Prostate Cancer

Prostate cancer is the most common cancer diagnosed in men, apart from skin cancer. It is increasingly common in men as they get older. In many men it grows very slowly and may not cause problems for many years.

Prostate Cancer Risk Assessment aims to:

  1. Find Prostate cancer in men who will benefit from treatment
  2. Reassure men who do not have an increased risk of Prostate cancer
  3. Give you an individual long-term Prostate cancer risk assessment plan. This is particularly important if you have an elevated PSA or family history of Prostate cancer.

What is PSA?

Prostate Specific Antigen (or PSA) is a blood test that can be used (in combination with family history, examination and sometimes MRI) to assess Prostate cancer risk. Men with Prostate cancer can have an elevated PSA test, but an elevated test does not necessarily mean prostate cancer is present.

Age

"Age-specific" PSA

< 50 years

< 2.5 ng/ml

50-60 years

< 3.5 ng/ml

60-70 years

< 4.5 ng/ml

> 70 years

< 6.5 ng/ml

"Age-specific" PSA reference ranges should be used to interpret your risk, as the PSA increases with age.

The change in PSA over time (PSA Velocity) can also be used to assess cancer risk, but: 

  • PSA normally doubling every 5 to 10 years. More rapid rise in PSA (doubling every 2-5 years) suggests more active prostate growth and suggests an increased risk of Prostate cancer
  • PSA levels can change with physical and sexual activity
  • PSA Velocity should be assessed on 3 or more PSA tests over 12 months to reduce the effect of day-to-day variation

Digital Rectal Examination (or DRE) can be performed by a GP, Specialist Nurse or Urologist and is important in the diagnosis and staging of Prostate cancer. Prostate cancer can be felt on DRE in around 60% of men with Prostate cancer.

Magnetic Resonance Imaging (or MRI) scans are able to detect some of the larger or more aggressive Prostate cancers. MRI scans are new, and not reimbursed by Medicare. They have not been validated in Prostate cancer screening trials, and their place in Prostate cancer risk assessment is still being worked out.

Calculate Your Prostate Cancer Risk

This Prostate Cancer Risk calculator used data from the Prostate Cancer Prevention Trial to give you an idea of your risk compared to men in North America. Just enter your details and calculate your risk of Prostate cancer.

The Prostate Cancer Risk Calculator will give:

  1. Your Overall risk of Prostate cancer
  2. Your risk of high grade (aggressive or "life threatening") Prostate cancer

The Prostate Cancer Risk Calculator

The results of this Risk Assessment calculator should be interpreted with the help of your Urologist or GP.

What is Prostate Biopsy?

Prostate biopsy can be performed in a number of ways. Each biopsy technique has pros and cons, but they are both highly accurate in detecting Prostate cancer. 

  • Trans-rectal Ultrasound (TRUS) Biopsy - under a light anaesthetic an ultrasound probe is passed up into the rectum. Ultrasound images are used to target areas of the prostate that are more likely to have cancer. Needle biopsies are taken through the back passage, 
  • Trans-perineal biopsy (TPBx) with or without mpMRI fusion - under a light anaesthetic an ultrasound probe is passed up into the rectum. Ultrasound images are fused with MRI images to target areas of the prostate that are more likely to have cancer. Needle biopsies are taken through the skin behind the scrotum.