In many cases, the cancer remains confined to the prostate gland and may never cause significant harm during a man’s lifetime. However, other types are more aggressive and require prompt, strategic intervention to prevent spread to other parts of the body.

Did you know:

In the UK, 1 in 8 men will be diagnosed with prostate cancer in their lifetime. This risk increases significantly to 1 in 4 for Black men, highlighting the importance of tailored screening and early awareness within specific risk groups.

Symptoms

Prostate cancer does not usually cause symptoms until it has spread to other parts of the body; in other words, symptoms are caused by secondaries. Urinary symptoms are usually caused by benign non-cancerous enlargement of the prostate (BPH), which is very common.  The prostate starts to enlarge in the vast majority of men in their 40s.

Nevertheless, you should consult a specialist if you notice:

• An increased need to urinate, especially during the night (nocturia).
• Difficulty starting to pee or straining during the process.
• A weak or interrupted flow of urine.
• A feeling that your bladder has not fully emptied.
• Blood in the urine or semen (haematuria).

In advanced cancer, symptoms might also include persistent back, hip, or pelvis pain, unexplained weight loss, or erectile dysfunction.

Mr. Collins Approach

Mr Gerry Collins views every diagnosis as a unique biological puzzle rather than a routine procedure. Having conducted extensive research at Edinburgh University and the Mayo Clinic, his approach is built on “Clinical Discernment.” This means looking beyond raw PSA numbers to understand the individual biology of each patient.

While MR is the current state of the art imaging, there are significant limitations in that MR cannot easily distinguish between cancer and inflammation (common) and therefore even abnormal MRs need to be interpreted before deciding to proceed to biopsy.

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Causes & Risk Factors

While the exact cause of prostate cancer remains unknown, several factors increase the likelihood of development:

The Solution: Treatment pathways

Management is categorised by risk groups: low, intermediate, and high risk. Treatment is never “one size fits all” and is dictated by the grade of the cancer and the patient’s overall health.

How to Prevent?

While you cannot change your genetics or age, you can support your prostate health through proactive lifestyle choices:

• Dietary Choices: Incorporate foods rich in lycopene, such as cooked tomatoes, and cruciferous vegetables like broccoli and cauliflower.
• Maintain a Healthy Weight: Evidence suggests that obesity is linked to more aggressive prostate cancers.
• Regular Exercise: Staying active improves overall metabolic health and can help manage hormone levels.
• Smoking Cessation: Smokers may have a higher risk of cancer recurrence and poorer outcomes following treatment.

FAQs

The post Prostate Cancer: A Guide to Risk, Diagnosis, and Measured Management appeared first on Gerry Collins Urology.

For many, the condition manifests as a persistent need to pass urine, often in small amounts, alongside a heavy, aching pressure in the lower tummy or pelvis. While it is more common in women, it significantly affects men as well, often being misdiagnosed as chronic prostatitis. Though there is currently no universal cure, the focus of modern urology is on strategic management: identifying unique triggers and cooling the “biological fire” within the bladder wall.

Symptoms

Because BPS symptoms can mimic other conditions, it is vital to recognise when your symptoms require specialist investigation. You should seek a consultation if you experience:

• Persistent pain in the bladder, lower tummy, or pelvic floor that does not resolve with standard treatments.
• An overwhelming and frequent urge to urinate, even when the bladder is empty.
• Nocturia: Waking up multiple times during the night to pass urine.
• Pain during or after sexual intercourse (penetration for women) or pain during erection or after ejaculation for men.
• Visible blood in the urine (haematuria): This requires urgent assessment to rule out other underlying causes.
• Symptoms that “flare” or worsen in response to specific triggers like stress, certain foods, or the menstrual cycle.

Mr. Collins Approach

With nearly 30 years of experience and a background in rigorous research at Edinburgh University and the Mayo Clinic, he understands that for a patient in pain, the “wait and see” approach only breeds anxiety.

In men, he carefully distinguishes BPS from BPH (enlarged prostate) or prostatitis, ensuring patients are not subjected to unnecessary treatments. By viewing every diagnosis through the lens of neovascularity and bladder biology, he filters out the clinical noise to create a highly personalised, measured intervention plan that respects the patient’s individual baseline.

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Causes & Risk Factors

While the exact cause of BPS remains a subject of ongoing research, several factors are believed to contribute to the irritation of the bladder wall:

Treatment pathways

Mr Collins focuses on a tiered approach, starting with the least invasive options and progressing to more advanced therapies where necessary.

Medical & Therapeutic Pathways:

• Oral Medications: This includes everyday painkillers, antihistamines to reduce inflammation, or nerve-blockers like amitriptyline to dampen pain signals.
• Bladder Instillations: Often called a “bladder cocktail,” this involves delivering soothing medicine (such as sodium hyaluronate or heparin) directly into the bladder via a thin catheter to protect the lining.
• Neuromodulation: Sacral nerve stimulation (SNS) involves a small device that sends electrical signals to the nerves controlling the bladder, helping to reset the “urgency” signals.
• Specialist Pelvic Physiotherapy: Targeted exercises to relax and coordinate pelvic floor muscles, which are often in a state of chronic spasm in BPS patients.

Surgical & Advanced Pathways:

• Cystoscopy with Bladder Overdistention: A procedure to stretch the bladder under general anaesthetic, which can sometimes desensitise the nerves and improve capacity.
• Resection of Hunner’s Ulcers: If specific lesions (ulcers) are found on the bladder wall, they can be cauterised or removed using a laser.
• Major Surgery: In extreme cases where all other treatments have failed, options such as a reconstructed bladder (neo-bladder) or urinary diversion may be discussed.

How to Prevent?

Managing BPS often starts with proactive changes at home to reduce the frequency of flare-ups:

• The Food Diary: Track your intake to identify personal “triggers.” Common culprits include caffeine, alcohol, spicy foods, and highly acidic items like citrus fruits and tomatoes.
• Bladder Retraining: Gradually increasing the time between bathroom visits can help the bladder learn to hold more urine over time.
• Stress Management: Stress is a known trigger for pelvic pain. Incorporating low-impact exercise like yoga or meditation can help regulate the nervous system.
• Smoking Cessation: Smoking irritates the bladder and restricts blood flow, hindering the natural healing process of the bladder lining.

FAQs

The post Understanding Interstitial Cystitis / Bladder Pain Syndrome (BPS) appeared first on Gerry Collins Urology.