By: RS Abdi Waluyo
Having no urinary symptoms does not necessarily mean you are free of prostate cancer. In its early stages, the disease often causes no symptoms. Understanding your risk factors is therefore just as important as noticing changes in your body.
At the same time, waking up at night to urinate or having a weaker urine stream does not automatically mean cancer. An enlarged prostate or other health conditions can cause similar symptoms. A medical assessment can help identify the cause.
Understanding the prostate and prostate cancer
The prostate is a small gland below the bladder that surrounds part of the tube carrying urine out of the body. It produces some of the fluid that makes up semen. Prostate cancer develops when cells in this gland grow uncontrollably.
The disease is more common in older men. However, age is not the only factor to consider. Family history and certain inherited gene changes can also increase risk.
Symptoms to pay attention to
Early prostate cancer usually causes no symptoms. As the disease progresses, possible symptoms include:
- Difficulty starting to urinate.
- A weak or interrupted urine stream.
- Urinating more often, especially at night.
- Feeling that the bladder has not emptied fully.
- Blood in the urine or semen.
More advanced disease may also cause persistent pain in the back, hips, or pelvis. These symptoms alone cannot confirm prostate cancer. Try not to assume the worst, but do not ignore changes that need medical attention. [1]
Who is at greater risk
Having a risk factor does not mean you will definitely develop prostate cancer. It does, however, help your doctor decide whether earlier testing should be considered.
Increasing age
The risk of prostate cancer rises with age, particularly after 50. Although less common, the disease can also affect younger men.
A family history of prostate cancer
Your risk is higher if your father or brother has had prostate cancer. This deserves particular attention when several relatives have been affected or were diagnosed at a young age. Tell your doctor which relatives had cancer and their approximate age at diagnosis.
Inherited gene changes
Certain inherited gene changes can raise risk, particularly changes in BRCA2. Other genes, including BRCA1, MSH2, and HOXB13, can also be associated with prostate cancer risk. You do not need to memorise these names. What matters is sharing your family history of cancer so your doctor can assess whether genetic counselling or testing would be appropriate.
Ancestry
Risk also varies across populations. Prostate cancer occurs more often in African American men and Caribbean men of African ancestry. The reasons for these differences are not fully understood. Ancestry should be considered alongside other risk factors. [2]
Talk to your doctor before symptoms appear
If you have risk factors or changes in your urinary habits, speak with your doctor. Screening means testing people who do not have symptoms. The decision should take into account your age, family history, overall health, and personal preferences.
One option is a PSA blood test, which measures a protein produced by the prostate. A raised PSA level does not always mean cancer. Screening may help detect cancer earlier, but it can also identify very slow-growing cancers that might never cause problems. Discussing both the benefits and risks with your doctor is an important part of the decision. [3]
If initial findings need further investigation, your doctor may consider a prostate MRI or a biopsy, which involves taking a tissue sample for examination. Not everyone needs all of these tests.
To discuss your symptoms and personal risk factors, consult a doctor at RS Abdi Waluyo. How does your doctor decide which tests are right for you? Learn about the roles of PSA testing, MRI, and biopsy in our next article: A High PSA Does Not Always Mean Prostate Cancer: Understanding MRI and Biopsy.
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