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Prostate cancer: Mar'13

Tags: cancer

To raise awareness of the importance of prostate cancer prevention and screening, Paula McKeown answered your questions. Paula is part of our Dedicated Nursing Service and has a strong background in urology.

AXA PPP healthcare asked: Welcome to today’s live chat on prostate cancer with Paula McKeown our dedicated nurse.

Paula McKeown, Specialist Nurse Advisor commented: Good morning.  I'm looking forward to answering your questions.

AXA PPP healthcare commented: Thanks Paula

AKS asked: Hi. I dont know about prostate cancer. What are the symptoms of prostate cancer?

Paula McKeown, Specialist Nurse Advisor  answered: It often doesn't have any symptoms but symptoms can include passing urine more often especially at night, blood in urine or sperm.  These symptoms can also been seen in other, less serious conditions

AKS commented: Thanks Paula. I wonder whether other skin related conditions such as Psoriasis could be mistaken for Prostate Cancer. Or may be these kind of skin conditions are related. Can you advice please. And, Are there any skin symptoms to identify prostate cancer?

Paula McKeown, Specialist Nurse Advisor  answered: There isn't any link as far as I'm aware and I'm not aware of any skin symptoms of prostate cancer.

Jay asked: Are there any alternative treatments for prostate cancer?

Paula McKeown, Specialist Nurse Advisor answered: There are several different treatments depending on stage of cancer and age. These include radiotherapy, brachytherapy, HiFU, surgery and hormone therapy.  Sometimes a combination of these are used.

Ruth asked: Hi, what is a PSA test and why is it important?

Paula McKeown, Specialist Nurse Advisor answered: PSA stands for prostate specific antigen - a protein.  It usually rises in prostate cancer but  can rise with urine/prostate infections, after any surgery to the prostate, as you get older or in non cancerous enlargement of the prostate.

DavidS commented: Do you recommend that all men over a certain age (say 50) and/or with a history of prostrate cancer in the family has a PSA test? How reliable are they?

acs commented: who should have a PSA test?

Paula McKeown, Specialist Nurse Advisor commented: PSA tests aren't particularly reliable as they can also detect non cancerous enlargement of the prostate. The current recommendations don't suggest everyone over 50 should have a PSA.  There is a suggestion that if you have a family history of prostate cancer that it can put you at higher risk.  If you have a familiy history of prostate cancer, particularly if diagnosed under 60, I would discuss a PSA test with your GP.

fiona asked: Hi there - is there a link between prostate cancer and nutrition? If so what kind of foods can help prevent the condition?

Paula McKeown, Specialist Nurse Advisor answered: There has been some suggestion that lycopenes in cooked tomatoes have some effect but there is limited research.  Generally speaking, an healthy diet with fruit and vegetable is suggested.

fiona commented: Are cooked tomatoes said to have a positive or negative effect?

Paula McKeown, Specialist Nurse Advisor answered: A positive effect is suggested by research.  Other foods which may help are Soy, vegetables such as spinach, broccoli and kale, Green tea and pulses.
Foods which may increase risk are processed meats, a high intake of dairy products and a high alcohol intake.

 

Heather asked: How common is prostate cancer in young men? Is there a more common age range that this type of cancer affects?

Paula McKeown, Specialist Nurse Advisor answered: Prostate cancer is more common in men over 50 and is very rarely seen in men under 40.  It get more common the older a man gets.

DavidS asked: Do you recommend that all men over a certain age (say 50) and/or with a history of prostrate cancer in the family has a PSA test? How reliable are they?

Paula McKeown, Specialist Nurse Advisor answered:
PSA tests aren't particularly reliable as they can also detect non cancerous enlargement of the prostate. The current recommendations don't suggest everyone over 50 should have a PSA. There is a suggestion that if you have a family history of prostate cancer that it can put you at higher risk. If you have a familiy history of prostate cancer, particularly if diagnosed under 60, I would discuss a PSA test with your GP.

Heather asked: Are there health checks for prostate cancer in the same way that women are able to check for cervical cancer? i.e. should my partner be going to get checked every 2 -3 years?

Paula McKeown, Specialist Nurse Advisor answered: At the moment there isn't.  The main test is PSA and it isn't reliable enough to serve as a screening test.

Heather commented: Do you think this could be something that will be developed further down the line?

Paula McKeown, Specialist Nurse Advisor answered: I think its possible.  There was a report this week on genetic tests that are being developed to identity people at greater risk and the group working on this are hoping to develop a simple test for this.

acs commented: Can men examine themselves in the same way women should check their breasts for signs of breast cancer?

Paula McKeown, Specialist Nurse Advisor answered: There isn't anything that they can check however if you notice you are passing urine more frequent or passing blood in your urine or sperm, you should see your GP.

Anonymous33 asked: What would be the difference in effect on recurring prostate cancer between surgical castration, hormonal therapy and radiation?

Paula McKeown, Specialist Nurse Advisor answered: There is some research to show that radiotherapy is more effective when combined with hormone therapy.  Surgical castration is rarely carried out now and only usually after hormone therapy is no longer working.

Luis Osvaldo asked: Hi Paula, could you explain why prostate cancer is more common in later life? Is it typically a result of lifestyle?

Paula McKeown, Specialist Nurse Advisor answered: As you get older, most cancers are more common as they develop when cells have faults as the divided and reproduce.  The older you are, the more likely these faults are.  Also the prostate gland gets larger naturally as you get older due to hormone changes.

Craig asked: Does age matter?

Paula McKeown, Specialist Nurse Advisor answered: Prostate cancer is much more common as you get older. However in older men, it tends to be a less aggressive form.  In men around aged 50 at diagnosis, prostate cancer is often more aggressive and can be much more serious and treatment tends to be more aggressive.

Anonymous2 asked: Is there a link between prostate cancer and lifestyle? Can eating habits affect the development of prostate cancer?

Paula McKeown, Specialist Nurse Advisor answered:
There is evidence to show that a generally healthy diet and lifestyle can help prevent prostate cancer.  Some research has suggested that lycopenes (in cooked tomatoes), Soy, Green tea and vegetables such as broccoli and kale can help.

Ross asked: Where are we with regard to use of MRI in Prostate Cancer? Has it gained mainstream acceptance, if not why not?

Paula McKeown, Specialist Nurse Advisor  answered: MRI is being used a lot more as part of the cancer staging process.  It can not replace other scans such as isotope bone scans as MRI is best looking at soft tissue rather than bone.

Anonymous34 asked: What are the highest values of PSA that could be considered “w/in the norm” for a 70+ years old man? Or is there such a thing?

Paula McKeown, Specialist Nurse Advisor answered: The normal level is less than 5 for those aged 70.  A level of 5-10 is often seen in benign (non cancerous) prostate disease.

Anonymous35 asked: I am 69 years old and my PSA level is at about 5.4. I have an enlarged prostate which which was noticed as a result of a MRI scan for something else. I was suggested a biopsy, but I have declined it. PSA level is stable at least for a year now. Am I doing the right thing? Thanks

Paula McKeown, Specialist Nurse Advisor answered: Generally speaking, they would be looking to see if the PSA was rising to see if cancer.  Your Urologist would be best placed to discuss what the risks/benefits would be of doing a biopsy or just monitoring your PSA.

Mike asked: What are the side effects of treatment?

Paula McKeown, Specialist Nurse Advisor answered:
Side effects can vary from person to person  and between treatments. They can include incontinence, erectile dysfunction, loss of libido, bladder problems, tiredness.

Mike commented: Can anything be done to solve these?

Paula McKeown, Specialist Nurse Advisor answered: There are several different treatments for erectile dysfunction which can be effective.  Incontinence often improves over time after treatment and there are medications and pelvic floor exercises can help.  Exercise can often help with the tiredness issue.

Mike asked: How does eating certain foods increase or decrease you prostate cancer risk?

Paula McKeown, Specialist Nurse Advisor answered: They don't currently understand fully why it is the case but research has shown certain foods can effect your risk.  Foods that are thought to reduce the risk include Soy, Pulse, lycopenes ( in cooked tomatoes), vegetables such are Broccoli, kale and spinach and green tea.
Foods that can increase the risk include processed meat, a high dairy or alcohol intake and foods high in fat/saturated fat.

ianto asked: I've read quite a lot about "overdiagnosis" of prostate cancer. Can you tell me what this might mean for people with concerns about prostate health?

Paula McKeown, Specialist Nurse Advisor answered: The concern about this has come about due to a lot of men being diagnosed with early stage prostate cancer and in some cases, the treatment has side effects.  Its not certain whether all of these patients need treatment and whether monitoring would be more appropriate for them.  Also as the PSA test is not specific to cancer, a biopsy is often done when it rises and cancer is not always diagnosed.

Anonymous36 asked: My husband was successfully treated for stage II prostate cancer. I've read that aspirin may aid in prostate cancer recovery. What are your thoughts on research showing that aspirin may play a beneficial role in the treatment, or potentially the prevention, of prostate cancer?

Paula McKeown, Specialist Nurse Advisor answered: There is some suggestion from a recent study that aspirin may reduce death rates in Prostate cancer.  The study was somewhat limited so I think further research may well need before we can say it is recommend.  Aspirin also has some significant side effects so it would be best to discuss this with your GP before starting it.

AXA PPP healthcare asked: Hi Paula, We have had a question come through on Facebook asking "are there any measures that can be taken to prevent prostate cancer?"
Are you able to answer this?

Paula McKeown, Specialist Nurse Advisor answered: Hi, a generally healthy diet and lifestyle is usually helpful. Certain foods are thought to reduce risk - Lycopenes ( found in cooked tomatoes),  Soy, vegetables such as spinach, broccoli and kale, Green tea and pulses.
Foods which may increase risk are processed meats, a high intake of dairy products and a high alcohol intake. Regular exercise can also reduce risk.

AXA PPP healthcare asked: Hi Paula, We have had another question asking if there is a link between having a vasectomy and increased chance of prostate cancer. Is there any link?

Paula McKeown, Specialist Nurse Advisor answered: There is conflicting evidence from different studies but the most recent review of these studies has not shown any link between Vasectomy and prostatectomy.

AXA PPP healthcare commented: Thank you Paula

Scott22 asked: Hi. I've had a TURP for benign prostate disease (BPH) and am worried that I may have prostate cancer because the symptoms haven't gone away. Does BPH increase prostate cancer risk?

Paula McKeown, Specialist Nurse Advisor answered: There is no evidence that BPH increases your risk on Prostate cancer.  If your symptoms are worsening, contact your GP or urologist to discuss your concerns.

fiona asked: Hi there my dad is turning 50 this year and reading through the comments on this chat it seems to be a worrying time for this condition. Does the NHS offer checks at this age or is it just a case of being vigilant?

Paula McKeown, Specialist Nurse Advisor answered: A PSA check is available via his GP, a rise in this level is not diagnostic of cancer but can also be seen in non cancerous enlargement of the prostate.  The best thing is to be aware of any symptoms and  discuss with the GP if a PSA test is recommended.

fiona commented: Thanks, I'll let him know

AXA PPP healthcare asked: Thank you to everyone who joined today's chat and thank you to our expert Paula for answering the questions. The live chat is now closed.

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