Sometimes there is no perfect answer in medicine, and prostate cancer screening remains one of those complex issues. The subject has recently returned to the headlines, and many people continue to ask questions about it, which suggests there is still considerable confusion surrounding prostate cancer testing, PSA test reliability, and the role of modern MRI scans in early diagnosis. Understanding your options and symptoms is the first step toward proactive men’s health management.

To begin at the beginning: what exactly is cancer? The term itself is something of a catch-all description for a wide range of diseases. In simple terms, cancer occurs when cells begin to grow and divide uncontrollably. Instead of dying naturally, as healthy cells should, they continue multiplying and can eventually spread into surrounding tissues and other organs. This process is known as metastasis.

There are more than 100 different diseases classified as cancer, and they vary enormously. Some cancers develop rapidly, while others progress very slowly. Research continues to advance at an impressive pace, and developments in genetic and DNA technology are helping clinicians better understand these diseases than ever before.

One principle, however, remains consistent: the earlier cancer is detected, the greater the chance of successful treatment. Some cancers produce warning signs early on, while others remain silent for years. The ultimate goal of screening is therefore to identify cancer at the earliest possible stage, when intervention is most effective.

The anatomy of the prostate and early signs

Prostate cancer presents a particular challenge. The prostate is a gland found only in men and plays an important role in reproduction. Anatomically, it sits deep within the pelvis and surrounds the urethra – the tube that carries urine from the bladder out of the body. The prostate also helps regulate the flow of urine, making it an important part of the male urinary system.

The controversy surrounding prostate cancer screening centres on the PSA test. PSA stands for Prostate-Specific Antigen, a protein produced by prostate cells. The test itself is simple: a routine blood sample that can usually provide results within a few days.

However, the PSA test is only the first stage of assessment. An elevated PSA level does not necessarily mean a man has prostate cancer. It is only one piece of the overall clinical picture.

The prostate naturally changes in size with age. In younger men, it is often compared to the size of a walnut, but it can enlarge significantly over time. As the gland grows, it may begin to compress the urethra, making urination more difficult. It can also press against the bladder, creating a frequent or urgent need to urinate, particularly during the night. These symptoms are common and do not automatically indicate cancer – although in some cases they may warrant further investigation.

This brings us back to a key principle of cancer care: early detection improves outcomes. Prostate cancer is often highly treatable when identified early.

Treatment options and active surveillance

In some cases, particularly with very slow-growing tumours, doctors may recommend active surveillance rather than immediate treatment. Depending on a patient’s age and overall health, careful monitoring may be entirely appropriate. Medications can also help relieve urinary symptoms.

In other cases, treatment depends on how advanced the cancer is and the level of risk it poses. Some therapies are designed to slow tumour growth, while radiotherapy can destroy cancer cells directly within the prostate. In certain situations, surgical removal of the prostate may be the best option.

The difficulty arises when prostate cancer is not detected early enough. Like many cancers, it can spread to other parts of the body, at which point treatment becomes far more difficult. In the United Kingdom, prostate cancer remains the second leading cause of cancer-related death among men, underlining the importance of taking the disease seriously.

Much of the debate reported in the media concerns the limitations of the PSA test. A raised PSA result alone is not sufficient to diagnose cancer, which means further investigations may be required. Traditionally, the next step after consultation with a urologist was often a biopsy.

Understanding the risks of traditional biopsies

A biopsy involves taking a small tissue sample from the prostate for microscopic examination. Accessing the prostate is not straightforward, and the procedure carries some risks, including:

• Infection

• Urinary incontinence

• Erectile dysfunction

Although these risks are relatively low, they are important considerations, and no patient should ever feel pressured into undergoing the procedure without fully understanding the implications.

Fortunately, diagnostic approaches have improved significantly in recent years.

The modern solution: MRI as the gold standard

Today, many patients are offered an MRI scan before a biopsy is considered. During an MRI scan, the patient lies inside a scanning machine while detailed three-dimensional images of internal organs are produced. Although MRI scanners were once limited in availability, they are now widely accessible and provide clinicians with highly detailed information. MRI imaging is now regarded as the gold standard in the assessment of suspected prostate cancer.

MRI scans can identify slow-growing tumours that may safely be monitored rather than treated immediately. If the scan is completely clear, invasive testing may not be necessary. If abnormalities are detected, any subsequent biopsy can be performed with much greater precision, significantly reducing the need for random sampling and limiting potential complications.

Who should consider a prostate cancer test?

So, what should men do?

Medical guidance has evolved over time. Previously, PSA testing was often recommended only after symptoms developed – although by that stage, opportunities for early treatment may already have been reduced. One reason for caution was the relatively high rate of false-positive PSA results.

With the increased availability and accuracy of MRI scanning, the approach is changing.

• Men over the age of 55: Should strongly consider having a PSA test and discussing the results with a consultant urologist if levels are elevated.

• Men between 40 and 55: Who experience urinary difficulties or frequent night time urination should also consider arranging a PSA test.

Breaking the stigma around men’s health

Cancer is understandably frightening and should never be dismissed lightly. The encouraging reality is that prostate cancer is often highly treatable, particularly when diagnosed early. While the PSA test is not perfect, it remains an important first step. Combined with modern MRI imaging, it forms the most effective diagnostic pathway currently available.

Finally, a word to the men reading this: your GP has dealt with these conversations countless times before. Feeling embarrassed is entirely natural, but there is no reason to avoid seeking advice. If you would feel more comfortable speaking to a male doctor, you are fully entitled to request one. Most practices will accommodate this, even if it means waiting slightly longer for an appointment. What matters most is not delaying the conversation.

The information provided in this column is for educational and informational purposes only, and does not constitute medical advice. It is not a substitute for a professional medical consultation, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health provider with any questions you may have regarding a medical condition.

Dr Marcus Stephan

Spain’s government has sent a new law to Congress aimed at banning fake sexual images created using artificial intelligence after growing concern that people could be exposed online abuse, harassment and the spread of manipulated content including those of women and children.

The government says the measures are designed to protect individuals from having their images turned into explicit material without consent, a problem that has raised particular concern among parents, schools and child protection groups.

The legislation would introduce some of the toughest penalties yet seen in Spain for the creation and distribution of sexual “deepfakes”, including fines of up to 35 million euros or 7% of a company’s global annual turnover in the most serious cases. The move follows increasing concern across Europe over the rise of digitally manipulated images and videos that can place a person’s face onto explicit content without their consent.

Focus on protecting victims from fake sexual content

The proposed law is to address fears that ordinary people, including teenagers and children, can be targeted using publicly available photographs taken from social media accounts or messaging platforms. In recent years, cases involving fake nude images of schoolgirls and women have attracted national attention in Spain, raising concerns about how quickly manipulated material can spread online and the emotional impact it can have on victims.

Under the proposed legislation, creating or sharing sexually explicit fake images without consent would face tighter legal restrictions. The measures are intended to protect people from having fabricated intimate material circulated online using their likeness. The legislation also includes measures targeting artificially generated child sexual abuse material and other forms of harmful digital impersonation.

Concerns over the impact on young people

The issue has become particularly sensitive following several investigations involving minors. Spanish authorities and campaign groups have warned that young people are especially vulnerable because photographs posted online can be copied and altered without permission.

Parents’ associations and child protection groups have repeatedly called for stronger safeguards after incidents involving school-age victims caused public concern in different parts of the country. The government argues that existing legislation has struggled to keep pace with the speed at which manipulated images can now be produced and shared.

New penalties and restrictions proposed

The bill approved by the Council of Ministers would create new penalties for companies and platforms that fail to comply with rules surrounding prohibited content. In the most serious cases, sanctions could reach 35 million euros or 7% of annual global turnover.

Spain’s Digital Transformation Minister Óscar López said the law is intended to protect citizens from harmful uses of technology and strengthen safeguards against abuse. Alongside restrictions on fake sexual content, the legislation would also prohibit certain forms of biometric categorisation and systems considered harmful to privacy or individual rights.

Mandatory labelling of altered content

The proposed law would require AI-generated material to be clearly identified in some situations so that users know when images, audio or video have been artificially altered or created.

Spanish officials say the aim is to reduce deception online and prevent manipulated material being mistaken for real content. The measures form part of Spain’s adaptation of wider European Union rules on artificial intelligence and digital safety.

Cases involving fake images have increased concern

Public debate around manipulated sexual images intensified after several high-profile cases involving teenagers emerged in Spain over the past two years. Some incidents involved fake nude images of minors created from ordinary photographs shared online.

Although the pictures were fabricated, families and campaigners warned that the damage caused to victims could still be severe. Experts working in child safety and digital rights have warned that the spread of manipulated intimate content can lead to humiliation, bullying and psychological distress, particularly among younger victims.

Law still faces parliamentary approval

The legislation must now pass through Spain’s parliamentary process before becoming law. Congress will debate the proposals and may introduce amendments before a final vote takes place. If approved, Spain would become one of the European countries with the strongest financial penalties linked to the creation and spread of fake sexual material generated using artificial intelligence.

The government says the legislation is intended to respond to growing public anxiety over how easily manipulated intimate content can now be produced and shared online. For many families, the debate centres on a simple concern: whether an ordinary photograph uploaded to the internet could be turned into fake explicit material without permission, and what legal protections exist if that happens.

Age Concern Marbella San Pedro always works to make sure life after 50 stays filled with fun, friendship and enjoyment for local residents.

Retired individuals or those who have recently stopped working can get chances to connect with others through dedicated events.

People dealing with common health issues or simply wishing to expand their social circle receive tailored assistance.

Coffee mornings operate in multiple locations

Six drop-in coffee mornings function across Marbella, San Pedro and Elviria to create inclusive spaces.

Participants can enjoy a warm welcome whether they attend alone or with a partner. Trained volunteers run each session and offer guidance to anyone who finds new environments slightly intimidating.

Venues host weekly sessions

• Neli G’s Gastro Cafe in Las Palmeras de Benavista, Benavista, provides space for one coffee morning.
• Sunday, San Pedro at Avenida Marques del Duero 82 in San Pedro Alcantara operates another regular session.
• Hapimag Marbella at Calle Camilo Jose Cela 17 in Marbella welcomes guests regularly.
• Urban Chai at Calle las Petunias local 6 bloque 1 in San Pedro hosts a coffee morning.
• Pandora on Avenida Marques del Duero in San Pedro Alcantara serves as an additional location.
• El Barracón in Centro Commercial Elviria local 16 completes the list of venues.

Full details appear in regular adverts placed in Euroweekly News.

Extensive services help maintain independence

Free welfare advice and targeted support feature among the wide variety of services. Monthly lunches, day trips and home visits supplement the programme. Activities take place at the community centre in San Pedro to match varied interests and abilities. English-speaking members of the over-50 community remain active, connected and independent as a result.

Contact options make sure of easy access

Helpline staff remain available 40 hours a week from Monday to Friday between 10am and 6pm. Callers reach the team at 689 35 51 98 or via WhatsApp for immediate responses from trained volunteers. Emails sent to info@ageconcernmarbella.com require inclusion of a daytime phone number for callbacks.

Join the caring community today

Membership of Age Concern Marbella San Pedro opens doors to fresh experiences and lasting friendships. People who sense isolation after family or friends have relocated benefit from immediate contact. Dedicated staff create an environment where every individual feels valued and part of the group.