Prostate cancer at a glance
The cancer develops from cells within the prostate gland.
The majority of prostate cancers are slow growing and many men are unaware that they have this cancer. However, a small number of prostate cancers grow more quickly and may spread to other parts of the body.
Click on the links below to find out more about prostate cancer.
Find out about what Cancer Research UK is doing about prostate cancer in the 'Our current research' section of this website.
If you are a patient looking for information on prostate cancer, please visit our patient information website, CancerHelp UK.
Risks and causes
The following things affect a person's chances of developing prostate cancer.
AgeThis cancer is rare in men under the age of 50 years.
Family historyThe risk of developing prostate cancer increases if there is a first-degree relative (father or brother) who was diagnosed with prostate cancer at a young age. Having an elderly relative with prostate cancer is not uncommon and does not increase the risk.
In a small number of cases, prostate cancer runs in families because of a faulty BRCA2 gene.
RaceProstate cancer is most common in men of African descent, and least common in men of asian origin.
DietSome evidence suggests that diet may influence a person's prostate cancer risk. For example, it is thought that a diet high in animal fats may slightly increase the risk of developing the disease.
You can find out more about what 'cancer risk' means in the 'Understanding 'risk'' section of this website.
Signs and symptoms
The prostate enlarges as men get older, and most men have some symptoms affecting urination. This very common condition, known as BPH, is not cancer. Many of the symptoms of prostate cancer are similar to those of BPH. Symptoms of prostate cancer include:
- having to rush to the toilet to pass urine
- passing urine more often and/or at night
- difficulty starting the flow of urine
- starting and stopping whilst passing urine
- a feeling of not having emptied the bladder fully
- dribbling of urine
- blood in urine or semen
- pain in the back, hips or pelvis.
The above symptoms may not be caused by cancer, but men who notice any of them should consult their doctor for advice on treatment, and to rule out prostate cancer.
Screening
There is a blood test available that can help doctors work out if a man has prostate cancer.
Prostate-specific antigen, or PSA, is produced by the prostate and can be measured in the blood. PSA levels are usually raised when a man has prostate cancer.
However, there is a big drawback to the PSA test:
- some men with high PSA levels do not have prostate cancer
- and some men with prostate cancer do not have high PSA levels.
The higher the PSA level, the more likely it is to be caused by prostate cancer.
Unfortunately, the test cannot tell the difference between prostate cancers that grow quickly and are life threatening, and those that grow slowly and do not require treatment.
This can lead to men receiving unnecessary treatment for a prostate cancer that may not cause clinical problems. Treatment is not without risk, and can occasionally lead to complications.
In 2001 the government introduced the Prostate Cancer Risk Management Programme, a key component of which entitles men over 50 to a PSA test if they want one, provided that they have received full information on its risks and benefits.
The possible introduction of a screening programme for prostate cancer based on the PSA test remains controversial. Many experts do not think that it would be helpful. Cancer Research UK is helping to find out whether a national screening test based on PSA would save lives.
Detection
Initially the doctor may ask about any previous problems, and carry out a physical examination. This will include:
- questions about any previous medical problems, including those of family members
- questions about current symptoms
- an examination of the back passage, or rectal examination (this allows the doctor to assess the size, shape, texture and tenderness of the prostate gland).
The doctor may also discuss the uncertainties surrounding the PSA blood test and treatments for prostate cancer.
A specialist may carry out further tests, such as:
Treatment
Treatment will depend on the stage of the cancer and the age and general health of the patient. Common treatments for prostate cancer include:
Active monitoring ('watch and wait')In cases where the disease is at an early stage, does not cause symptoms or discomfort, and does not require aggressive treatment, doctors may suggest 'watch and wait'. This means monitoring the situation closely, and delaying treatment until the cancer shows signs of progressing further.
SurgeryDepending on the type and stage of the cancer, doctors will remove part or all of the prostate gland.
RadiotherapyRadical radiotherapy aims to eliminate all cancer cells without the need for an operation. If the cancer has spread to the bones, doctors may use radiotherapy to provide relief from symptoms such as pain.
Hormone therapyDoctors may use hormonal treatments before or after radiotherapy or surgery. Most prostate cancers depend on male sex hormones ('androgens') to grow. So if the amount of these hormones in the blood is reduced, it can slow down or stop the growth of the tumour. Treatment to lower the amount of male hgormone in the blood is sometimes called 'androgen ablation therapy'.
ChemotherapyChemotherapy treatment is currently of limited value for prostate cancer. Doctors may use it if the cancer has spread outside the prostate gland and hormonal therapy has not worked, or has ceased to be effective. The aim of this treatment is to improve the quality of life.
