Cambridge researchers say public need to know that early prostate cancer is silent

Men with early prostate cancer are missing opportunities to have their cancer detected because national guidelines and campaigns focus on urinary symptoms – even though there is a lack of evidence that these indicate prostate cancer.

This is the message from a new review from the University of Cambridge in the UK, published in BMC Medicine. The authors argue that the emphasis on urinary symptoms may deter men from coming forward for early testing of a potentially treatable cancer if they do not have problems urinating.

“When most people think of the symptoms of prostate cancer, they think of problems with peeing or needing to pee more frequently, particularly during the night,” said Vincent Gnanapragasam, Professor of Urology at the University of Cambridge and an Honorary Consultant Urologist at Addenbrooke’s Hospital, Cambridge.

“This misperception has lasted for decades, despite very little evidence, and it’s potentially preventing us picking up cases at an early stage.”

The paper says that there is some evidence that a lack of urinary symptoms may, in fact, be an indicator of a higher likelihood of cancer.

“We need to emphasise that prostate cancer can be a silent or asymptomatic disease, particularly in its curable stages,” said Professor Gnanapragasam. “Waiting out for urinary symptoms may mean missing opportunities to catch the disease when it’s treatable.”

“Men shouldn’t be afraid to speak to their GP about getting tested, and about the value of a PSA test, especially if they have a history of prostate cancer in their family or have other risk factors such as being of Black or mixed Black ethnicity.”

In September, the European Commission is due to announce whether it will recommend national screening programmes for prostate cancer. Europa Uomo has been campaigning for national early detection programmes across Europe, based on risk-stratified PSA testing.