LIVING WITH CANCER

Prostate cancer develops in the prostate, a small gland just below the bladder that plays a role in producing semen.

It is the most common cancer affecting men in the UK. Some prostate cancers grow very slowly and may never cause serious harm. Others are more aggressive and can spread to nearby lymph nodes or bones if left untreated.

Because of the prostate’s location, early prostate cancer often causes no symptoms.

Who’s most at risk and why

Risk increases with age, particularly after the age of 50. Some men are at higher risk and may wish to speak with their GP about PSA testing from the age of 45. This includes men who are Black or of African-Caribbean heritage and those with a close family history of prostate or breast cancer.

Other factors such as being overweight, having a sedentary lifestyle, and certain inherited genetic changes may also contribute to risk.

Knowing the signs

Many men with prostate cancer experience no symptoms in the early stages.

When symptoms do appear, they are usually linked to changes in urination. These may include going to the toilet more often, especially at night, difficulty starting or stopping urine flow, or a feeling that the bladder has not emptied properly.

Some men notice blood in the urine or semen, or experience persistent pain in the lower back, hips, or pelvis.

These symptoms can also be caused by a non-cancerous enlarged prostate, which becomes more common with age. Even so, any new or persistent symptoms should be discussed with a GP.

Diagnosis: Is it cancer?

The first step usually involves a GP appointment to discuss symptoms or risk factors.

You may be offered a PSA blood test, which measures the level of prostate-specific antigen. A raised PSA level can indicate a problem with the prostate but does not confirm cancer. PSA levels can also rise due to benign prostate enlargement, infection, or recent physical activity.

A rectal examination may also be performed to assess the prostate. If further investigation is needed, an MRI scan may be arranged. In some cases, a biopsy is taken to confirm whether cancer cells are present.

What’s going to happen

If prostate cancer is diagnosed, your case will usually be reviewed by a multidisciplinary team including urologists, oncologists, radiologists, and specialist nurses.

They will assess how active the cancer is and whether it has spread beyond the prostate before recommending appropriate treatment options.

Treatment

Treatment depends on how active or advanced the cancer is. Some men are advised to follow active surveillance. This means the cancer is monitored closely through regular tests and scans without immediate treatment. Many slow-growing prostate cancers can be managed safely this way.

Other treatment options include surgery to remove the prostate or radiotherapy to destroy cancer cells.

These treatments can affect urinary control and sexual function, so decisions often involve weighing the potential benefits against the possible side effects.

For more advanced cancers, hormone therapy may be used to block testosterone, which helps slow the cancer’s growth. Chemotherapy or targeted treatments may also be offered in certain situations.

Prognosis

The outlook for prostate cancer is often very good, particularly when it is detected early.

Many men live full and active lives after treatment or while being monitored through active surveillance. Even when the disease has spread, modern treatments are helping men live longer while maintaining quality of life.