Feeling healthy and having no difficulty urinating does not necessarily mean the prostate is free from disease, men have been warned.
Prostate cancer can develop silently in its early stages, according to urologist Dr Estefania Linares.
The specialist in urological oncology at Madrid’s Ruber Internacional Hospital says checks should be tailored to each man’s individual risk rather than beginning at the same age for everyone.
Men at average risk should discuss a first PSA blood test at around 50. This falls to 45 for those with a significant family history and to 40 for carriers of certain inherited genetic mutations, particularly BRCA2.
BRCA2 mutations are associated with an increased risk of prostate cancer, although testing and screening decisions should always be discussed with a doctor.
Warning signs that should not be ignored
Men should seek medical advice if they experience persistent changes such as:
- A weaker urine stream
- Difficulty starting to urinate
- Feeling that the bladder has not emptied
- Increased urgency
- Regularly waking at night to urinate
- Blood in the urine
- Repeated urinary infections
- Inability to urinate
These symptoms do not automatically indicate cancer. Benign prostate enlargement is common and can cause similar problems, while prostatitis can also affect urination.
What an elevated PSA result means
PSA is produced by both normal and cancerous prostate cells. A raised result can therefore be caused by cancer, but also by an enlarged prostate, infection, inflammation, urinary retention or recent medical procedures.
A single abnormal result is not enough to diagnose cancer. Doctors may repeat the test and consider the patient’s age, family history, prostate size and examination findings before requesting further investigation.
Multiparametric MRI can identify suspicious areas before a biopsy, allowing doctors to take targeted samples and sometimes helping lower-risk patients avoid an unnecessary procedure.
Even when prostate cancer is found, immediate treatment is not always required.
Active surveillance, including using regular PSA tests, scans and, when needed, and repeat biopsies, is a recognised option for many men with low-risk disease.
Dr Linares recommends that men learn their individual risk, avoid dismissing persistent urinary symptoms and maintain a healthy weight through regular physical activity and a balanced diet.
She said: ‘There is no single food or supplement that specifically prevents prostate cancer, but maintaining a healthy weight, exercising, and following a balanced diet are sound health recommendations.’
