Prostate cancer

Please note: the information below does not constitute medical advice. If you have any concerns at all, speak to your GP or consultant.

 

 

 

Approved: April 2024

 

 

 

Review date: April 2026

About prostate cancer

Prostate cancer is the most common type of cancer found in males. Every year over 52,000 males in the UK will be diagnosed with prostate cancer – 1 in 8 males will be diagnosed with prostate cancer in their lifetime.

What is the prostate?

The prostate is a walnut-sized gland found in males, lying between the penis and bladder. The prostate starts off relatively small in boys, then grows larger during puberty as testosterone levels increase. In healthy adults, the prostate is around the size of a walnut, with a volume of approximately 20ml.

The prostate gland plays a key role in the male reproductive system by producing fluid that nourishes and transports sperm. At ejaculation, sperm is mixed with fluid from the prostate gland. A substance called prostate-specific antigen (PSA) liquidises the ejaculate to improve the chances of fertilization. The fluid produced by the prostate also prevents infection in the urethra.

Prostate cancer is usually “slow growing” and may go unnoticed however, in some cases, it can be aggressive and spread to other parts of the body, particularly the bones and lymph nodes.

Who gets it?

It is most common among men over 50 years old and the risk increases with age. Other risk factors include those with a close-family history of prostate cancer, black African – Caribbean men and those with certain genetic mutations.

Our work in prostate cancer

The Urology Foundation has launched a coordinated campaign to raise awareness and shine a spotlight on all those impacted by and involved in prostate cancer. Find out more about our campaign here.

See our campaign video below for more information.

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Prostate cancer symptoms

Symptoms of prostate cancer are not always apparent in the early stages, but as the cancer progresses, symptoms can include:

  • Difficulty urinating – starting or maintaining
  • Urine leakage
  • Pain when urinating
  • Needing to urinate often
  • Blood in the urine or semen
  • Erectile dysfunction
  • Pain in the hips, back, or chest

If you notice any of the following symptoms, book an appointment with your GP

Prostate cancer diagnosis

Tests

There is no single test to check for prostate cancer, so a series of tests must be performed to reach a diagnosis. Your GP may:

  • Ask you about your symptoms, and medical history, including any family history of prostate cancer or other relevant conditions.
  • Take a sample of urine to test for infection.
  • Perform a rectal exam to check the size, shape, and texture of your prostate.
  • Perform a blood test known as the Prostate-Specific Antigen (PSA) Test to check PSA levels. Raised PSA levels can indicate the presence of prostate cancer, although other factors such as age, prostate size, and certain medications can affect PSA levels.

If the GP suspects prostate cancer they may refer you to a urologist for further investigation. The urologist may repast the above examinations and tests and also recommend:

  • A biopsy. This where small samples of prostate tissue are taken and are then examined under a microscope to determine if cancer cells are present.
  • Imaging test such as an MRI (magnetic resonance imaging), or CT (computed tomography) scans to look at the prostate gland and surrounding tissues, as well as to determine the extent (stage) of the cancer if it is diagnosed.

Prostate cancer treatment

Deciding on treatment

Once prostate cancer is diagnosed a number of factours will determine the type of treatment offered. These include general health, lifestyle or personal preferences, the stage of the cancer and how aggressive it is.

  • Staging which determines the stage of the cancer, including whether it has spread beyond the prostate gland to other parts of the body.
  • The Gleason score which helps predict how aggressive the cancer is

Treatment options

Your urologist and healthcare team may suggest the following treatments:

  • Watchful waiting
  • Active Surveillance: active surveillance involves regular monitoring of the cancer through PSA tests, rectal exams, and possibly imaging tests. Other treatments may be offered if the cancer shows signs of progressing.
  • Surgery to remove part or all of the prostate gland depending on how it has progressed.
  • Radiation therapy uses high-energy beams to destroy cancer cells. It can be delivered externally using a machine (external beam radiation therapy) or internally by placing radioactive seeds directly into the prostate gland (brachytherapy).
  • Hormone therapy aims to reduce or block the levels of male hormones called androgens, such as testosterone. Prostate cancer cells rely on these hormones to grow.
  • Chemotherapy uses drugs to kill cancer or stop the cells growing.

Other treatment options might include:

  • Targeted therapy drugs target certain pathways involved how prostate cancer progresses.
  • Immunotherapy drugs work by helping the immune system to recognise and attack cancer cells.
  • Cryotherapy involves freezing prostate tissue to destroy cancer cells.
  • HIFU or High Intensity Focused Ultrasound uses high-intensity sound waves to heat and destroy prostate tissue.

Living with and beyond prostate cancer

Prostate cancer can have a profound impact on the physical and mental wellbeing of the people who experience it. The effects of prostate cancer treatment can bring new challenges. Urology health may not go back to normal immediately and new challenges can arise. We hear you and we understand that life may have changed but there can be help available.

We encourage anyone facing new challenges after prostate cancer treatment to speak to your healthcare professional.

The Urology Foundation Research Update - Prostagram

Our researchers are developing the concept of a rapid MRI scan as a potential mass screening tool for prostate cancer. Prostagram is currently being evaluated across the UK as one of the biggest ever urology trials.

Watch video here

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