Prostate cancer

Prostate cancer is when cells in the prostate gland grow abnormally and in an uncontrolled way. The prostate gland surrounds the tube that carries urine and semen (urethra) and its main function is to produce the fluid found in semen.

In 95% of cases, prostate cancer starts in the outer cells of the prostate. These are called acinar adenocarcinomas. They tend to grow slowly and are unlikely to spread, but some can grow and spread more quickly.

Prostate cancer is the most common cancer in men in the UK. It’s usually diagnosed in men over 65.

Usually, you won’t have any symptoms until the prostate is large enough to affect your urethra. This can cause:

• Difficulty urinating – feeling like you need to strain
• Feeling like your bladder hasn’t fully emptied
• Frequent urination
• Weak flow of urine

These symptoms are common in older men, and most will have a non-cancerous prostate enlargement called benign prostatic hyperplasia (BPH).

If the cancer spreads, it’s most likely to spread to your bones causing pain and tenderness in affected bones.

Your GP will physically examine your prostate (known as a digital rectal examination) and recommend:

• A blood test to check the levels of prostate specific antigen (PSA)
• A urine test to rule out an infection

If these results suggest prostate cancer, you’ll be referred to a specialist and for further tests. These include:

• Prostate biopsy – a small tissue sample is taken for analysis in a lab
• CT scan
• MRI scan
• Bone scan – to check if the cancer has spread to your bones

The exact cause of prostate cancer is unknown, but there are risk factors that can increase your chance of getting it. These include:

• Aging – most cases affect men aged over 50
• Ethnicity – men of African-Caribbean or African descent are more likely to get it
• Family history of prostate cancer
• Obesity
• Diet – evidence suggests there’s a link between a high calcium diet and an increased risk

Treatment options vary between different cases. Depending on the stage of your cancer, treatment may aim to:

• Cure the cancer
• Control the cancer and prevent it from spreading
• Ease symptoms and prolong life if it’s spread

Often, a combination of two or more of the following is used:

• Surgery – the main treatment for benign tumours and early malignant tumours
• Radiotherapy – high energy radiation is directed at cancerous tissue to kill cells or stop them from multiplying
• Hormone treatment – blocks or lowers the level of testosterone in your body to shrink a tumour or prevent it from returning
• Chemotherapy – to kill cancer cells or stop them from multiplying

In some cases, particularly older men or if the cancer is in its early stages, your doctor may recommend active surveillance (watchful waiting). This is monitoring how the cancer develops and only treating it if it shows signs of getting worse or causing symptoms.