Prostate Cancer

Prostate cancer is a cancer that develops in the prostate gland in men, usually growing slowly over years. It is one of the more common cancers affecting older men and, when detected early, has a good chance of successful treatment.

• Often no symptoms in early, localised disease
• Difficulty urinating, weak urine stream, or increased urinary frequency as the tumour grows and affects the urethra
• Blood in the urine or semen in some cases
• In advanced disease that has spread: bone pain, particularly in the back or hips, and unexplained weight loss

• The exact cause is not fully known, but risk increases with age, being most common in men over 50.
• Family history of prostate cancer increases risk.
• Risk may also vary with ethnicity and certain inherited genetic factors.

• Digital rectal examination may reveal a hard, irregular, or enlarged prostate, though a normal examination does not exclude cancer.
• Prostate-specific antigen (PSA) blood testing, where available, can raise suspicion, though it can also be elevated by non-cancerous prostate conditions.
• Prostate biopsy is required to confirm the diagnosis and assess how aggressive the cancer is.
• Further imaging may be used to check whether the cancer has spread beyond the prostate.

Treatment depends on the stage, grade, and the man's age and overall health, and is planned at a specialist urology or oncology centre.

Localised, low-risk prostate cancer, particularly in older men, may sometimes be managed with active monitoring rather than immediate treatment, given its typically slow growth.

Surgery (removal of the prostate) or radiotherapy are standard treatment options for localised disease requiring active treatment.

Hormone therapy, which reduces the male hormones that fuel prostate cancer growth, is used for more advanced or higher-risk disease, often alongside radiotherapy or as the main treatment when cancer has spread.

Bone pain from advanced disease that has spread to bone is managed with pain relief and other supportive measures alongside cancer-directed treatment.

• Discuss the potential benefits and limitations of prostate cancer screening with a health worker, particularly from age 50 or earlier with a family history.
• Seek prompt assessment for new or worsening urinary symptoms rather than assuming they are simply age-related.
• Maintain a healthy diet and lifestyle, which may help support overall health, though this has a less clearly established role in prostate cancer prevention specifically.
• Attend regular follow-up if previously treated for prostate cancer, to monitor for recurrence.