Prostate cancer
Prostate cancer affects the prostate gland under the bladder and usually happens to men over 50 years old. There are different treatments and it can often be cured if diagnosed early.
If these symptoms are severe, persistent or worsening, seek medical advice promptly.
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On this page
Main symptoms of prostate cancerSee a GP if:What happens at your GP appointmentWho is more likely to get prostate cancerTests to diagnose prostate cancerGetting your resultsNext stepsMain treatments for prostate cancerMonitoring your prostate cancerSurgeryRadiotherapyHormone therapyChemotherapyOther treatmentsWhat happens if you have been told your cancer cannot be cured
Prostate cancer affects the prostate gland under the bladder and usually happens to men over 50 years old. There are different treatments and it can often be cured if diagnosed early.
What is prostate cancer?
- Prostate cancer affects the prostate gland.
- The prostate is a small, walnut-size gland under the bladder. It produces a thick, white fluid that mixes with sperm to make semen.
- Prostate cancer is most common in men over the age of 50 or from a Black African or Caribbean background. Anyone with a prostate can get it.
- How serious prostate cancer is depends on if it's spread to other parts of the body.
- Prostate cancer can be successfully treated if it's diagnosed at an early stage.
- Prostate cancer does not usually have any signs or symptoms at first. Later signs may include back, hip or pelvis pain, or difficulty maintaining an erection. You may also have problems peeing, but this could be a sign of other prostate problems.
Symptoms of prostate cancer
Main symptoms of prostate cancer
Prostate cancer often has no symptoms at first.
Prostate cancer usually starts to grow on the outer part of the prostate. This means it does not press on the tube that carries urine from the bladder to the penis (urethra) and cause symptoms, until the cancer has grown or spread.
If this happens, it can cause changes to the way you pee, such as:
- finding it difficult to start peeing or straining to pee
- having a weak flow of urine
- "stop start" peeing
- needing to pee urgently or often, or both
- feeling like you still need to pee when you've just finished
- peeing during the night
Other symptoms can include:
- erectile dysfunction (being unable to get or keep an erection)
- blood in your urine or blood in your semen
- lower back pain and losing weight without trying to (these may be symptoms of advanced prostate cancer)
See a GP if:
- you're over 50 years old, come from a Black ethnic background or have a history of prostate cancer in your family and you're worried about your risk of prostate cancer
- you're having trouble peeing or other symptoms of prostate cancer
If you're at higher risk of having prostate cancer, you can ask your GP about doing a blood test that shows if there are any problems with your prostate.
Try not to be embarrassed if you have possible symptoms of prostate cancer. The doctor or nurse will be used to talking about these symptoms.
Important
These symptoms do not always mean you have prostate cancer. You can also get some of these symptoms if you have an enlarged prostate. This is a non-cancerous condition caused by the prostate getting larger as you get older.
You might find you get used to some of these symptoms. But it's important to be checked by a GP if your symptoms change, get worse, or do not feel normal.
What happens at your GP appointment
The GP will ask about your health and if you have any health problems. They may ask if anyone in your family has had prostate cancer, ovarian cancer or breast cancer. This is because some genes can increase your risk of getting cancer.
They may then ask to check your prostate gland by doing a rectal examination. This is where a doctor or nurse gently puts 1 finger inside your bottom. They wear gloves and put lubricating gel on their finger first.
You can ask for a male or female doctor or nurse, if one's available. You can have a friend, family member or other member of staff in the room with you if you want.
Referral to a specialist
You may get an urgent referral for more tests or to see a specialist in hospital if the GP thinks you have symptoms which could be cancer. This does not definitely mean you have cancer.
PSA blood test
Your GP may also ask if you want to have a PSA blood test. They'll explain the benefits and risks of the test to help you decide.
A PSA test cannot tell you if you have prostate cancer, but it can show if there are any problems affecting your prostate.
You'll need to have other tests to confirm if you have cancer, or if you have something less serious such as an enlarged prostate or prostate infection (prostatitis).
PSA test results usually take 1 to 2 weeks.
Causes of prostate cancer
Who is more likely to get prostate cancer
The risk of developing prostate cancer increases with age and mostly affects men over 50 years old.
Anyone with a prostate can get it.
You may have a higher chance of getting prostate cancer if:
- you're over 50 years old
- you're from a Black ethnic background
- you have a history of prostate cancer in your family
- a close relative has had breast cancer or ovarian cancer because prostate cancer is sometimes caused by the same inherited genes
Important
Speak to a GP if you're worried about your prostate cancer risk, even if you do not have any symptoms.
Symptoms of prostate cancer do not always appear until the cancer has grown or spread.
Tests and next steps for prostate cancer
Tests to diagnose prostate cancer
If you're referred to a specialist because there's a chance you could have prostate cancer, the test usually given is an MRI scan. This can give a clearer view of the prostate and show if you need any more tests.
If your specialist needs to find out more, they'll usually do a test called a biopsy. This is where a small needle is put into the prostate to take a tissue sample so it can be checked for cancer cells.
Getting your results
It can take a few weeks to get the results of your tests.
You can call the hospital or contact your GP if you're worried and want to get an update.
When the results are ready, the specialist will explain what they mean and what happens next.
You may want to bring someone with you for support.
If you're told you have prostate cancer
Being told you have prostate cancer can feel overwhelming. You may feel anxious and worried, but a team of specialists will be available throughout the diagnosis and treatment to help you.
This team will include a clinical nurse specialist who will be your main point of contact. You can ask them any questions you have.
Next steps
If you've been told you have prostate cancer, you may need more tests, which can include:
- a CT scan
- an MRI scan
- a PET scan
- a bone scan
This will help your specialist team decide what treatment you need.
Treatment for prostate cancer
Main treatments for prostate cancer
Prostate cancer does not always need treatment.
If the cancer has not spread, your care team may suggest monitoring your cancer to see if it is growing or not.
When they know how the cancer is behaving, they can decide what treatment is best for you.
Treatments for prostate cancer include surgery, radiotherapy and hormone therapy. If the cancer has spread, you may need chemotherapy.
A specialist care team will look after you during your treatment. If you have any concerns, speak to them. You do not need to wait for your next check-up.
You'll have regular check-ups during and after any treatments. You may also have tests and scans.
Monitoring your prostate cancer
If your cancer is small and not causing any symptoms, it may just be monitored at first.
This is because prostate cancer often grows slowly and may never cause problems. Treatments for prostate cancer can also cause side effects, which can be serious and long-lasting.
If your care team recommends monitoring your cancer, they may suggest either:
- having regular check-ups and blood tests at your GP surgery (called watchful waiting)
- having regular tests and scans in hospital (called active surveillance)
If the cancer grows or starts to cause symptoms, your care team will talk to you about your treatment options.
Surgery
Surgery for prostate cancer involves removing your prostate gland (radical prostatectomy).
Like any operation, this surgery carries some risks. After surgery, some people experience:
- peeing without meaning to
- problems having or keeping an erection (erectile dysfunction)
- problems with orgasms, such as difficulty reaching orgasm or not ejaculating during orgasm
Having a prostatectomy also means that you will not be able to have children by having sex. Your doctor will be able to tell you more about your options.
Radiotherapy
Radiotherapy uses high-energy radiation to kill cancer cells.
You may have radiotherapy for prostate cancer to:
- treat cancer that has not spread very far, or advanced prostate cancer
- help with symptoms or slow the cancer down if it has spread
Hormone therapy
The hormone testosterone causes prostate cancer to grow. Hormone injections and tablets can stop testosterone being produced or block its effects.
Hormone therapy may be used alongside other treatments (such as medicines called targeted therapies). It can be used at all stages, including if the cancer has not spread, has not spread very far or the cancer is at an advanced stage.
Hormone therapy alone does not cure prostate cancer, but it can slow it down and help symptoms. Hormone therapy with radiotherapy aims to cure early prostate cancer.
Chemotherapy
Chemotherapy is medicine that kills cancer cells. It's a common treatment for advanced prostate cancer and may be used with hormone therapy, and steroids.
It may be used if your cancer has spread outside the prostate but not very far.
It can be used on its own or combined with hormone therapy, radiotherapy or both to treat cancer that has not spread (localised).
Other treatments
There are other treatments for prostate cancer but they may not be available everywhere. These include:
- high-intensity focused ultrasound (HIFU) – this uses sound waves to kill cancer cells
- cryotherapy – this kills cancer cells by freezing them
These treatments are usually used if the cancer has not spread past the prostate.
What happens if you have been told your cancer cannot be cured
If you have advanced prostate cancer, it might be very hard to treat and not possible to cure.
You may be given chemotherapy, hormone therapy or both. Steroid treatment may also be used to slow down the growth and spread of the cancer. These may reduce your symptoms and help you live longer.
If you decide not to continue with treatment, your care team will respect your decision.
You'll be referred to a special team of doctors and nurses called the palliative care team or symptom control team.
They'll work with you to help manage your symptoms and make you feel more comfortable.
The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.
