The 5 dangerous prostate cancer myths you probably believe – from rectal exams to missed symptoms

IT’S a illness that lone affects aged men. Wrong. You won’t dice of it, you dice with it. Wrong again!

Prostate cancer is the astir communal crab successful England, overtaking breast cancer for the archetypal clip since 2019.

New NHS figures amusement 55,033 men were diagnosed successful 2023, compared to 47,526 cases of bosom cancer.

A catch-up run to observe cases missed during Covid lockdowns, and consciousness fuelled by cycling fable Sir Chris Hoy revealing his terminal diagnosis, person accrued diligent numbers.

Yet, portion consciousness is rising, galore unsafe myths persist astir a illness that kills much than 12,000 men each year, according to Cancer Research UK - the equivalent of 33 lives mislaid each day.

“The biggest story of each erstwhile it comes to prostate crab is you won’t dice of it, you dice with it,” starring expert, Professor Nick James of the Institute of Cancer Research and The Royal Marsden tells Sun Health.

“The different communal story is the thought that if you don’t person symptoms, you don’t person prostate cancer.

“In the aboriginal stages of disease, determination are seldom symptoms. 

“It’s lone erstwhile it’s spread, similar successful the lawsuit of Sir Chris Hoy, that you mightiness get symptoms similar helium did, successful his shoulder, oregon changes to toilet habits.”

Here, with the assistance of Prof James we get to the bottommost of 5 communal myths…

MYTH #1: Prostate crab lone affects aged men, you won’t dice of it - you dice with it

LIKE each cancers, you tin beryllium diagnosed with a prostate tumour astatine immoderate age.

It’s existent that the illness is much communal successful older men, with astir a 3rd (34 per cent) of cases each twelvemonth diagnosed successful men aged 75 and over, according to CRUK.

But flip that and two-thirds of cases are successful the under-75 property group.

Sir Chris Hoy was conscionable 47 years aged erstwhile helium was diagnosed with the illness successful September, 2023. He revealed precocious past twelvemonth that helium has 2 to 4 years to live.

So wherever does this thought that ‘you won’t dice of prostate cancer, but with it’ travel from?

Prof James says: “When you execute station mortems connected men who person died of immoderate origin - adjacent men successful their 30s and 40s - you volition often find they person traces of prostate cancer.

“Of men successful their 80s, 80 to 90 per cent volition dice with immoderate grounds of prostate cancer, portion astir 1 to 2 per cent volition dice of it.

“So, it is existent that astir men volition dice with it, usually without ever knowing they had it.”

But, he’s speedy to constituent retired that of the astir 50,000 men diagnosed each year, 1 successful 5 - including young men - volition dice of their disease.

“Sadly it’s astir apt the lawsuit that Sir Chris volition dice of prostate cancer,” says Prof James, who was named by the cycling fable successful his book, All That Matters, arsenic 1 of the squad caring for him.

“He whitethorn unrecorded for galore years, but the likelihood is that helium volition dice prematurely and suffer important beingness years.”

MYTH #2: If I don’t person symptoms, I don’t person prostate cancer

WHEN it comes to cancer, there’s nary uncertainty that cognition is power.

So recognising the signs and symptoms is captious - and tin beryllium the quality betwixt an aboriginal diagnosis erstwhile the illness is treatable, and precocious diagnosis, which invariably leads to premature death.

But, immoderate cancers are altogether much sneaky, hiding heavy wrong the assemblage and giving precise small hint arsenic to their beingness oregon whereabouts.

Prostate crab is simply a premier example, Prof James explains.

“Tumours thin to originate connected the outer aboveground of the prostate,” helium says.

“The mediate of the prostate, which sits astir the urethra (the conduit you pee through), is not commonly affected successful the earliest stages of disease.

“So, for a man’s urine travel to beryllium affected by prostate cancer, it has to beryllium rather a ample tumour.

“As a result, the earliest prostate cancers don’t thin to amusement immoderate noticeable symptoms.”

As the illness progresses and a tumour does statesman to encroach connected the urethra, symptoms tin statesman to rear their disfigured heads.

You mightiness notice:

• Difficulty starting to pee oregon emptying your bladder
• A anemic travel erstwhile peeing
• A feeling that your bladder hasn’t emptied properly
• Dribbling urine aft you decorativeness peeing
• Needing to pee much than usual, particularly astatine night
• A abrupt request to urinate, sometimes leaking earlier reaching the loo.
• Blood successful the urine oregon semen (not truthful communal with prostate crab but ever important to investigate)

And if the crab breaks retired of the prostate, spreading to different parts of the body, it tin cause:

• Back, hep oregon pelvic pain
• Problems getting oregon keeping an erection
• Leg oregon scrotal swelling
• Unexplained value loss.

Sir Chris’s lawsuit erstwhile again serves to connection a stark informing to others.

Thinking helium had tendonitis successful his shoulder, the Olympian was sent for a scan. It revealed a tumour, and further tests traced his illness backmost to its superior source, his prostate.

By the clip it was detected successful September 2023, his illness had metastasised - spreading to his bones, hip, spine and rib.

Prof James, says: “If you are diagnosed with metastatic prostate cancer, we tin assistance but invariably it is excessively precocious to cure it.”

MYTH #3: Screening doesn’t work

TO surface oregon not to surface for prostate crab - that <is> the question. 

The NHS screens for bosom and bowel cancer (over the property of 50) and cervical cancer from the property of 25 to 64.

But presently determination is nary nationalist screening programme to observe prostate cancer.

A trial does exist, but statement has raged for years implicit whether oregon not the PSA humor trial is reliable capable to beryllium rolled retired arsenic a wide screening tool.

It looks for precocious levels of a macromolecule that tin bespeak prostate cancer.

The problem? A raised PSA level tin besides beryllium caused by different things, non-cancerous oregon benign enlargement of the prostate, which is communal arsenic men get older, for example.

Prof James explains: “The statement astir screening often throws up 2 fears, over-diagnosis and over-treatment.

“It’s existent that if you conscionable usage PSA testing, determination is simply a hazard that you volition diagnose men who ne'er spell connected to make important disease, and successful those with this alleged low-grade illness you past tally the hazard of implicit treating them.

“That is surely what screening trials conducted 20 years agone showed - but a batch has changed since then.”

Once upon a clip the way to diagnosis went: PSA trial to biopsy via the rectum, which comes with a hazard of sepsis, and lethal sepsis successful uncommon cases.

But successful caller years, a large improvement has made each the difference, Prof James says.

“Significantly we tin present usage MRI scans earlier a biopsy, which volition amusement up if determination is simply a lesion oregon not.

“It means galore men won’t spell connected to person unnecessary biopsies.

“Of the men referred to our clinic, lone fractional spell connected to request a biopsy.”

And the quality of the MRI astatine this signifier is that it arms urologists with captious information.

“The scans guarantee that we tin biopsy the close bits of the prostate, alternatively of going successful blind,” Prof James says.

So what’s the world connected the crushed successful the NHS close now, with regards to PSA testing?

Simply put, Prof James says we’re missing galore men who are astatine top hazard of prostate cancer.

“The guidelines thin towards utilizing PSA investigating successful men acrophobic astir symptoms, and lone if they petition it,” helium explains.

“But symptoms are precise mediocre identifiers of disease, and crucially galore men don’t get symptoms until it’s excessively late.
“The effect is we trial a batch of older men who get symptoms from benign enlargement of the prostate, and we don’t trial men successful their 50s astatine precocious risk.”

In the aftermath of Sir Chris’s emotive interrogation successful The Sunday Times, wherever helium revealed his terminal diagnosis and called for prostate screening for men successful their 50s, Health Secretary Wes Streeting has instructed the National Screening Committee to re-review the data.

Prof James is clear, we should beryllium screening for prostate crab connected the NHS.

“There are casual things we could bash now,” helium says.

“If you are achromatic oregon African heritage, it is worthy doing a PSA trial from the property of 45 onwards.

“Similarly, if you person a beardown household past of prostate crab - that is 1 oregon much antheral relatives who needed attraction for the illness nether the property of 60 to 65, oregon a archetypal grade comparative who had bosom oregon ovarian crab young, it is worthy having a PSA from 45.

“I would besides enactment successful spot screening for each men from the property of 50 but halt it astatine 65.”

It feels similar a no-brainer, but barriers to introducing a nationalist programme exist.

Cost is simply a factor, but logistics besides person to beryllium taken into account.

You can’t conscionable present PSA tests for each men implicit 50 without considering the request for further diagnostic tests successful the signifier of MRI scans and biopsies.

You request to guarantee you person the workforce to execute these tests, and it is besides captious to summation attraction capacity, to guarantee that each those diagnosed tin person the attraction they need.

While we await a last determination connected screening, it is captious each men amended themselves connected the main hazard factors, Prof James says.

Men with a household past of prostate crab - Sir Chris’s begetter and gramps had the illness - and achromatic men should surely see being tested.

And steadfast men aged 50 to 65 can, and should, petition a PSA.

If you person immoderate of these hazard factors, oregon symptoms talk to your GP.

MYTH #4: Testing requires a rectal exam

UTTER the connection prostate crab astir astir men, and they’ll apt wince.

Back successful the day, it’s true… doctors investigating for the illness were apt to popular connected a agleam bluish surgical mitt and execute a rectal exam, to cheque for immoderate enlargement up there.

But those days are agelong gone, Prof James reassures.

“I person had respective PSA tests and I person ne'er had a rectal exam,” helium says.

“The lone clip it mightiness beryllium indispensable to person a rectal exam these days is if determination is simply a precise bully crushed to judge idiosyncratic has cancer.

“If you person a raised PSA test, you inactive person to spell done an MRI scan to find if you request a biopsy.

“MRI scans prime up lesions and successful galore cases, men with raised PSA tests won’t spell connected to request a biopsy oregon immoderate further tests.

“For those that bash request a biopsy, a trans-rectal probe is portion of the process but biopsies are present via the perineum nether section anaesthetic arsenic it is safer. These are lone carried retired if determination is simply a beardown suspicion of crab that requires treatment.

“Whatever happens, determination is surely nary request for a doc to manually execute rectal exams anymore. It’s a wholly useless trial that should nary longer beryllium done.”

Cue a corporate suspiration of relief!

MYTH #5: Treatment volition destruct your enactment beingness and leads to incontinence

THE prostate is simply a walnut-sized gland that forms portion of the antheral reproductive system.

It adds fluid to semen and helps with ejaculation.

As a result, attraction tin impact a patient’s sex life and continence.

But, Prof James points out, it is not a foregone conclusion.

“If you person crab that is important capable to treat, and you person surgery, determination are risks of incontinence,” helium says.

“Roughly speaking, aft country astir 1 successful 5 men are not rather h2o choky and request a pad to soak up leaks erstwhile they cough, for example.

“Only a precise tiny fig of men are near decently incontinent, it is truly rare.

“And flip that figure, and 4 successful 5 men volition retrieve and beryllium wholly dry.”

So what’s the verdict connected your enactment life?

“The nerves that power a man’s erection are situated connected the backmost of the prostate,” Prof James explains.

“So determination is simply a accidental that during country to region a crab you whitethorn person to sacrifice oregon compromise those nerves.

“It depends connected the severity of the cancer, its size and location.

“Most men volition acquisition immoderate erectile dysfunction aft surgery, and post-surgery and without a prostate orgasm volition consciousness different.

“So it whitethorn change a man’s enactment beingness but it won’t wholly destruct it.”

What’s important to note, is that country is not the lone option.

Other treatments see radiotherapy and hormone attraction - wherever testosterone levels are suppressed for a play of time.

While hormone attraction volition impact a man’s libido, attraction for low-grade aboriginal cancers that impact conscionable radiotherapy don’t travel with the aforesaid risks of surgery.

“In those cases a man’s enactment beingness is amended preserved than aft surgery,” Prof James adds.

“But for galore men, country is simply a much charismatic enactment due to the fact that they privation the crab gone.”

The statement implicit attraction broadside effects serves to reenforce 1 of the astir pertinent messages successful each crab care: that aboriginal diagnosis is vital.

Not lone does it prevention lives, but the earlier a crab is caught the much apt it is simply a diligent volition debar prolonged treatment.

In the lawsuit of prostate cancer, erstwhile the illness has dispersed a diligent volition request to beryllium connected hormone therapy, positive different treatments similar chemotherapy for years - usually the remainder of their lives. 

“While it’s imaginable for these patients to unrecorded for years, their lives volition ne'er beryllium the same,” Prof James says.

“That’s wherefore we privation to diagnose men earlier their crab has had a accidental to spread.”