSA test previously, and you have a life expectancy of more than 10 years.

Having a prostate check is your decision. The check won’t tell you if you have prostate cancer, but it will tell you how likely you are to have it. Checks usually involve a blood test called a prostate-specific antigen (PSA) test and a digital rectal examination (DRE).

Read more about prostate testing.

How is prostate cancer diagnosed?

If you have an abnormal PSA test and abnormal digital rectal examination, further tests, such as an ultrasound scan and a prostate biopsy, are needed to diagnose prostate cancer and confirm the presence of cancer cells.

What are the treatment options for prostate cancer?

If you have prostate cancer, you will be referred to a specialist (urologist) and a radiation specialist. The choice of treatment depends on the size, type, growth and spread of the cancer, and your age, general health, symptoms and personal choice. Talk to your doctor to find out the best treatment options for you.

Treatment options for prostate cancer include active surveillance, surgery, radiation therapy (radiotherapy), hormone therapy and palliative care.

Active surveillance (no active treatment, but watch and wait)

No treatment is provided and instead you are monitored frequently by blood tests or other investigations, either in hospital or by GP follow-ups. This option is usually recommended if you have an early stage of prostate cancer or your cancer is slow growing. This is because it may not be of benefit to have treatment if the cancer is not affecting your quality of life (and it may never do so). It can also be offered if you have a late stage of prostate cancer and your life expectancy is less than 10 years.

Surgery

This can be an option if it is possible to remove all the cancer cells through taking out part or all your prostate. The aim of surgery is to cure your prostate cancer.

Radiation therapy (radiotherapy)

The aim of radiotherapy is also to cure your prostate cancer. Radiotherapy has side effects such as pain when peeing, loose bowel motions, bleeding from your rectum, impotence and more. Your doctor will explain more to you when discussing treatment options. Read more about radiotherapy.

Hormone therapy

This involves giving you medicines to stop your body from producing the male hormone testosterone. Testosterone helps prostate cancer cells grow.

Palliative care

This is usually offered to people with late stage or advanced cancer. Treatment is focused on relieving your symptoms. Read more about palliative care.

How can I reduce my risk of prostate cancer?

You can reduce your risk of prostate cancer by finding the cancer early and by having a healthy lifestyle.

Healthy lifestyle choices include:

Read more about healthy living.

Learn more

The following links provide further information about prostate cancer. Be aware that websites from other countries may have information that differs from New Zealand recommendations. 

Is a check right for you? Kupe, NZ
Should I have prostate cancer screening? The Royal Australian College of General Practitioners
Prostate cancer Ministry of Health, NZ
Prostate cancer testing Better Health Channel, Australia

Credits: Health Navigator Editorial Team.