The prostate is a small gland located beneath the bladder that forms part of the male reproductive system. Although many men rarely think about their prostate when they are younger, prostate-related conditions become increasingly common with age and are an important aspect of men’s health.
Prostate health concerns range from benign enlargement and urinary symptoms through to prostate cancer screening and assessment of elevated PSA levels. Many prostate conditions are highly treatable, particularly when identified early.
At The Wright Practice, we provide comprehensive assessment and advice regarding prostate health, helping men understand symptoms, screening options and the investigations that may be appropriate for their individual circumstances.
PSA (Prostate Specific Antigen) is a protein produced by the prostate gland and measured through a simple blood test. It is one of the most commonly used investigations when assessing prostate health and plays an important role in the early detection of prostate cancer.
However, PSA testing is not a cancer test in the same way that a pregnancy test is a pregnancy test. An elevated PSA does not necessarily mean that prostate cancer is present, and a normal PSA cannot completely exclude it. Understanding the strengths and limitations of PSA testing is therefore essential.
What Can Cause A Raised PSA?
For this reason, PSA results should always be interpreted in the context of age, symptoms, family history and previous PSA measurements.
Who Should Consider PSA Testing?
The Importance of PSA Trends
One of the most useful aspects of PSA testing is the ability to monitor changes over time. A stable PSA level over several years is often reassuring. Conversely, a rising PSA may warrant further assessment, even if the value remains within the laboratory reference range. For this reason, previous PSA results are often as important as the current result.
What Happens If PSA Is Raised?
An elevated PSA does not automatically mean cancer. Depending on the circumstances, further assessment may include repeat PSA testing, additional blood tests, MRI scanning of the prostate, urology referral or further specialist investigations. Modern prostate MRI has significantly improved our ability to assess men with elevated PSA levels and often forms an important part of the investigation pathway before considering biopsy.
Should Every Man Have A PSA Test?
There is no universal agreement that every man should undergo routine PSA screening. The decision should be individualised and based on age, family history, ethnicity, overall health and personal preferences. At The Wright Practice, we believe informed decision-making is key. We discuss the potential benefits, limitations and implications of testing so that each patient can decide whether PSA screening is appropriate for them.
Our Approach
PSA testing is one component of a broader assessment of prostate health. We consider PSA results alongside symptoms, risk factors and overall health to provide personalised recommendations regarding monitoring, further investigation and screening. For many men, PSA testing provides reassurance. For others, it identifies an opportunity for earlier assessment and intervention before significant disease develops.
Prostate cancer is the most common cancer affecting men in the UK. In many cases it develops slowly and causes no symptoms during its earliest stages, which is why many men are interested in understanding their risk and exploring whether screening may be appropriate.
Unlike some other cancers, there is currently no national screening programme for prostate cancer in the UK. This is because no single test can reliably distinguish between harmless prostate cancers and those that may become clinically significant. At The Wright Practice, we take an individualised approach to prostate cancer screening, helping men understand both the potential benefits and limitations of available investigations.
Who May Benefit From Screening?
Screening Options
PSA Testing remains the most commonly used screening test and can provide valuable information regarding prostate health. However, PSA should always be interpreted within the wider clinical context. MRI Scanning has transformed the investigation of prostate disease and can provide detailed information regarding the structure of the prostate gland. MRI may be particularly useful when PSA levels are elevated, rising over time or when additional reassurance is required.
Risk Assessment — screening decisions should also take into account age, family history, ethnicity, previous PSA results, general health and life expectancy.
The Importance of Early Detection
Whilst many prostate cancers are slow growing, some can be aggressive and benefit from early diagnosis and treatment. Screening aims to identify clinically significant cancers at a stage when management options may be broader and outcomes potentially more favourable.
Understanding The Limitations
It is important to recognise that screening is not perfect. Some prostate cancers may never cause symptoms or affect lifespan, whilst others may not be detected by screening tests alone. Screening decisions should therefore be based on an informed discussion of both benefits and limitations.
Our Approach
We believe prostate cancer screening should be personalised rather than routine. Our role is to help men understand their individual level of risk, discuss the advantages and disadvantages of screening and develop an approach that aligns with their health goals and personal preferences.
Benign Prostatic Enlargement (BPH), also known as benign prostatic hyperplasia, is one of the most common conditions affecting men as they get older. The prostate gland gradually increases in size with age and, whilst this enlargement is not cancerous, it can sometimes interfere with normal urinary function.
Many men experience some degree of prostate enlargement during their lifetime. For some, symptoms are mild and require little intervention. For others, urinary symptoms can become increasingly troublesome and begin to affect quality of life.
Common symptoms include:
Why Does It Happen?
The prostate surrounds part of the urethra, the tube that carries urine from the bladder. As the prostate enlarges, it can place pressure on the urethra and partially obstruct the flow of urine. The degree of enlargement does not always correlate with symptoms.
Assessment typically includes a detailed symptom review, medical history, urine testing, PSA testing where appropriate, blood tests and physical examination where appropriate. In selected cases, further investigations or specialist urology assessment may be recommended.
Treatment Options
Treatment depends on symptom severity and the impact on daily life. Lifestyle measures may include reducing evening fluid intake, limiting caffeine, limiting alcohol and bladder training strategies. Medication options may include alpha-blockers to relax the prostate and improve urine flow, and medications designed to reduce prostate size over time. For men with more severe symptoms, minimally invasive procedures or surgery may occasionally be required.
Does An Enlarged Prostate Mean Cancer?
No. Benign prostate enlargement and prostate cancer are different conditions. Although both become more common with age and may occasionally coexist, having an enlarged prostate does not mean that prostate cancer is present.
Our Approach
Our goal is to identify the cause of urinary symptoms, assess whether prostate enlargement is contributing and develop a personalised management plan. Many men achieve excellent symptom control through relatively simple interventions, whilst others may benefit from medication or specialist treatment.
Urinary symptoms are extremely common in both younger and older men and can arise from a variety of causes. Whilst many symptoms are related to benign prostate enlargement, they may also be caused by infection, inflammation, bladder conditions, lifestyle factors or, less commonly, more serious underlying disease.
Many men assume that urinary symptoms are simply an inevitable part of ageing. However, persistent symptoms should not be ignored, particularly if they are affecting quality of life or becoming progressively worse.
Common urinary symptoms include:
Potential causes include:
Assessment begins with understanding the nature, severity and duration of symptoms. Depending on your circumstances, investigations may include urine testing, PSA testing, blood tests, assessment of kidney function, screening for diabetes, ultrasound scanning where appropriate and specialist urology referral where required.
When Should You Seek Assessment?
We recommend seeking medical advice if symptoms are persistent, progressively worsening, affecting sleep or quality of life, associated with blood in the urine, associated with recurrent infections, associated with pelvic pain, or associated with difficulty emptying the bladder.
Treatment Options
Management depends on the underlying cause and severity of symptoms. Treatment may include lifestyle modifications, fluid management strategies, reducing caffeine and alcohol, medication, treatment of infection or inflammation, and specialist referral where appropriate. Many urinary symptoms respond well to relatively simple interventions once the underlying cause has been identified.
Our Approach
Urinary symptoms can have a significant impact on daily life, sleep, confidence and overall wellbeing. Our aim is to identify the underlying cause, provide reassurance where appropriate and develop an effective treatment strategy tailored to the individual.
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I have been going to Dr Wright for a number of years now. He is highly knowledgeable, compassionate, open minded and efficient, I couldn’t recommend him highly enough
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101 Harley Street, London, W1G 6AH
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