Risk factors and symptoms of advanced (metastatic) prostate cancer 1

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1 Risk factors and symptoms of advanced (metastatic) prostate cancer 1 Risk factors and symptoms of advanced (metastatic) prostate cancer This information is from the booklet Understanding advanced (metastatic) prostate cancer. You may find the full booklet helpful. We can send you a free copy see page 5. Contents Risk factors and causes of prostate cancer Symptoms of advanced (metastatic) prostate cancer More information and support Risk factors and causes of prostate cancer The number of men diagnosed with prostate cancer in the UK has increased in recent years. Experts believe this is because more men are having tests that detect very early prostate cancers, that previously would not have been found. These tests include the PSA test. This is a blood test that measures a type of protein called prostate-specific antigen (PSA). A small amount of PSA is normally found in the blood, but men who have prostate cancer tend to have a higher level of PSA in their blood. If you d like to know more about PSA testing, we can send you our free booklet Understanding the PSA test. Call to order a free copy. The causes of prostate cancer are still unknown. But, there are some risk factors that can increase a man s chance of developing the disease.

2 Risk factors and symptoms of advanced (metastatic) prostate cancer 2 Age This is the strongest risk factor for prostate cancer. Men under 50 have a low risk of prostate cancer. The risk increases as they get older. Approximately 75 in 100 prostate cancers (75%) are diagnosed in men aged 65 and over. Ethnicity Some ethnic groups have a greater chance of developing prostate cancer than others. For example, black African and black Caribbean men are more likely to develop prostate cancer than white men. Asian men have a lower risk of developing it. Family history Most prostate cancers aren t caused by inherited cancer genes and most men who get prostate cancer don t have a family history of it. If you ve had just one relative who developed prostate cancer at an older age, your risk is unlikely to be different from other men the same age as you. But sometimes prostate cancer can run in families. In general, the more men in a family who have been diagnosed with prostate cancer, the younger they were when diagnosed and the more closely related they are, the more likely it is there s a family link. It is thought that a man s risk of developing prostate cancer is higher if they have: one first-degree relative who developed prostate cancer at or under the age of 60. A first degree relative is a father, brother or son two or more close relatives on the same side of the family who have had prostate cancer. A close relative is a father, brother, son, grandfather, uncle, or nephew. Experts think that 5 15% of prostate cancers are linked to inherited gene changes that increase the risk of developing it. There isn t one specific prostate cancer gene that explains most of the cases of hereditary prostate cancer. Instead, it is thought that variations in several genes may be involved. In a small number of men, prostate cancer is linked to the breast and ovarian cancer genes BRCA1 and, particularly, BRCA2. So if you have a relative with prostate cancer and there is also a strong history of breast or ovarian cancer in the same side of the family, this may be due to a BRCA1 or BRCA2 gene. If you re concerned about your family history of prostate cancer, we can send you our leaflet Are you worried about prostate cancer? We also have a booklet called Cancer genetics how cancer sometimes runs in families. Call to order these.

3 Risk factors and symptoms of advanced (metastatic) prostate cancer 3 Diet Some evidence suggests that diet can affect your risk of prostate cancer, but this is not completely clear. Current thinking suggests that a diet high in animal fats may increase your risk of developing prostate cancer. Animal fats can be found in red meat (such as beef, lamb and pork) and dairy products (including butter, full-fat milk, cheese, eggs and cream). Eating a healthy, balanced diet that s high in fibre and low in fat and sugars may reduce your risk of getting certain types of cancers and other illnesses. Symptoms of advanced (metastatic) prostate cancer Prostate cancer is often slow-growing and symptoms may not occur for many years. The symptoms of advanced prostate cancer may include symptoms that are due to an enlarged prostate gland, or the result of secondary cancers. Symptoms of an enlarged prostate gland can include: difficulty passing urine for example, a weak flow or having to strain to pass urine passing urine more frequently than usual or waking up at night to pass urine feeling that the bladder has not fully emptied blood in the urine (this is rare). The symptoms related to a secondary cancer will depend on which part of the body is affected, although there are a few general symptoms which some men have. These include: being more tired than usual generally feeling unwell having less of an appetite. Secondary cancer in the bones The first sign of a secondary cancer in the bones is usually a nagging ache in the affected bone. This can become painful, making it difficult to sleep at night, or move around without taking painkillers. The pain is generally present both day and night, whereas pain from arthritis, for example, is often worse early in the morning and is not there all the time. A secondary cancer in the bone may gradually make it weaker. Pain and weakness can make getting around difficult, and a bone that is very weak may break (fracture) more easily. If the bones in the spine are affected, this can sometimes lead to weakness and tingling or numbness in the legs. This is uncommon, but it can happen if the cancer is pressing on the spinal cord. This is called malignant spinal cord compression.

4 Risk factors and symptoms of advanced (metastatic) prostate cancer 4 We have information about spinal cord compression that we can send you. If you have weakness, pain, tingling or numbness in your legs it s important to let your doctors know immediately even at the weekend or during a holiday period. If you can t get hold of your cancer doctor, you should go to the nearest A&E department. Explain to them that you have cancer and describe your symptoms. Sometimes, when bones are affected by cancer cells, extra calcium may be released into the blood. This is called hypercalcaemia. It is rare in prostate cancer, but can cause symptoms such as tiredness, feeling sick, constipation, thirst, poor appetite and confusion. Secondary cancer in the bone marrow Sometimes, prostate cancer can spread to the bone marrow. This is the spongy material found in the centre of our bones. It produces the different types of blood cells, which include: red blood cells, which carry oxygen around the body white blood cells, which help fight infection platelets, which help the blood to clot and prevent bleeding. If the bone marrow is unable to produce enough blood cells, you may become anaemic, be more likely to get infections or have bruising or bleeding. Other symptoms Prostate cancer can occasionally affect other parts of the body such as the lungs, lymph nodes, brain or liver. If you notice any new symptoms that last for a couple of weeks or more, you should discuss them with your cancer specialist. It s important to remember that any of the symptoms mentioned here can be caused by conditions other than cancer.

5 Risk factors and symptoms of advanced (metastatic) prostate cancer 5 More information and support More than one in three of us will get cancer. For most of us it will be the toughest fight we ever face. And the feelings of isolation and loneliness that so many people experience make it even harder. But you don t have to go through it alone. The Macmillan team is with you every step of the way. Visit macmillan.org.uk or call us on , Monday to Friday, 9am to 8pm. You can order a copy of Understanding advanced (metastatic) prostate cancer or any other cancer information, from be.macmillan.org.uk or by calling us. Hard of hearing? Use textphone , or Text Relay. Speak another language? We have telephone interpreters. We provide information in a range of languages and formats. Visit macmillan.org.uk/otherformats or call us. We make every effort to ensure that the information we provide is accurate and up to date but it should not be relied upon as a substitute for specialist professional advice tailored to your situation. So far as is permitted by law, Macmillan does not accept liability in relation to the use of any information contained in this publication, or third-party information or websites included or referred to in it. Macmillan Cancer Support Registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Registered office 89 Albert Embankment, London, SE1 7UQ Revised in October, Next planned review in 2018.

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