Ask the Doctor: ‘My husband’s family has a history of prostate cancer and I want him to get a check up — what’s involved?’

“My husband is in his 50s. With a history of prostate cancer in the family, I want him to get a check-up, but he’s apprehensive. What’s involved in checking the prostate and what are the symptoms to look out for?”

Answer from Uro-Oncology Clinical Nurse Specialist, Karen Thomas, Beacon Hospital

One in seven men in Ireland will be diagnosed with prostate cancer in their lifetime. However, the good news is that there is a lot you can do. Just knowing some important facts about risk and when to act helps to allow for early detection. Age, genetics and ethnicity can all play a factor.

The cause of prostate cancer is unknown at present but there are factors that can increase risk. Prostate cancer is more likely to develop in older men. Only about one in 100 cases of prostate cancer are aged under 50.

Generally speaking, if you have a father or brother diagnosed with prostate cancer at a younger age, you are 2.5 times more likely to get prostate cancer yourself, compared to the average man.

Prostate cancer is more common in Black Caribbean and Black African men than in white or Asian men. Asian men have a lower risk than white men. This difference seems to be due to a mixture of inherited genes and environmental factors. When men move from a country where the prostate cancer risk is low to one where it is higher, their risk increases. For example, South Asian men living in Ireland have a higher risk of prostate cancer than men living in South Asia.

Prostate cancer grows slowly, so years might pass by before symptoms become noticeable. Waiting for symptoms before you do anything is not the answer. Symptoms may include difficulty when urinating, things not feeling right during sex, aches or pains in your hips or pelvis, and bloody urine or semen. Be mindful that noticing symptoms does not automatically mean someone has prostate cancer. What it does mean, however, is that it’s high time you check in with your doctor.

A PSA test is a routine blood test that measures the prostate-specific antigen protein in the bloodstream. Higher PSA levels could mean a range of conditions – including prostate cancer.

It’s important to note that an elevated PSA level does not definitely mean someone has prostate cancer. In fact, age, prostate size, medications, infections, and other factors can affect PSA levels in a test. Your doctor is the best person to help you understand what your PSA level means. If your PSA test is high, your doctor will often refer you to a Urologist. The Urologist will talk to you about any urinary symptoms and will examine your prostate. They will often suggest you have an MRI scan of your prostate and they may then discuss if you need to have a prostate biopsy.

There are also things you can do to reduce the risk of prostate cancer. There is some evidence that choosing a healthy diet that’s low in fat and full of fruits and vegetables may contribute to a lower risk of prostate cancer. Some studies show that men who are more physically active have a lower risk of getting prostate cancer.

In summary, if there is a family history and your husband is aged 50 or above, it is always worthwhile to check in with his GP to keep on top of his general health and any concerns he, or indeed you, might have.

Have a question for the professionals you’d like answered? Get in touch with sarah.gill@image.ie with the subject headline ‘Ask The Doctor’.

This article was originally published in November 2023.