Prostate cancer is the most common cancer in men in the UK. It usually develops slowly, so there may be no signs for many years.
Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis (urethra).
When this happens, you may notice things like:
- an increased need to pee
- straining while you pee
- a feeling that your bladder has not fully emptied
These symptoms should not be ignored, but they do not mean you have prostate cancer.
It's more likely they're caused by something else, such as prostate enlargement.
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What is the prostate?
The prostate is a small gland in the pelvis, found only in men.
About the size of a satsuma, it's located between the penis and the bladder, and surrounds the urethra.
The main function of the prostate is to produce a thick white fluid that creates semen when mixed with the sperm produced by the testicles.
The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.
The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.
For reasons not yet understood, prostate cancer is more common in men of African-Caribbean or African descent, and less common in Asian men.
Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.
Recent research also suggests that obesity increases the risk of prostate cancer.
Tests for prostate cancer
There's no single test for prostate cancer.
All the tests used to help diagnose the condition have benefits and risks that your doctor should discuss with you.
The most commonly used tests for prostate cancer are:
- blood tests
- a physical examination of your prostate (known as a digital rectal examination, or DRE)
- an MRI scan
- a biopsy
The blood test, called a prostate-specific antigen (PSA) test, measures the level of PSA and may help detect early prostate cancer.
Men over 50 can ask for a PSA test from a GP.
Men are not routinely offered PSA tests to screen for prostate cancer, as results can be unreliable.
This is because the PSA blood test is not specific to prostate cancer.
Your PSA level can also be raised by other, non-cancerous conditions.
Raised PSA levels also cannot tell a doctor whether a man has life-threatening prostate cancer or not.
If you have a raised PSA level, you may be offered an MRI scan of the prostate to help doctors decide if you need further tests and treatment.
For many men with prostate cancer, treatment is not immediately necessary.
If the cancer is at an early stage and not causing symptoms, your doctor may suggest either "watchful waiting" or "active surveillance".
The best option depends on your age and overall health. Both options involve carefully monitoring your condition.
Some cases of prostate cancer can be cured if treated in the early stages.
- surgically removing the prostate
- radiotherapy – either on its own or alongside hormone therapy
Some cases are only diagnosed at a later stage, when the cancer has spread.
If the cancer spreads to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms.
All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary symptoms, such as needing to use the toilet more urgently or more often.
For this reason, some men choose to delay treatment until there's a risk the cancer might spread.
Newer treatments, such as high-intensity focused ultrasound (HIFU) and cryotherapy, aim to reduce these side effects.
Some hospitals may offer them as an alternative to surgery, radiotherapy or hormone therapy.
But the long-term effectiveness of these treatments is not known yet.
Living with prostate cancer
As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment.
You may find it beneficial to talk about the condition with your family, friends, a family doctor and other men with prostate cancer.
Financial support is also available if prostate cancer reduces your ability to work.