Prostate cancer develops when cells in your prostate gland start to grow in an uncontrolled way. Sometimes, prostate cancer grows very slowly. But in other cases, it grows quickly and can spread to other parts of the body, such as the bones.
The prostate gland is about the size of a walnut, and gets bigger as you get older. It sits underneath your bladder and surrounds your urethra, which is the tube you pee through. It produces the fluid that makes up part of your semen.
Prostate cancer can affect anybody who has a prostate gland. This includes:
Studies looking at how common prostate cancer is are mostly based on data from men. From them, we know that prostate cancer is the most common type of cancer in men in the UK. It’s more common in men over 65 and in Black men.
While there are different types of prostate cancer, nearly all people with prostate cancer have a type called adenocarcinoma. Prostate cancer can spread. When your doctor is talking to you about your cancer, they may use these terms to describe it.
How far your cancer has spread will affect your treatment options. See our section on ‘treatment for prostate cancer’ for more information about this.
Prostate cancer usually has no symptoms in its early stages.
If the cancer grows, it may cause problems when you pee, including:
But these symptoms are more likely to be caused by an enlarged prostate. This can happen when your prostate gland gets bigger as you get older. It is called ‘benign prostatic hyperplasia’ and is common in older men. It is not cancer.
If you have prostate cancer, it may start to spread to the surrounding tissues. This can lead to symptoms such as:
If the cancer has spread to other parts of your body, you might:
If you have these symptoms, contact your doctor.
If you have symptoms, your doctor will ask about them and examine you. They may also ask you to have the following tests.
If you’re transgender, non-binary or intersex and have a prostate, it’s important to make sure your doctor knows. That way, they can make sure you’re offered these tests when you need them. If you’re not sure whether you have a prostate, your doctor will be able to tell you. They can do this by asking you some questions, and by examining you if needed.
Depending on your test results, your doctor may refer you to a specialist. This is likely to be an urologist who is a specialist in treating prostate conditons.
Your urologist may suggest a prostate biopsy. This is when your doctor takes small samples of tissue from your prostate and sends them to a laboratory. Before the biopsy, you’ll usually have a magnetic resonance imaging (MRI) scan to show what area should be focused on. While the biopsy is being carried out, ultrasound helps to guide the biopsy needles. You’ll either have a local anaesthetic or a general anaesthetic for the biopsy. The results can show whether you have cancer.
If the biopsy shows you have prostate cancer, your doctor may recommend more tests to see whether it has spread. A computerised tomography (CT), or bone scan can help your doctor see if there is cancer anywhere else. Your doctor may organise a more specialised imaging test called a PSMA PET scan.
You can ask your doctor about having a PSA blood test and it’s possible to be diagnosed this way. Your doctor can give you information about the possible benefits and possible harms of having the test.
There are several different ways to treat prostate cancer. A team of specialists will discuss the best treatment for you.
Your treatment options will depend upon several things, including:
Your doctor will discuss your treatment options with you to help you decide what’s right for you. It’s your choice whether to have any treatment. Many treatments for prostate cancer carry the risk of side-effects. Some of these can have a significant effect on your day-to-day life. They can affect your relationships, social and work life. Ask your doctor to explain these to you, so you can weigh up the risks and benefits of your options.
You can also get information about treatments from the organisations listed below in our section ‘other helpful websites’.
This is when you don’t have treatment, but your doctor does regular check-ups. Your doctor may suggest this if:
If tests show that the cancer is growing, or if you start to get symptoms, your doctor may suggest treatment. This may help to ease your symptoms rather than cure the cancer.
With active surveillance, your doctor regularly checks the risk of the cancer spreading. It’s like watchful waiting, but your doctor takes biopsies as well as doing other tests such as MRI scans. It’s an option if the cancer is slow-growing and unlikely to spread. Or you may choose this option if you don’t want to have treatment straightaway. If the cancer changes, your doctor will offer you treatment to remove it.
You can have an operation to remove your prostate gland and some of the tissue around it. This is called radical prostatectomy. Surgery is an option if it seems the cancer is just in your prostate. Your surgeon may also take out the lymph nodes nearby if there’s a risk the cancer might have spread.
A prostatectomy can be done in several different ways.
Having your prostate gland removed can cause some side-effects. These include problems getting an erection and leaking of urine (incontinence).
Radiotherapy. uses radiation to destroy the cancer cells. Radiotherapy can be used as a treatment on its own or alongside other treatments. You may be offered it if the cancer is only in or around the prostate gland, as well as when the cancer has spread. Radiotherapy can also be used to reduce pain or control other symptoms.
There are two main types of radiotherapy for prostate cancer.
Prostate cancer cells need the hormone testosterone to help them grow. Hormone therapy blocks or lowers the amount of testosterone your body makes. This can slow down the growth of the cancer. Hormone therapy may be used before, during or after radiotherapy. It can be used to treat cancer or to control it.
Hormone therapy can cause some side-effects. These include problems getting an erection, less desire for sex and hot flushes.
If you’re transgender, non-binary or intersex, you may have been having hormone treatment for some time. This can reduce your chance of getting prostate cancer, but it doesn’t remove the risk completely.
There are several other treatments for prostate cancer. These include:
Your doctor can tell you if these are an option for you. If so, ask them to explain the risks and benefits.
Doctors don’t yet know exactly why prostate cancer happens.There are some things that can increase your risk of prostate cancer. These include the following.
The cancer, and the treatment you have for it, can affect you in many different ways.
Everyone is different, but you may find that you have issues with:
You may need time to adjust after your treatment. Try to eat healthily to help your body heal, and look after your mental health.
Being diagnosed with cancer can be distressing for you and your family. You may need support to deal with the emotional aspects as well as physical symptoms. Specialist cancer doctors and nurses are experts in providing the support you need. Talk to your doctor or nurse if you’re finding your feelings hard to cope with. The organisations listed under ‘other helpful websites’ will be able to provide information, advice and support too.
Most people do not get any symptoms from prostate cancer in the early stages. If the cancer grows it can cause problems when you pee. These include going more often, needing to go more urgently and having a weak stream.
But these symptoms are more commonly caused by an enlarged prostate that isn’t cancer.
Later symptoms of prostate cancer include blood in your pee and having difficulty getting an erection. For more information, see our section above on symptoms of prostate cancer.
Knowing the stage of a cancer helps your doctor decide on the best treatment. Cancer staging uses a system called TNM. This stands for Tumour, Node and Metastasis.
In prostate cancer, the size of the tumour (T) can range from 1 to 4, where T1 is too small to be seen on a scan. T4 means the tumour has spread to nearby body organs, such as the bladder and back passage. Node can be N0 or N1, depending on whether the cancer has spread to your lymph nodes. Metastasis (M0 or M1) describes whether the cancer has spread to other parts of your body.
If you have prostate cancer, no one can tell you for sure how long you’ll live. Survival depends on many different things. These include:
In general, more than nine out of 10 men with prostate cancer will survive for one year or more. More than eight out of 10 will live for over five years, and nearly eight out of 10 will live for 10 years or more.
Not necessarily. PSA is a protein produced by both normal and cancerous cells in your prostate. You may have a blood test to measure your PSA level . If your PSA is raised, it doesn’t necessarily mean you have prostate cancer. It may be due to other problems with your prostate or just increasing age. Around seven out of 10 men with a raised PSA level don’t have prostate cancer.
It might do. Both the cancer and treatment can affect your relationships, your sex life and how you feel about yourself. This can be very distressing and it may have a big impact on your quality of life. If you’re worried about your sex life, relationships or your mental health, it’s important to talk to someone about it. Ask your nurse or doctor for support.
In General, there isn't a screening programme for prostate cancer. Although the prostate specific antigen (PSA) test can mean you have cancer, it’s not a good
enough test for a screening programme. These are the main reasons why.
prostatecanceruk.org
www.prostatecanceruk.org/prostate-information/are-you-at-risk/trans-women-and-prostate-cancer
cancerresearchuk.org
macmillan.org.uk
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