Autumn/Winter 2012 Newsletter
Our chosen topic for the Autumn/Winter Resource Meetings was Prostate Cancer.
We would like to thank Lucinda Poulton, Macmillan Lead Uro-Oncology CNS for
GHNHSFT and Countywide for her interesting and informative presentation.
The Prostate Gland sits beneath the bladder in men and surrounds the urethra. A
healthy prostate is usually the size and shape of a walnut. Its main purpose is to
make semen.
From about the age of 50, it is common for the prostate to enlarge. This is usually a
benign enlargement (BPE) which can cause narrowing of the urethra. The main
symptom of this will be a weaker or intermittent urine flow.
Approximately 40% of men over the age of 50 and 75% of men in their 70’s will
experience urinary symptoms caused by an enlarged prostate.
Other common symptoms include urinary frequency and nocturia, a feeling of
incomplete bladder emptying, difficulty initiating micturition, post-micturition
dribble, urgency to void and urinary incontinence.
It is important that men experiencing any of these symptoms should be offered a
thorough assessment which includes a symptom check, urinalysis and Digital Rectal
Examination (DRE). If the DRE indicates there may be an underlying malignancy, then
a Prostate Specific Antigen (PSA) blood test should be offered after counselling of
the patient.
Further tests may include a bladder ultrasound scan to assess if the bladder is
emptying to completion and Urodynamic Investigations (Flow tests), but these do
not need to be offered routinely at initial assessment.
Symptomatic BPE can be treated effectively with medications. Alphablockers such as
Tamsulosin and Doxazosin, among others should be prescribed for men with
moderate to severe symptoms. Some men may also benefit from antimuscarinic
medication such as Oxybutynin and Solifenacin, among others if urgency symptoms
are particularly problematic.
In 2009, 40.841 men in the UK were diagnosed with Prostate Cancer. In 2005 –
2009, 81% of men in England survived their prostate cancer for five years or more.
Family history is one of the strongest known risk factors. There is also a link to a
strong family history of breast cancer.
In the UK, black Caribbean and black African men are 2-3 times more at risk of
Prostate Cancer than white men, while Asian men generally have a lower than
average risk.
Diets rich in cooked tomatoes may play a role in reducing the risk of developing
Prostate Cancer but there is a possible increased risk with a high calcium diet.
The Pathologist, Donald Gleason, established the scoring system for Prostate Cancers
in 1966. This was to provide an effective grading system which could give an idea of
how a cancer might behave. It is not a prediction of what will happen.
Prostate Cancer cells are graded on a scale of 1 to 5 according to how they look, with
1 being the most normal looking and 5 the most abnormal. The two most prominent
(primary grade) cells are added to the next most prominent (secondary grade) cells
to give the combined Gleason score. The score can be as low as 2 or as high as 10.
Some doctors write the score separately, for example 3 + 4, instead of 7. These days,
most doctors will only score tissue biopsies as 3 or higher so the combined score will
be between 6 and 10.
Treatment options will vary depending on the severity of the cancer and patient
choice but they include Radical Prostatectomy, Brachytherapy, Chemo and
Radiotherapy and hormone treatments in Advanced Prostate Cancer.
Cotswold Prostate Cancer Support Group (2nd Tuesday of month in Gloucester).
Cotswold Prostate Cancer partners Group (8 days after the CPGSG)
ROBOCAP
Please check your emails for dates of the 2013 Resource Meetings.
May we take this opportunity to wish you all a very Merry Xmas and Happy New
Year.