While early-stage prostate cancer may present no symptoms, more advanced forms may exhibit the following features:
• difficulty urinating
• weaker urine stream
• blood in the semen
• pelvic discomfort
• pain in the bones
• erectile dysfunction
Always share your symptoms and concerns with your doctor, who will help you decide what action to take.
The precise cause of prostate cancer is unclear. The process seems to begin with cell mutation within the prostate gland. Because of these abnormalities, cancerous cells grow rapidly and do not decay like normal cells. Eventually, tumours form and cancerous cells can spread to adjoining tissue or break away to spread elsewhere in the body.
Preliminary investigation is likely to involve:
- a DRE (digital rectal exam), where your doctor physically checks for prostate gland abnormalities via your rectum
- a PSA (prostate-specific antigen) test in which a blood sample is used to measure your PSA levels
Digital rectal exam
Abnormal levels of PSA in your blood, or problems detected via the DRE procedure, will require further investigation, using the following procedures:
- transrectal ultrasound uses an ultrasound probe placed in your rectum to create an image of your prostate gland for further assessment
- a prostate biopsy collects a small sample of prostate tissue for laboratory analysis to determine whether cancerous cells are present, and how aggressive they might be
If tests indicate the presence of cancer, some of the following methods may be used to check whether it has spread to other regions:
It is unlikely that any individual will need to have every test.
Treatment options will depend on the stage of your cancer, which is assessed on the following scale:
- A small, early, non-aggressive cancer, confined to a small sector of the prostate
- A cancer within the prostate, considered aggressive and perhaps growing
- A cancer that has spread to nearby tissues
- An invasive cancer, which is present in other organs
Your recommended options for prostate cancer treatment will be based on an evaluation of your cancer, alongside other factors, such as your current general health. In some cases, no immediate treatment may be required and your doctor may therefore suggest active regular monitoring of your condition.
Where treatment is necessary, the options include:
Radiation therapy, which employs powerful radiation to destroy cancer cells, using one of two techniques:
- external beam radiation, which directs X-ray or proton energy at the source of your cancer
- brachytherapy, which implants radioactive seeds internally to kill off cancer cells, via low-dose radiation
Hormone therapy, which uses medications to inhibit the production of testosterone (a male hormone), causing cancerous cells to slow their growth (and decay in some cases). This treatment is sometimes used to enhance the effectiveness of radiation therapy.
The main surgical intervention is a radical prostatectomy, which removes the prostate gland, along with some adjoining healthy tissue and some lymph nodes. The techniques used include:
- abdominal robotic prostatectomy, which can be performed with great precision
- retropubic surgery, which removes your prostate via the lower abdomen
- perineal surgery to remove your prostate via a rear incision – which offers a more rapid recovery
Cryosurgery destroys cancerous cells by freezing the abnormal tissue, along with some healthy adjoining tissue.
Chemotherapy uses drug treatments to eradicate fast-growing cancer cells.
For males diagnosed with the most common prostate cancers, 99% will survive a further five years or more. For those males whose cancer is confined to the prostate (or close by), almost 100% will survive a further five years or more.
Your risk of prostate cancer can be reduced by healthy lifestyle choices, such as:
- eating a healthy diet
- taking regular exercise
- maintaining a healthy weight
Read more about prostate cancer prevention.