Editing Prostate (section)

===Cancer===
{{Main|Prostate cancer}}
{{Multiple image
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 | image2    = Diagram showing prostate cancer pressing on the urethra CRUK 182.svg
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 | caption2  = A diagram of prostate cancer pressing on the urethra, which can cause symptoms
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 | caption4  = [[Micrograph]] showing normal prostate cancer in the right upper aspect of image. [[HPS stain]]. [[Prostate biopsy]].
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Prostate cancer is one of the most common [[cancer]]s affecting older men in the UK, US, Northern Europe and Australia, and a significant [[cause of death]] for elderly men worldwide.<ref>{{Cite journal |vauthors=Rawla P |date=April 2019 |title=Epidemiology of Prostate Cancer |journal=World J Oncol |type=Review |volume=10 |issue=2 |pages=63–89 |doi=10.14740/wjon1191 |pmc=6497009 |pmid=31068988}}</ref> Often, a person does not have symptoms; when they do occur, symptoms may include urinary frequency, urgency, hesitation and other symptoms associated with BPH. Uncommonly, such cancers may cause weight loss, retention of urine, or symptoms such as [[back pain]] due to {{wt|en|metastatic}} lesions that have spread outside of the prostate.{{sfn|Davidson's|2018|pp=437–9}}

<!--Investigations-->
A [[digital rectal examination]] and the measurement of a [[prostate-specific antigen]] (PSA) level are usually the first investigations done to check for prostate cancer. PSA values are difficult to interpret, because a high value might be present in a person without cancer, and a low value can be present in someone with cancer.{{sfn|Davidson's|2018|pp=437–9}} The next form of testing is often the taking of a [[prostate biopsy]] to assess for [[tumour grade|tumour activity]] and invasiveness.{{sfn|Davidson's|2018|pp=437–9}} Because of the significant risk of [[overdiagnosis]] with widespread screening in the general population, [[prostate cancer screening]] is controversial.<ref>{{Cite journal |last1=Sandhu |first1=Gurdarshan S. |last2=Andriole |first2=Gerald L. |date=September 2012 |title=Overdiagnosis of Prostate Cancer |journal=Journal of the National Cancer Institute. Monographs |volume=2012 |issue=45 |pages=146–151 |doi=10.1093/jncimonographs/lgs031 |issn=1052-6773 |pmc=3540879 |pmid=23271765}}</ref> If a tumour is confirmed, [[medical imaging]] such as an [[MRI]] or [[bone scan]] may be done to check for the presence of tumour {{wt|en|metastases}} in other parts of the body.{{sfn|Davidson's|2018|pp=437–9}}

<!--Management-->
Prostate cancer that is only present in the prostate is often treated with either surgical [[prostatectomy|removal of the prostate]] or with [[radiotherapy]] or by the insertion of small radioactive particles of [[iodine-125]] or [[palladium-103]], called [[brachytherapy]].<ref>{{Cite web |title=What is Brachytherapy? |url=https://www.americanbrachytherapy.org/resources/for-patients/what-is-brachytherapy/ |access-date=8 August 2020 |website=American Brachytherapy Society |language=en}}</ref>{{sfn|Davidson's|2018|pp=437–9}} Cancer that has spread to other parts of the body is usually treated also with hormone therapy, to deprive a tumour of sex hormones (androgens) that stimulate proliferation. This is often done through the use of [[GnRH analogues]] or agents (such as [[bicalutamide]]) that block the receptors that androgens act on; occasionally, [[orchidectomy|surgical removal of the testes]] may be done instead.{{sfn|Davidson's|2018|pp=437–9}} Cancer that does not respond to hormonal treatment, or that progresses after treatment, might be treated with [[chemotherapy]] such as [[docetaxel]]. [[Radiotherapy]] may also be used to help with pain associated with bony lesions.{{sfn|Davidson's|2018|pp=437–9}}

Sometimes, the decision may be made not to treat prostate cancer. If a cancer is small and localised, the decision may be made to monitor for cancer activity at intervals ("active surveillance") and defer treatment.{{sfn|Davidson's|2018|pp=437–9}} If a person, because of [[Frailty syndrome|frailty]] or other medical conditions or reasons, has a [[life expectancy]] less than ten years, then the impacts of treatment may outweigh any perceived benefits.{{sfn|Davidson's|2018|pp=437–9}}