How much do we know about prostate problems and the PSA?

I asked Dr. Patel to write about this issue as it is always me that nags my husband to go and have a prostate check-up. As you will read in her article men do not receive letters reminding them as women do for breast check-ups and cervical smears. Maybe the NHS know that they have a team of nagging women out there making sure their husbands, partners, brothers and sons are having regular check-ups. Anyway, this article will hopefully answer many of your questions about this area of men’s health and if you want to know more then book a consultation online or in-person with Dr. Patel (details at bottom of the article). Annabel

A common reason that women attend clinics with their partners is prostate concerns. The prostate is a golf ball-sized gland that is found in men, in the region between the bladder and the penis. The prostate gland is important as, without it, men would not be able to have control of their urine, and would lose their erectile function.

Whilst there are National Health Service (NHS) screening programmes to proactively check for breast cancer and cervical cancer in women, there is currently no equivalent programme for men’s testicular or prostate cancer. This is probably why men are not used to being proactive about their health, as they are not invited to regular health screening appointments throughout their life. This may also be a factor as to why men present later to health professionals.

Men over the age of 40 years old (although this process starts in men from the age of 25 years old), commonly attend my GP clinic, with natural age-related signs of prostate enlargement that all men suffer from. Common symptoms that patients present with are difficulty starting to pass urine, finding that their urinary stream is not as strong, not being able to completely empty their bladder and having to pass urine more frequently. If they attend with their partner, it is because they are waking their partners up in the night as they need to pass urine!

The exact mechanism of why the prostate enlarges in men with age is unknown, but current scientific research points to evidence of a hormonal imbalance that causes the prostate gland to grow. Some patients will need specific investigations and treatment if their symptoms are troublesome, but many men manage the change that the prostate causes.

A common question patients ask me is whether they need to have their PSA test done?

The prostate-specific antigen (PSA) is a protein that is only found in men as it is only made by the prostate gland. The PSA level can be checked by a blood test by your GP. Your GP will always have a consultation and discussion with you before they carry out a PSA test, as while this test is specifically related to the prostate gland, it is not always accurate. For example, in a group of men who have a raised PSA result, approximately 75% of patients will not have cancer.

The PSA test can also miss prostate cancer, so a normal result is not always accurate either. It is for this reason that your GP will offer to carry out a prostate examination using their finger in the clinic, which can be embarrassing and uncomfortable. Together with a PSA blood test result, this can help to offer a more accurate likelihood that further investigations such as a prostate biopsy are required. Symptoms of prostate cancer can include; any of the urinary symptoms mentioned above, having to rush to the toilet to pass urine, blood in the urine or semen.

If you are concerned about symptoms of an enlarged prostate or prostate cancer or worried that your partner may have symptoms of this, please discuss your concerns with your general practitioner and make an appointment to see them today.

For previous articles written by Dr. Patel click HERE.

Dr. Hana Patel BSc MBBS FRCGP MSc (Med Ed) ILM7

NHS and Private Senior General Practitioner (FRCGP) (for remote consultations)

Executive Business and Life Coach ILM7for a coaching appointment- either face to face in my South London private office or remotely, please email me directly at

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Margaret Longden
Margaret Longden
1 year ago

My husband died two days ago from advanced prostate cancer. He had regular PSA tests and PR checks. He had an unusual type of cancer which did not produce a raised PSA and as he was a really fit and healthy man, it wasn’t until he had an episode of acute retention of urine at the start of the pandemic that a biopsy was done. I know so many women whose partners, fathers, brothers and even sons have this insidious disease which can be easily and successfully treated if caught early. The cost of treating it as it becomes more advanced must be so much greater that even the economic cost of good screening programme would be mitigated. For this, however, we need a reliable test. Women can play their part by encouraging men to get symptoms checked out and to lobby for the reliable test which is needed.

1 year ago

Hi Margaret. I am so so sorry for your loss and your story really highlights the message behind Dr. Patel’s article. I am sure that Dr. Patel will answer your comment asap. In the meantime, I can only, once again, pass on our condolences to you during this very sad time. A&G x

1 year ago
Reply to  Annabel

Dear Margaret, I am so sorry to hear about the recent loss of your husband. I completely agree with you regarding the need for a reliable screening test to detect prostate cancer. Research is ongoing in this area, and I continue to encourage everyone to be proactive about their health and echo Annabel’s request for men to have a regular prostate checks carried out. Raising awareness, and you have been so brave to share your story to inform others, is a way to continue to bring the awareness of prostate cancer to the forefront and help to drive positive change. My condolences, Hana