Testing for Prostate Cancer or Not?

Prostate cancer and testing for it are health issues which have caused increasing concern among men in Hong Kong. In 2003, prostate cancer ranked fourth among all cancers in Hong Kong men, with 826 new cases reported. The incidence and mortality rates of prostate cancer have shown substantial increase since the mid 1990s. It is believed that the increased use of the Prostate Specific Antigen (PSA) blood test for testing for prostate cancer may have contributed to this rising trend.

As for the PSA test, some of you may want to know a straight-forward answer on whether you should go for the testing or not. However, you may find that you will get different answers, depending on whom you are talking to, or which magazine/journal you are reading.

Causes and risk factors

The causes for prostate cancer are unknown but it tends to happen in older men and is rarely found in men below the age of 50. In 2003, over 99% of newly diagnosed cases were in men aged 50 or above. Other major risk factors are:

• a family history of prostate cancer
• diet that is high in animal fat
• long-term exposure to certain environmental pollutants and chemicals such as cadmium and dioxin

Symptoms

You should seek prompt medical advice when the following symptoms arise:

• difficulties in urination
• slow or weak stream of urine
• pain when urinating
• blood in urine
• swollen lymph nodes in the groin area

However, it is important to bear in mind that most of these symptoms are also found in men suffering from benign prostatic hyperplasia (BPH), which is a benign condition affecting more than half of all men aged over 60 years, and in which the prostate is enlarged due to non-cancerous growth within the gland.

Testing if no symptom?

No doubt, a lot of you may have heard about the PSA test. For those of you who may consider taking a PSA blood test as a "screening" test, here are some facts for your consideration:

• About 15 to 25% of men with prostate cancer may not have a raised PSA, which means the test may fail to detect the presence of prostate cancer.
• A raised PSA can be caused by other conditions such as BPH, prostatitis (inflammation of prostate) and infection. 2 out of 3 men with a raised PSA do not have prostate cancer, which means some will eventually be given further tests, such as needle biopsy, that they may not need. These tests have risks.
• Prostate cancer is not always an aggressive disease. Many men with prostate cancer do not have symptoms and do not die from it. These men do not really need treatment, which may have side effects on its own and may cause more problems than the cancer does.

So, it is important to discuss with your family doctor about the pros and cons of a "screening" PSA blood test. Let him or her help you make the choice - an informed one, of going for testing or not.

Of course we shall not forget the magic word - "Prevention". Remember, a healthy lifestyle, apart from having other health benefits, minimizes the risk of getting prostate cancer. So, eat lots of fruits, vegetables, grains and cereals, while cutting down your intake of animal fat.

For further information on prostate cancer, you may wish to visit the relevant section in our website.

(Last Updated on 05-12-2006)