Prostate Cancer

Topic - Prostate cancer.

A guide for patients and families

What is prostate cancer The prostate is a small gland below the bladder that makes part of semen. Prostate cancer develops when its cells grow out of control. Many prostate cancers grow slowly; some grow faster or spread. Your test results help your team decide whether you need treatment or careful monitoring.

Risk rises with age. Black ancestry, a close relative with prostate cancer, and some inherited gene changes can also increase risk. Tell your clinician about cancers in your family.

Symptoms to get checked Early prostate cancer often causes no symptoms. Arrange an appointment for a weak urine stream, difficulty starting, needing to pee more often, or a feeling that your bladder does not empty. Report persistent back, hip or pelvic pain, or unexplained weight loss.

Urinary symptoms are often caused by a non-cancerous enlarged prostate or infection. Testing can help find the cause. Blood in your urine needs prompt assessment—see the next page.

PSA testing and diagnosis A PSA blood test measures prostate-specific antigen, a protein made by the prostate. A high PSA does not prove you have cancer: enlargement or inflammation can also raise it. A low PSA does not completely rule cancer out.

Your clinician may recommend a repeat PSA, a prostate examination through the rectum, an MRI scan, or a biopsy. A biopsy takes small tissue samples and usually confirms the diagnosis. The Grade Group or Gleason score describes how aggressive the cells look. The stage describes how far the cancer has spread.

If you have no symptoms, discuss the benefits and harms of PSA screening before testing. It may find cancer early, but can lead to unnecessary biopsies or treatment of cancers that would never cause harm. The decision depends on your age, risk, health and preferences.

Choosing treatment or monitoring

• Active surveillance: regular PSA tests, examinations, and sometimes MRI scans or repeat biopsies for suitable low-risk cancers. Treatment can begin if the cancer changes. Keep every follow-up appointment.

• Surgery or radiation: treatments that may cure cancer confined to the prostate. Your team will discuss which options suit you.

• Hormone therapy: lowers or blocks testosterone, which can help cancer grow. It may be combined with radiation or other medicines. Advanced cancer may need chemotherapy or other specialist treatments.

• Watchful waiting: focuses on treating symptoms if they develop, often when other health problems make cancer treatment less helpful. It involves less testing than active surveillance.

Side effects and everyday care Ask how each option could affect bladder control, erections, sex life, fertility and bowel function. Hormone therapy can cause hot flushes, tiredness, weaker bones and changes in weight or mood. Support and treatments are available.

• Ask about pelvic floor exercises for urine leakage and support for sexual changes. Discuss sperm storage before treatment if future fertility matters to you.

• Stay active within your ability, including strength exercise when advised. Eat balanced meals and ask about bone health if you receive hormone therapy.

• Take medicines as prescribed. Check with your team before using supplements or herbal products; none is proven to cure prostate cancer.

• Bring a trusted person to appointments if you wish. Ask for help with worry, low mood, relationships or practical needs. Palliative care can relieve symptoms alongside cancer treatment.

When to seek help

Get emergency assessment now

• You cannot pass urine, especially with a painful or swollen lower abdomen; or you have heavy bleeding or blood clots in your urine.

• New back pain with leg weakness, numbness around the groin, trouble walking, or loss of bladder or bowel control. This may mean pressure on the spinal cord. Call 911 if you cannot travel safely.

• Fever, shaking chills or feeling very unwell after a prostate biopsy. During chemotherapy, a temperature of 38°C or higher needs immediate contact with your cancer team. If you cannot reach them promptly, go to the emergency department.

Call 911 for collapse, severe breathing difficulty or new severe chest pain.

Get medical advice today Contact your clinician for visible blood in your urine, fever with urinary symptoms, or new severe or worsening bone or back pain. Follow any specific instructions given after a biopsy or treatment.

AI generated Canadian Cancer Society information and support: 1-888-939-3333. Sources and further reading Canadian Cancer Society • Prostate cancer and treatment options Canadian Cancer Society • Finding prostate cancer early UCLH NHS • Prostate biopsy aftercare (UK guidance)