MANY of the most common diseases are well publicised and the public often know how to reduce the risk of falling foul of them.

This is not the case with prostate cancer, however. Almost 22,000 men in the UK are diagnosed with this disease every year, and it could soon become the most common cancer in men.

Despite its prevalence, little is known about what causes it. The risk is increased if there is a family history of the disease, but nothing else is known for sure.

Some people do not even know what the prostate is or where to locate it. Such ignorance makes this week's Prostate Cancer Awareness Week all the more important.

The prostate is a male sex gland located beneath the bladder, which produces a component of semen.

The disease mainly affects older men, but, as Worcestershire Royal Hospital's consultant urological surgeon Terry Chen explains, it is now being diagnosed more often in men in their 40s.

"It was initially thought to be an old man's disease and there was little in the way of treatment," he said.

"Many elderly people with prostate cancer would die of other causes. But things have changed in the past 10 years.

"Men and their wives are more aware of men's health and diseases."

In the past, many men who experienced symptoms such as difficulty and pain when urinating would put them down to old age and would be reluctant to visit their GP.

Now, as men take more responsibility for their health and younger people are diagnosed with the disease, treatment has become much more of an issue.

With older victims of the cancer, the risk of treatment is still considered too great, and a policy of "watchful waiting" is employed to monitor the disease.

When the patient is younger or the cancer is more aggressive, there are a number of options open to them.

To operate or not to operate: that is the question the surgeon is then faced with.

"When a diagnosis of cancer is made, it's not like breast cancer where you find it and remove it," said Mr Chen.

"There are complications of age, the age their parents lived to, and concurrent medical problems.

"You have to look at the nature of the cancer and its grade."

Prostate cancer is graded from one to 10, depending on how aggressive it is. This does not depend on how early it is caught; some prostate cancers are simply more aggressive than others.

"You need to look at whether it has spread, or if it is still within the prostate," said Mr Chen.

"We then talk to the patient and give them information about their treatment."

The main two courses of treatment for prostate cancer are surgery and radiotherapy.

Helen Worth, a specialist urology nurse, said the patient had to consider a variety of factors before deciding what treatment to choose.

"We try to get them to weigh up the pros and cons, and think of which side effects they are more happy to put up with," she said.

"Some people don't like the thought of having it left inside their body, so they go for surgery.

"Some don't want to have major surgery, and decide they can put up with the side effects of radiotherapy."

They are often encouraged to speak to family members or friends who have had the disease.

It is not an easy decision - both options carry significant risks. Surgery brings with it the possibility of impotence and a slight risk of incontinence, while radiotherapy can also lead to bladder damage and involves visiting hospital 30 times in the space of six weeks.

Other options include hormone treatment, which aims to stop or slow the growth of the tumour, and brachytherapy, where radioactive "seeds" are implanted directly into the tumour.

The grade of the tumour is also a significant factor. "If it's above seven, surgery has benefits over radiotherapy," said Mr Chen.

For four out of five people, however, radiotherapy is the preferred option.

Although the treatment sounds unpleasant, the survival rate is excellent if the cancer is caught early.

"The mortality rate is less than one per cent," said Mr Chen. "If the patient is cured, they should have a normal life expectancy.

"If you don't cure them, they will still survive longer."

With the likely side effects of the treatment, aftercare is every bit as important as the treatment itself.

Worcestershire Royal Hospital is currently without a support group, but Mrs Worth is hoping to get one up and running later in the year.

The problem, unsurprisingly, is lack of staff. Mrs Worth is the only specialist urology nurse at the hospital, and has precious little time to devote to establishing a group.

"We need more patient involvement," she said. "In Kidderminster, patients have taken the lead in their own support."

In the mean time, patients can make use of the Kidderminster group or visit Macmillan nurses.

"There's an increasing amount of support out there for men," said Mrs Worth.