Prostate Cancer Testing – It’s No Joke..

A study discovered that 86% of patients surveyed believed appropriate humour was important during their cancer journey, 79% of them stated it helped to relieve some of the anxiety associated with their cancer and 4% of them said it was the most important quality in their interactions with healthcare professionals¹. Prostate cancer, the most common form of cancer in men, can be a difficult topic and one many men would rather avoid. So, in this spirit, before getting into the nuts and bolts of this sensitive topic of prostate cancer testing, we thought we’d crack the ice by mentioning a few of the funniest things heard by real doctors during prostate exams:

The prostate is a small, walnut-sized gland located below the bladder, between the penis and rectum, that surrounds the urethra. Its primary role is to produce the white fluid that, when mixed with sperm, creates semen². This is essential to keep the sperm cells alive on their journey to find and fertilise an egg. Running along each side of the prostate is the neurovascular bundle, a collection of nerves and blood vessels responsible for controlling erectile function³.

The prostate itself is divided into zones or anatomic regions. Prostate cancer most commonly forms in the peripheral region, the one at the back or closest to the rectum. In these cases, the doctor may request a digital rectal exam (DRE)³. This is an examination that involves the doctor inserting a gloved finger into the rectum to examine the prostate first-hand. This examination can’t be used alone as a definitive diagnosis; therefore, it will normally be accompanied by a PSA test³.

The reproductive tract is a hostile environment for sperm, filled with bacteria and pathogens. Therefore, it must be well protected to reach the finish line. This is the role of the semen⁴. The semen contains a variety of components, some for energy, others are enzymes, like prostate specific antigen (PSA). The job of this enzyme is to liquefy the semen, keeping it mobile to allow the sperm to reach the egg⁴. When PSA leaks into the blood, it can be measured and used to give an indication of prostate cancer status. We’ll look at this in more detail later.

What is Prostate Cancer?

Prostate cancer is the most common form of cancer in men. In the UK, 1 out of 8 men will receive a prostate cancer diagnosis within their lifetime. It is estimated that 12,000 men die every year from prostate cancer… that’s 1 death every 45 minutes⁵.

Cancer typically arises when cells start multiplying rapidly, leading to the formation of a tumour. This abnormal growth often occurs due to the absence of a ‘stop’ signal that typically restrains cell proliferation when necessary⁶. Once established, certain cancers utilise androgens (sex hormones influencing male development) as a source of sustenance, fuelling further expansion. Some types of prostate cancer progress slowly and are often identified before spreading beyond the prostate. Yet, this delayed growth pattern poses a challenge as prostate cancer commonly exhibits no distinct symptoms, complicating its detection and potentially allowing it to metastasise (spread) beyond the prostate⁶.

Risk Factors

Prostate cancer is mostly diagnosed in European men over 50 years old. Unlike some other cancers, it is not strongly associated with a wide range of modifiable risk factors, but there are a few factors that are known to increase risk:

Prostate Specific Antigen and Prostate Cancer Diagnosis

Normal PSA levels vary in the population and increase with age, however, men aged between 50-69 are expected to have a PSA level of <3 nanograms per ml⁸. Serum PSA levels can be elevated due to several mechanisms:

1. When prostate cancer eliminates certain cells, it can disrupt the structure of the prostate, allowing more PSA to enter the bloodstream.
2. The increased number of cells caused by prostate cancer tumours express PSA in addition to that produced by healthy prostate cells, driving the increase in PSA concentration.

Monitoring for prostate cancer with PSA can be tough as elevations are not specific to prostate cancer. High PSA levels might mean an enlarged prostate, prostatitis, or a urinary infection. Furthermore, research shows that 3 out of 4 men with high PSA won’t have prostate cancer⁸. However, PSA testing is a useful indicator and is used throughout the world to estimate risk and supplement diagnosis. In the UK, there isn’t a definitive diagnostic pathway for prostate cancer; it often takes a combination of PSA testing, DRE, and MRI scans, considered alongside risk factors and symptoms to achieve a positive prostate cancer diagnosis².

Myths about Prostate Cancer

In the age of misinformation, deciphering fact from fiction can be a hard nut to crack. Here, we will take a quick look at some of the myths swimming around in relation to prostate cancer.

Genetic Screening at Randox Health

At Randox Health we believe in an initiative-taking approach to your health. There are 3 main contributing factors to risk of prostate cancer: age, family history and ethnicity. This is why we have developed our Prostate Cancer Risk test. This test investigates the genome at 12 distinct sites, to identify potentially harmful variants in the genetic code. Having one of these genetic variants does not mean that a person will develop prostate cancer but does suggest that they are at increased risk. You can read about some of these genetic variants below:

These mutations, along with the others included in our Prostate Cancer Risk Test, are used in combination to estimate risk of prostate cancer. However, there’s a lot to consider before deciding to go ahead with genetic screening.

Genetic counselling is crucial for informed decision-making on genetic testing. These experts meticulously review the individual’s and their family’s medical history, pinpointing possible genetic concerns. This holistic approach determines the appropriateness of genetic testing.

After opting for genetic testing, counsellors provide invaluable assistance in interpreting the results. They elucidate the implications for the individual’s health and their family members and discuss strategies for managing any emerging issues. This could involve recommending closer monitoring or preventive measures.

With all genetic screening at Randox Health, you can book an appointment with a genetic counsellor who will help empower you with the knowledge to navigate genetic risks and make informed choices for your well-being. If you or someone you know would like to find out about risk of prostate cancer, information on how to book an appointment is available here: https://randoxhealth.com/en-GB/in-clinic/prostate-cancer-risk and don’t forget to book a consultation with one of our Genetic Counsellors.

Prostate Health Risk at Randox Health

At Randox Health, we also offer advanced Prostate Health testing for those who wish to investigate their risk of prostate disease. As we’ve mentioned, PSA isn’t specific to prostate cancer; it may indicate prostatitis, an enlarged prostate, or a urinary tract infection. This is why, in addition to PSA, our new Prostate Health test includes analysis of a novel combination of biomarkers including EGF, IL-8, and MCP-1 to generate a prostate cancer risk score, which can significantly improve the predictive potential of PSA alone in identifying individuals at risk of prostate cancer. Appointments can be booked online for a time and date that suits, during which we’ll take a blood sample. Then, our laboratorians will get to work running the test and determine whether results show a high or low risk of  prostate cancer. Once testing is complete, a personalised and comprehensive report detailing results will be provided. Don’t forget, remote GP appointments to discuss results are also available.

Men’s Mental Health

While we are here to help promote physical health and wellbeing, it is crucial that we look after our mental health. Only 36% of referrals to NHS talking therapies are men¹⁴. It’s also well known that the biggest killer of men under 50 is suicide. Men can find it much harder to open up about how they feel and are more likely to develop potentially harmful coping mechanisms such as drugs or alcohol¹⁴.

If you or someone you know is struggling with their mental health, speak to someone you trust, a partner, relative or friend. You can contact The Samaritans in confidence. They provide emotional support, 24 hours a day. To speak to someone, Call 116 123 for free or email jo@samaritans.org.uk. You can also visit a Samaritans branch to talk to someone in person. You can find your local branch here https://www.samaritans.org/branches/.

Alternatively, speak to your GP who can give you advice on the next steps. We’ll leave some additional contact information below, if you’re struggling, please reach out to someone.

You are not alone.

National Suicide Prevention Helpline UK: 0800 689 5652 (6pm to midnight every day).

Shout – Offers a confidential 24/7 test service for those seeking mental health support: Text SHOUT to 85258.