We asked Chris Parker, senior lecturer and honorary consultant in clinical oncology at the Institute of Cancer Research and Royal Marsden Hospital, what he would want to know about prostate cancer.
I have been diagnosed with prostate cancer. Can it be cured?
When men are told they've got prostate cancer, the word cancer obviously makes them they feel extremely anxious. But it is important to realise that prostate cancer is not like other cancers and in particular it is the only one that often does not require any treatment at all. Men can live with prostate cancer for decades without it causing them any problems whatsoever.
What is a risk group?
Most cases of prostate cancer are localised (confined to the prostate gland). Localised prostate cancer is divided into three risk groups:
- Low risk.
- Intermediate.
- High risk.
The risk groups are based on:
- What the prostate feels like when the doctor examines you.
- What the tissues samples look like under the microscope.
- What the prostate specific antigen (PSA) is in the blood.
If the prostate feels normal, the tissue samples look relatively normal under the microscope and the PSA level is less than 10, that's a low-risk prostate cancer. At the other end of the scale, if the prostate feels very abnormal and the tissue samples look aggressive under a microscope and the PSA level is more than 20, that is a high-risk localised prostate cancer.
Will I need treatment?
The treatment is very different for the three risk groups. Men with low-risk localised prostate cancers are often observed rather then treated immediately.
During this period of observation they have regular blood tests, to measure the PSA and will usually have repeat biopsies over the few years. As long as the cancer doesn’t progress, they can continue with observation.
If the PSA level rises significantly, or the biopsies show cancer progression, then they can go on to have either surgery or radiotherapy. This is called an active surveillance policy.
What is the best treatment for me?
The cure rate is no different between surgery or radiotherapy. They do, however, differ in terms of convenience and side effects. All treatment can cause adverse effects on bladder function, bowel function and sexual function, which is why not all men with prostate cancer require treatment. If treatment had no side effects then we would treat everyone, but treatment can have significant adverse effects so we aim to target treatment only to those who need it.
