Prostate Cancer Awareness Month
Prostate Cancer Awareness Month provides a chance once again to highlight this key issue in men's health.
Prostate Cancer Awareness Month and the well-known ‘Movember’ campaign provide a chance once again to highlight this key issue in men’s health. Last week I wrote about the recently discovered correlation between the BRCA 1 and BRCA 2 genes (strong indicators for breast cancer) and prostate cancer. The Institute of Cancer Research estimates about 1 in 300 men in the UK have the same genetic errors that increase the risk of breast cancer in women, and in men these genetic errors present as prostate cancer (or PC).
The NHS states that PC is the most common cancer in men in the UK; this is common knowledge or at least should be. For us men the chances of developing PC increase as we get older, with most cases developing at 50 or older. The awareness of PC overall has recently been increased by celebrities such as Stephen Fry and BBC presenter Bill Turnbull who did a combined documentary together on Channel 4. Bill Turnbull, the 63-year-old presenter, is well-known to us all because he hosted the BBC morning show for 15 years from 2001 to 2016. He was diagnosed with what appeared to be PC in 2017.
Bill Turnbull’s Story
He commented at the time of his diagnosis “I’d had my prostate checked when I was 40, and again when I was 50. I thought that had put me in the clear, but it didn’t. There were no early warning signs, and by the time I felt anything, it was too late.” Meanwhile back at our clinic, what does concern me is just how many male patients over 50 have never even had a prostate check. This is either due to the embarrassment of the process involved or because of lack of awareness. This is relevant as prostate cancer can also be the cause of lower back pain, so it is something we do ask periodically if we feel it is relevant. However, the overall health implications are obviously more pertinent. Bill’s story has certainly helped raise the profile of prostate cancer awareness.
The significance of Prostate Cancer Awareness Month
As cancer diagnoses go, PC is often fortunately a less serious one but prostate cancer awareness month is still an important reminder. PC is frequently slow-growing and slow to spread. For many elderly men, PC is often less serious than their other medical conditions. For these reasons, and possibly because of earlier detection of low-grade prostate cancers, PC has one of the highest survival rates of any type of cancer. 84% of men are predicted to survive their disease for at least ten years or more in the UK. In all, out of 20 common cancers in England and Wales, ten-year survival for prostate cancer ranks 3rd highest.
Fewer men (about 7 %) have more advanced PC at the time of diagnosis. Once PC has spread beyond the prostate, survival rates do fall markedly. For men with a distant spread like this (metastasis) of prostate cancer, about one-third will survive for five years after diagnosis. Bill Turnbull was very lucky to recover as his cancer had spread to his bones in his pelvis. All this is detailed in his documentary with Stephen Fry.
What are the risk factors for Prostate Cancer?
Researchers do not know exactly what causes PC. But they have found some risk factors and are trying to learn just how these factors might cause prostate cells to become cancer cells. On a basic level, prostate cancer is caused by changes in the DNA of a normal prostate cell. DNA, as we know, is the chemical in our cells that makes up our genes, which in turn control how our cells function. We usually look like our parents because they are the source of our DNA.
But DNA affects more than just how we look. Some genes control when our cells grow, divide into new cells, and die. Certain genes that help cells grow, divide, and stay alive are called oncogenes. Genes that normally keep cell growth under control, repair mistakes in DNA, or cause cells to die at the right time are called tumour suppressing genes. Cancer can be caused by DNA mutations (or other types of changes) that keep oncogenes turned on, or that turn off tumour suppressor genes. These types of gene changes can lead to cells growing out of control. DNA changes can either be inherited from a parent or can be acquired during a person’s lifetime.
Some gene mutations can be passed from generation to generation (inherited) and are found in all cells in the body. Inherited gene changes are thought to play a role in about 10% of prostate cancers. Several inherited mutated genes have been linked to hereditary prostate cancer. BRAC1 and BRACA 2 genes are tumour suppressor genes that normally help repair mistakes in a cell’s DNA (or cause the cell to die if the mistake can’t be fixed). Another common gene mutation is also HOXB13. This gene is important in the development of the prostate gland. Mutations in this gene have been linked to early-onset prostate cancer (prostate cancer diagnosed at a young age) that runs in some families. Fortunately, this mutation is rare.
prostate cancer and Gene Mutation
Obviously, some genes can also mutate during a person’s lifetime, and the mutation is not passed on to children. These are called acquired mutations. As we have already mentioned most gene mutations related to prostate cancer seem to develop during a man’s life rather than through inheritance. Every time a cell prepares to divide into 2 new cells, it must copy its DNA. This process isn’t perfect, and sometimes errors occur, leaving defective DNA in the new cell. It’s not clear how often these DNA changes might be as random events, and how often they are influenced by other factors (such as diet, hormone levels, etc.). In general, the more quickly prostate cells grow and divide, the more chances there are for mutations to occur. Therefore, anything that speeds up this process may make prostate cancer more likely. For example, androgens (male hormones), such as testosterone, promote prostate cell growth. Having higher levels of androgens might contribute to prostate cancer risk in some men. Some research has found that men with high levels of another hormone, insulin-like growth factor-1 (IGF-1), are more likely to get prostate cancer. However, other studies have not found such a link. Further research is needed to make sense of these findings.
There are a host of factors which can serve to influence both acquired and inherited mutations and increase your risk of developing the condition. These points are the most significant. These include age – and most cases are diagnosed in men over 50 years of age. Your ethnic group – prostate cancer is more common among men of African-Caribbean and African descent than in Asian men. Family history also has a strong correlation e.g. having a brother or father who developed prostate cancer before age 60. Research also shows that having a close female relative who developed breast cancer may also increase your risk of developing prostate cancer. Obesity – recent research suggests there may be a link between obesity and prostate cancer, and a balanced diet and regular exercise may lower your risk of developing prostate cancer. Clearly diet is also important – research is ongoing into the links between diet and prostate cancer, and there is some evidence that a diet high in calcium is linked to an increased risk of developing prostate cancer. Prostate cancer awareness month gives us all a chance to raise money for further search.
What are the Symptoms of Prostate Cancer?
Symptoms of prostate cancer:
Slow or weak flow of urine
Urinating more frequently or urgently than usual
Difficulty starting to urinate
Pain or burning sensation when urinating
Unexplained urinary infection
Constipation, altered bowel movement
Impotence
Difficulty getting or maintaining an erection or pain during ejaculation.
We are raising money at the clinic to help raise fund for Prostate Cancer Awareness Month. To make a donation please feel free to drop into clinic.