Frequently Asked Questions about Prostate Cancer
How common is prostate cancer?
What are the symptoms of prostate cancer?
What are some other common issues with the prostate?
Is it possible that I have prostate cancer without symptoms?
What tests can be done to detect prostate cancer?
What is the PSA test?
What is a Transrectal Ultrasound (TRUS) Biopsy of the prostate?
What is staging?
What is the Gleason Score?
Are some men more prone to prostate cancer?
How is prostate cancer treated?
How much does it cost to have treatment?
How common is prostate cancer?
Prostate cancer is the most common cancer among New Zealand men, occurring most often in men over 50 years old. Around 3,000 men are diagnosed with prostate cancer in New Zealand each year. (Source: New Zealand Cancer Society)
What are the symptoms of prostate cancer?
Most commonly, there are no symptoms. Some men will experience symptoms such as frequent or burning urination, or difficulty starting or stopping the flow of urine, difficulty in having an erection, among other possible symptoms. However, these symptoms are not always an indicator of the presence of prostate cancer; other issues can cause them. It is important to speak to your doctor about any concerns you may have so they may run tests to find the cause of the symptoms.
What are some other common issues with the prostate?
Some men may experience symptoms that are caused by non-cancer issues within the prostate. Common issues include:
Benign enlargement of the prostate – This commonly occurs with ageing, and affects more than half of all men older than 50. Medicines or surgery are used to treat it but only when symptoms become unmanageable, and it is important to note that while many of the symptoms are similar, BPH is not prostate cancer. Read more about benign enlargement of the prostate here.
Infection of the prostate – And infection of the prostate (prostatitis) is indicated by pain, fever, swelling of the prostate and blood and pus in the urine. An infection of the prostate is often coupled with an infection of the bladder, and is treated by antibiotics. Again, an infection may have similar symptoms to prostate cancer, and BPH.
Is it possible that I have prostate cancer without symptoms?
If the cancer is caught early through routine examinations, there may be no symptoms. This is why it is important to have regular check ups with your GP so that they may be able to detect prostate cancer indicators that you wouldn’t usually notice.
What tests can be done to detect prostate cancer?
There are several tests that can be done to detect changes in your prostate and also to identify and confirm the presence of prostate cancer. The most common test to check for any changes to your prostate is the Digital Rectal Exam (DRE). This exam involves your doctor inserting a gloved, lubricated finger into the rectum to feel for any abnormalities in the prostate, which is located just in front of the rectum. This exam may be uncomfortable, but only lasts a short time.
There is also a blood test that can help detect prostate cancer, the Prostate-specific antigen (PSA) test.
If these two tests produce results that cause concern to your doctor, they may call for further testing to rule out or identify prostate cancer.
What is the PSA test?
A blood test for PSA (prostate specific antigen) is usually performed in addition to DRE (digital rectal exam) in the process of detecting prostate cancer. The test measures the level of PSA, a small protein produced by the prostate, in the bloodstream.
If the amount of PSA in the blood is above normal levels, it may be due to an enlarged prostate, prostatitis or prostate cancer. If the PSA level is high, it is more likely to be due to prostate cancer. However, results from a PSA test alone cannot confirm whether prostate cancer is present.
Blood levels of PSA can be measured by very sensitive laboratory tests. PSA levels usually increase with age, but the normal range of PSA in the blood is up to about four micrograms per litre.
What is a Transrectal Ultrasound (TRUS) biopsy of the prostate?
If the results of a patients’ digital rectal exam (DRE) and/or PSA (prostate specific antigen) test give cause for concern, the urologist may opt to perform a prostate biopsy to run further tests. The transrectal ultrasound (TRUS) is the first stage of the biopsy, which serves to determine where the biopsies will need to be taken from to ensure adequate sampling.
During the TRUS, an ultrasound probe is inserted into the rectum, and sound waves help to produce a picture of the prostate.
What is staging?
When a patient is diagnosed with prostate cancer, their doctor will go through a process to categorize the risk of the cancer having spread beyond the prostate, and in turn, the likelihood of the cancer being cured with treatment. Staging is based on a combination of guides, including; PSA level, digital rectal examination (DRE), transrectal ultrasound (TRUS) and Gleason Score.
Sometimes where necessary, your doctor may suggest a whole body bone scan in an effort to determine whether the prostate cancer has spread to bone. This will further inform the staging process. There are different grading systems in use, and they can seem complicated at first. Your doctor can talk you through staging, and explain what your score or stage means.
What is the Gleason Score?
The Gleason Score is calculated by adding the two most common Gleason Grades on the biopsy sample. The Gleason Grade ranges from 1-5, and the Gleason Score ranges from 2-10. The Gleason Score identifies how aggressive the cancer is.
Your doctor will be able to explain to you exactly how the grade and score are determined, and also what they mean for your diagnosis and outlook.
Are some men more prone to prostate cancer?
Prostate cancer is the second most common cause of cancer deaths among all men, and it is the leading cause of death from cancer in men over 75 years of age. There is thought to be a link between living in a developed country, eating certain types of foods, and being of certain racial origins. The disease is common in New Zealand and Australia, North America and North West Europe, and more rare in Asia, Africa and South America. The lowest incidence occurs in Japanese men and vegetarians. (Source: Prostate Cancer, Your guide to the disease, treatment options and outcomes, Associate Professor Prem Rashid)
It also appears that prostate cancer has a family connection, with men who have a close family member who has had prostate cancer more likely to be affected by the disease.
How is prostate cancer treated?
There is a range of treatment options available for prostate cancer in New Zealand. Your doctor will likely recommend a course of treatment that will offer the best outcome to your unique circumstances, but more than one option may be open to you. Your options may include one or more of the following:
- Watchful waiting
- Radical prostatectomy
- External beam radiotherapy
- Brachytherapy
- Cryotherapy
- Robotic-assisted laparoscopic prostatectomy
There are several factors to take into account when deciding on the treatment option that best suits you, including:
- Age
- Overall health
- The stage of the cancer
- How aggressive the cancer is
- The impact treatment may have on quality of life
- The different side effects of each treatment option
Advancements in cancer treatments, combined with an increased likelihood of early detection thanks to regular screening, prostate cancer has become a treatable disease with a high survival rate.
To further explore some of the treatment options offered in the Bay of Plenty, New Zealand, through the Grace Prostate Cancer Centre, click here.
How much does it cost to have treatment?
Each type of treatment for prostate cancer has a different cost, varying for each patient.
Many prostate cancer patients will attest to the importance of having insurance, as it opens up your options when it comes to choosing a treatment course.
Your insurance provider and individual policy will determine your coverage.
The estimated costs for the procedures are:
- Robot-assisted surgery $32-35,000
- Brachytherapy $22-26,000
- Cryotherapy $21-25,000
- Open radical $15-16,000
The final cost depends on the duration of the hospital stay and any variation in the anaesthetist fee. With Brachytherapy, radioactive seeds are placed in to the prostate gland. These seeds costs $75 each and the number needed varies according to the size of the prostate.
How long is recovery time after treatment?
Your recovery time will depend on the stage of the cancer, the treatment, your age and health, so is different for every patient. You may be required to stay in hospital after the treatment, and there will be a period of time after the treatment where you may be restricted from undertaking physical activity.
