Former US president Joe Biden, 82, has been diagnosed with aggressive prostate cancer that has spread to his bones. Here the PA news agency examines symptoms of the disease and forms of treatment.
– What is prostate cancer?
Prostate cancer is the most common cancer affecting men and usually develops slowly over many years.
Cancer cells begin to grow in the prostate, the small gland found just below the bladder that helps make semen.
Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the urethra, which is the tube carrying urine from the bladder out of the penis.
In 2022, some 50,751 men were diagnosed with prostate cancer in England.
– What are the symptoms of prostate cancer?
The most common symptoms of prostate cancer are needing to urinate more often and straining to pee.
Men may also feel as though their bladder has not fully emptied.
These symptoms are common and do not always mean somebody has cancer, but they should be checked out by a GP.
– What causes prostate cancer?
Scientists do not know the exact causes of cancer but they do know that some factors increase the risk.
The chances of developing prostate cancer increase as men get older, with the vast majority of cases in those aged over 50.
Family history also plays a role, with men whose fathers or brothers had the disease at increased risk.
For reasons not yet understood, prostate cancer is also more common in black men and less common in Asian men.
Prostate cancer is also linked to obesity.
– How is prostate cancer diagnosed?
Doctors have a range of tests for diagnosing prostate cancer.
These include a physical examination of the prostate (known as a digital rectal examination, or DRE), blood tests, biopsies and MRI scans.
Men may be offered a prostate specific antigen (PSA) test to look for markers in the blood.
High levels may be a sign of a prostate condition, such as an enlarged prostate, or prostate cancer.
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The PSA test is not used in routine NHS screening because it is not yet reliable enough to detect prostate cancer that needs treatment.
However, men over 50 can ask their GP for a PSA test.
– How is prostate cancer treated?
If prostate cancer is at an early stage and not causing troubling symptoms, doctors may suggest something called “watchful waiting” or “active surveillance”.
This involves close monitoring of the cancer to see whether it is getting worse.
Treatments can have side-effects, such as erectile dysfunction and needing to urinate more often, which is why slow-growing cancers may just be monitored.
Other prostate cancer treatments include surgically removing the prostate, or radiotherapy either on its own or alongside hormone therapy.
If the cancer has spread to other parts of the body, such as the bones or lymph nodes, it cannot be cured but treatment is still available.
This may include hormone therapy or chemotherapy alongside hormone therapy.
Hormone therapy works by either stopping the body from making testosterone, or by stopping testosterone from reaching cancer cells.
Prostate cancer usually needs testosterone to grow and so this is a key treatment.
External beam radiotherapy may also be offered as it has been shown to help some men live longer when combined with other treatments.
Drug plans are tailored to the patient and so men should speak to their doctor about the best treatment for them.