Frequently Asked Questions about Prostate Cancer

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Can prostate cancer be hereditary?

It is thought that around 10% of prostate tumours are of genetic origin, transmitted by high penetrance genes. If a first-degree relative has had prostate cancer, the risk of developing it doubles. An association between genetic mutations that predispose a person to tumours has been observed, for example the BRCA gene.

From what age should you have your prostate checked?

The recommendations vary depending on whether there is a family history of first-degree relatives affected by prostate cancer or not. 

In the general population, screening is usually indicated as of 50 years of age and consists of performing a PSA blood analysis and a rectal examination.

If you have a first-degree relative with prostate cancer, screening is usually done from 45 years of age.

What is PSA?

PSA (prostate specific antigen) is a protein that is exclusively produced in the prostate and can be detected using a blood test. Its usual function is to participate in the production of seminal fluid. Its production depends on the levels of androgens and the size of the prostate.

The usual values can be altered by benign prostate pathology such as infections, prostate growth, or by surgery on the prostate or the bladder.

What is a normal PSA level?

Normal PSA levels vary depending on each laboratory and the patient characteristics, but as a general rule a PSA level of under 4 ng/ml is considered normal. When it is over 4 ng/ml, the need for a prostate exam should be assessed.

What should I do if I have high PSA?

If a high PSA level is shown, you should consult your urologist. An overall assessment will have to be carried out by the urologist to plan the following steps, including which tests to carry out, if necessary.

Does having high PSA mean I have prostate cancer?

Prostate tumours are often indicated by a high PSA level, but other benign illnesses can also give rise to this. Urinary infections, benign prostate growth (benign prostatic hyperplasia) and surgery on the urinary tract, especially on the prostate and the urethra, can elevate PSA.

Is PSA analysis enough to detect prostate cancer, or are more tests needed?

PSA analysis is the first step to detecting prostate cancer. In addition, a physical rectal examination should be performed. To confirm the diagnosis of prostate cancer, a prostate biopsy must be performed which, on occasions, is accompanied by the prior performance of a magnetic resonance on the prostate.

Is surgery the only alternative for treating prostate cancer?

Surgery is not the only treatment option for prostate cancer. Surgery is one of the multiple treatment options for prostate cancer, which will be indicated depending on the characteristics of the tumour and the patient. Other treatment options may include radiotherapy, hormonal treatment or chemotherapy.

Does having prostate cancer affect erection and ejaculation?

Prostate cancer can affect erection and ejaculation, although erectile problems most commonly appear for reasons other than a prostate tumour.

Blood in the semen does not necessarily mean there is a problem with the prostate. It could be cancer, or something else.

Prostate cancer treatment frequently produces changes to erections and ejaculation, which will be more or less severe depending on the treatment that has been given.

How will prostate surgery affect my sex life?

The surgical treatment of prostate cancer may affect erection and ejaculation in various ways and can be temporary or permanent.

If a radical prostatectomy is carried out, surgery which consists of a total removal of the prostate and seminal vesicles, the man will no longer produce semen or be able to ejaculate following surgery.

Erections can be affected by surgery, either temporarily or permanently. The most common way for surgery to affect erections is when the nerves that contribute to producing an erection, which are located behind and next to the prostate, are removed or damaged. Whenever surgery is performed, an attempt is made to preserve these nerves, but the erection may still be affected. Depending on the quality of erection following surgery, treatment can be given to improve them.

Is there any lifestyle or diet that helps to prevent prostate cancer?

Prostate tumours are not clearly associated with a particular lifestyle or diet. Despite this, a Mediterranean diet with balanced saturated fats is recommended, as is maintaining an active lifestyle to prevent tumours.

Can prostate cancer reappear?

Once remedial treatment has been performed on the prostate tumour, it should be monitored with blood tests in order to check for and detect any reappearance of the tumour.

What is Cancer?

General information about Cancer

Read more

Substantiated information by:

Antoni Vilaseca
Ascensión Gómez Porcel
Izaskun Valduvieco
Meritxell Costa
Oscar Reig Torras
Pilar Paredes Barranco
Rafael Salvador

Published: 6 May 2019
Updated: 6 May 2019

The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.

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