According to Prostate Cancer UK, 1 in 8 men will get prostate cancer in their lifetime and it is the most common cancer in men in the UK.

In 2021, around 52,000 men were diagnosed with prostate cancer in the UK alone and the risk of developing it increases with age, as most cases are diagnosed aged 65 and over.

It’s not uncommon for men find out by complete chance, and often it can be too late when the diagnosis is less treatable. For that reason, it’s essential to understand the symptoms, available tests, and the importance of early detection.

What is the Prostate?

The prostate gland is a small, walnut-sized gland located below the bladder and in front of the rectum in males. It plays a key role in the male reproductive system by producing seminal fluid, which nourishes and helps transport sperm during ejaculation.

As men age, the prostate can undergo changes, including enlargement (benign prostatic hyperplasia) or other conditions, such as prostatitis (inflammation) and prostate cancer.

Regular check-ups and awareness of symptoms are important for prostate health.

What is Prostate Cancer?

Prostate cancer occurs when cells in the prostate gland grow uncontrollably.

An enlarged prostate is very common in men over the age of about 50, but having an enlarged prostate is not the same as having prostate cancer.

Having an enlarged prostate doesn’t increase your risk of getting prostate cancer. But it’s possible to have an enlarged prostate and prostate cancer at the same time.

While many men with prostate cancer may not experience symptoms, early detection is vital for effective treatment.

Symptoms of Prostate Cancer

In its early stages, prostate cancer may not cause noticeable symptoms. However, as the disease progresses, some common symptoms include:

• Needing to urinate more often than usual, especially at night
• Difficulty starting or stopping urination
• Weak or interrupted urine flow
• Painful urination or ejaculation
• A feeling that your bladder hasn’t emptied properly

If prostate cancer breaks out of the prostate (locally advanced prostate cancer) or spreads to other parts of the body (advanced prostate cancer), it can cause other symptoms, including:

• Persistent pain in the lower back, hips, or pelvis
• Unexplained weight loss or fatigue
• Blood in urine or semen
• Problems getting or keeping an erection

If you experience any of these symptoms, it’s crucial to consult a healthcare professional for evaluation.

All these symptoms are usually caused by other things that aren’t prostate cancer. But it’s still a good idea to tell your GP about any symptoms so they can find out what is causing them and make sure you get the right treatment, if you need it.

Who Should Consider a Prostate Screening?

1. Men aged 50 and older: if you’re at average risk, starting at 50 is recommended.
2. Men aged 45 and older: if you have a higher risk, such as a family history of prostate cancer.

Tests for Prostate Cancer at Fleet Street Clinic

Several tests can help confirm the presence of prostate cancer:

1. Prostate-Specific Antigen (PSA) Test: This blood test measures the level of PSA, a substance produced by the prostate gland. Elevated PSA levels can indicate prostate cancer, but they can also be elevated due to benign conditions such as an enlarged prostate. A normal PSA indicates that the chance of a prostate cancer is very low.
2. Digital Rectal Exam (DRE): During this exam, a doctor manually examines the prostate for any irregularities or lumps. While this test can help identify abnormalities, it is typically used in conjunction with the PSA test.

Consider booking a GP appointment for either of these Prostate Cancer tests, or for a more comprehensive assessment, opt for our Prostate Cancer Check, which includes both tests.

Factors That Can Cause the PSA to be Falsely Raised

Several factors can cause a false elevation in Prostate-Specific Antigen (PSA) levels, potentially leading to misleading test results. Here are common causes:

1. Recent Ejaculation: Sexual activity, especially ejaculation, can elevate PSA levels temporarily. Avoid sexual activity for 24–48 hours before a PSA test.

1. Prostate Manipulation: Any recent procedures or physical manipulation, such as a digital rectal exam (DRE) or catheter insertion, can elevate PSA levels. Let your doctor know if you’ve had any recent prostate exams or urological procedures.
2. Vigorous Exercise: Activities that put pressure on the prostate, like cycling or horseback riding, can raise PSA levels temporarily. Avoid these activities for a f48 hours before the test.
3. Prostate Infections or Urinary Tract Infections (UTIs): These infections can cause inflammation and increase PSA levels. Treat infections and allow recovery before testing.
4. Benign Prostatic Hyperplasia (BPH): An enlarged prostate from BPH can raise PSA levels even though it’s not cancerous. Make sure your doctor considers this in the interpretation.
5. Certain Medications: Some drugs, like testosterone, can increase PSA levels, while others like finasteride (for hair loss or BPH) can decrease it. Inform your doctor of any medications you’re taking.

Avoiding or managing these factors before a PSA test can help improve the accuracy of the results. Always discuss any concerns with your doctor.

You may need additional tests, as listed below, if your PSA is raised or if there is concern from the examination. We can refer you to specialists who may be available for same-day consultations to provide further evaluation.

1. Imaging Tests: Additional imaging tests, such as an MRI or CT scan, may be conducted to visualise the prostate gland.
2. Biopsy: If initial tests indicate potential cancer, a biopsy is often performed to confirm the diagnosis. During this procedure, a small sample of prostate tissue is removed and examined under a microscope for cancer cells.

Movember, an organisation focused on raising awareness of men’s health issues, including prostate cancer, emphasises the importance of regular check-ups and understanding one’s own health risks. Their campaigns encourage men to talk openly about health issues, promoting early detection and treatment.

Prostate cancer is a serious health concern for men, but awareness and early detection can lead to better outcomes. Regular check-ups and understanding the symptoms are essential steps in addressing this disease.

If you have concerns about prostate cancer or related symptoms, don’t hesitate to seek medical advice by booking a GP appointment. Early action can make a significant difference in your health and well-being.

Related services at Fleet Street Clinic

Prostate Cancer Check

Private GP Appointments

Annual Medical

Blood Tests

Sleep plays a crucial role in maintaining overall health and well-being, and recent research has revealed a strong link between sleep and cardiovascular health. A study conducted by the University of Warwick in the UK found that individuals who get 7-9 hours of sleep per night have a lower risk of cardiovascular disease (CVD) and mortality compared to those who sleep less or more than the recommended range. 

The study, published in the Journal of the American College of Cardiology, analysed data from over 116,000 participants in the UK Biobank study and found that those who slept less than 6 hours or more than 9 hours had a higher risk of CVD and mortality. These findings add to the growing body of evidence that suggests a link between sleep duration and cardiovascular health. 

The exact mechanisms by which sleep affects cardiovascular health are not fully understood, but researchers suggest that it may be related to the impact of sleep on cardiovascular regulation, inflammation, and metabolic function. 

It is important to prioritize sleep and aim for the recommended range of 7-9 hours to maintain cardiovascular health.  

It’s worth noting that these findings are observational, and more research is needed to fully understand the relationship between sleep and cardiovascular health, but it’s a good indication that sleep plays a vital role in maintaining a healthy cardiovascular system. 

To read the full study, continue reading here:
medscape.co.uk – Does sleep duration influence cvd and mortality risk?

Related services available at Fleet Street Clinic: 

• GP Services
• Well Person Medical

Women today lead incredibly busy lives. They run and organise homes and build successful careers, usually all whilst taking on the majority share of caring for their children and often their older relatives. It is therefore not uncommon for women to have little or no time to look after themselves, their health included.

In addition to not making time to prioritise their health, it seems that when women do put their health first and seek medical advice, they are less likely to feel heard and supported in comparison to their male counterparts.

A recent survey by The Department of Health and Social Care found that “more than 4 in 5 (84%) women they surveyed had experienced times when they (or the woman they had in mind) were not listened to by healthcare professionals.”

Based on the data they collected, ‘not being listened to’ appears to be present at all stages of the healthcare pathway. Specifically, many women told them: 

• their symptoms were not taken seriously and/or dismissed upon first contact with GPs and other health professionals 
• they had to persistently advocate for themselves to secure a diagnosis, often over multiple visits, months and years 
• if they did secure a diagnosis, there were limited opportunities to discuss or ask questions about treatment options and their preferences were often ignored

Many women recalled their symptoms being dismissed upon first contact with GPs and other professionals; women felt they had to persistently advocate for themselves to secure a diagnosis, often over multiple visits, months and years; and post-diagnosis, discussions about treatment options were often limited, and some said their preferences were ignored. 

To make matters worse, there is some evidence that due to historical clinical trials being disproportionately male-orientated there is much less research into women-only health concerns and assumptions have been made that similar medical treatments will work for both sexes. The top reasons for the under-representation of women in trials were the belief that hormone fluctuations could influence results and concerns that fertility could be affected. A widely accepted negative repercussion, amongst others, being that women are much more likely to experience adverse side effects of medications because drug dosages have historically been based on clinical trials conducted on men.

A combination of these factors may explain why there is a gender gap in health outcomes, with women experiencing poorer health outcomes in comparison to men. We strongly believe in equality and ensuring health is a top priority for all.

Therefore, here are the top health symptoms women should never ignore:

1) Any change in bowel habit and/ or urination

This includes blood in the stools, unexplained persistent abdominal pain, weight loss, lumps around the anus, lack of appetite, blood in the urine or increased frequency of urination. These are all reasons for seeing your doctor ASAP as these symptoms could be due to bowel, bladder or ovarian cancer. All patients should have an annual faecal occult blood (FOB) test to exclude bowel cancer, which has increased in incidence in the UK for reasons unknown. Or if you are looking for a more in-depth investigation, you should request a colonoscopy which entails looking at the bowel with a colonoscopy. This is the gold standard, but an FOB is the next best thing and far less invasive as a first investigative option. It takes no time at all and is a good preventative check.

​​2) Any changes to the breast.

Any breast lumps, skin changes, nipple discharge, nipple changes or pain in the breast must be checked ASAP. Breast cancer is the most common type of cancer in the UK and often can present insidiously. Get to know what your breast feels like so that any subtle changes can be detected as early as possible.

3) Skin lesions that do not heal.

Any scab on the skin which does not heal, especially around the eyes, nose, ears and face should be checked. All these areas are the most sun-exposed, and, as such, are more at risk of skin cancer. If these lesions are picked up and treated early, scarring is minimal, but if left, then disfiguring scars and skin grafts may be necessary.

4) Bleeding after the menopause.

If you experience any bleeding after 1-year of your last menstrual period, you must visit your GP for further investigation. Bleeding after the menopause is not common and could be an indicator of cancer of the uterus, or the cervix. They will usually opt for a biopsy of the uterine lining to exclude both – don’t worry, this doesn’t hurt.

5) Always have regular cervical screens. 

Most people don’t find cervical screens painful, although they can feel somewhat uncomfortable. If you are concerned about the pain or you have previously found the procedure painful with the NHS, you can opt to book a private appointment. It is important that you don’t miss your appointment. 

6) Bleeding between periods.

At any age, you should never ignore bleeding between periods or after intercourse, as this can be a sign of cervical or uterine cancer. Whilst cervical cancer is monitored by regular screening, it is important to still get bleeding between periods checked out following a normal smear result. Cancer of the endometrium is becoming increasingly common in women who have not had children.

7) A persistent cough.

Regardless of gender, you should get a persistent cough checked out by your doctor, especially if you are coughing up discoloured sputum or blood.

8) Any unexplained changes to your body.

Any new indigestion, shortness of breath on exertion, neck or left arm pain requires follow up ASAP. Make sure a GP examines your chest and makes the appropriate investigations.

The same applies to calf pain or any pain in the chest. By taking a full history, examining you and doing quick and easy investigations, worrying conditions can be excluded, such as a pulmonary embolism or a heart attack.

Some recent examples of cases where other healthcare providers have failed our new female patients:

1) We saw a 36 year old who had not had a cervical screening for 5-years because the last one was so painful. The NHS advises a screening every 3-years but we advise yearly screenings to ensure any abnormalities are found as early as possible. 5-years is far too long!

2) We saw a woman who had a suspicious lump at her anal margin, which her usual GP had told her was part of her bladder. She wanted a second opinion because it had grown in size and was now painful. The patient was referred for an urgent assessment to exclude cancer.

3) We saw an 88 year old patient who was disfigured by a large basal cell carcinoma on her forehead, about which she was embarrassed. The patient had been seen by a dermatologist who had frightened her about having the lesion removed by saying she might not survive an anaesthetic. The patient wished that she had taken the risk and asked to be referred back, as the skin lesion was disfiguring and ruining her quality of life.

** The outcomes of these patients are yet unknown, but they are all certainly serious health concerns that should have been properly addressed long before now. 

We want to encourage women to take ownership over their health and be assertive when they feel that something has changed from our normal. If they feel like they are not being taken seriously or not being heard, they should seek a second opinion. 

If you cannot get an appointment with your usual GP or through the NHS, rather than waiting  for weeks and worrying about what it could be, make an appointment with a private GP who can usually see you on the same day! 

Put your mind at ease with private healthcare.