What’s the point in having a prostate?

Speaker: Professor Anthony Mundy PhD (Hon), FRCP, FRCS, FRACS (Hon), FACS (Hon)

Professor Mundy will ask the question “What’s the point of having a prostate?”. It could be said, almost sarcastically, that one point is to give men a source of distress, disruption and sometimes death due to the potential for prostate cancer.

Every year in the UK, more than 63,000 men are diagnosed with this malignancy. It is the most common cancer in men in the UK, accounting for approximately 30% of all new male cancers annually and for more than 12,000 deaths a year. Despite these worrying numbers, it is reassuring that for 95% of men of 70 years and above, the 10-year risk of death directly attributed to prostate cancer is less than 1%.

The routinely available screening test for prostate cancer is the prostate-specific antigen (PSA) and it has been proposed that the PSA should be offered as a routine screening test for men over 50. But the PSA is not entirely reliable, creating the risk of over diagnosis and then over treatment. The UK National Screening Committee has reviewed the evidence and, in November 2025, decided against offering PSA screening for all men, citing evidence that ‘harms outweigh the benefits’.

Prostate cancer treatment options are surgery, radiotherapy, chemotherapy and hormone treatment and all have their potential risks. The most common harms associated with surgery are urinary incontinence with leakage when coughing, lifting or exercising, and erectile dysfunction due to nerve damage. Tony Mundy has a wealth of experience in performing remedial surgery for those with persistent urinary incontinence and no doubt he will cover this unwanted consequence of prostatectomy, the potential for which migh increase when PSA screening can lead to a false positive diagnosis and potentially unnecessary treatment. In addition, even when prostate cancer is accurately diagnosed, 40-50% of these cases will be slow growing and require only regular monitoring and perhaps only hormone therapy.

Notwithstanding the Screening Committee’s decision which is still subject to a consultation period, there is widespread concern that, without a full screening programme, large numbers of men will miss out on the opportunity of an early diagnosis of prostate cancer. Unsurprisingly, alternative screening programmes are being evaluated to determine the safest, most accurate and most cost-effective way to screen men for this unwelcome disease.

To learn more on this important subject please join us at The Athenaeum and hear the views of our vastly experienced speaker, Professor Tony Mundy, and on other aspects of prostatic function and disease, mostly from a surgical perspective.

Dr Russell Cowan