• What is prostate cancer?
• Where is it found?
• Early signs and symptoms
• Types, stages and grades
• Causes and risk factors
• Diagnosis and tests
• Treatment overview
• Complications
• Preventing prostate cancer
• Prostate cancer treatment at GenesisCare

Prostate cancer is the most common cancer type found in men in the UK with one in eight men being diagnosed¹ during their lifetime. This type of cancer often starts in the outer part of the prostate gland, but it can develop in any prostate tissue.

Prostate cancer starts in the prostate, which is a male gland that sits under the bladder. 

A normal prostate is roughly the size of a walnut and makes prostate fluid, found in semen, and a protein called prostate specific antigen (PSA).

Prostate cancer begins when cells in the prostate gland become abnormal and grow faster than they should. Over time this forms a tumour, which can cause symptoms if it starts to press on the bladder and urine tube (urethra). 

Often, prostate cancer grows very slowly and may not need active treatment for some time. But if the tumour is growing quickly, treatment is needed to stop it from spreading through the body. 

Prostate cancer can strike at any time in adulthood, but age is the biggest factor. Most cases are in men over 65. The risk increases from age 40 for black men and age 50 for white men. 

The prostate gland is underneath the bladder and wraps around the urine tube, called the urethra, next to the rectum. It can be felt through the back passage, approximately 2 inches inside.

Prostate cancer starts in the prostate but can spread elsewhere in the body. This is called metastasis and most commonly happens in the lymph nodes and bones.

Learn more about the prostate in the video below, including where it’s found and common prostate problems. 

Early-stage prostate cancer is when the cancer cells or tumour are only inside the prostate. Often, there are no symptoms at this stage.  

As the prostate cancer grows, it may start to press on the bladder and urethra. This can cause symptoms including:

• Finding it hard to start urinating
• Weak urine flow
• Needing to urinate often or urgently, especially at night
• Feeling like your bladder isn't empty after you've just urinated
• Leaking urine

Symptoms of prostate cancer that has spread include bone pain, difficulty getting or keeping erections, blood in the semen or urine, and unexplained weight loss.

Other conditions such as an enlarged prostate (also known as benign prostatic hyperplasia or BPH) can cause similar problems with urination. If you have one or more of these symptoms, it does not mean you have prostate cancer, however you should see a doctor so they can give you the appropriate advice, diagnosis, and treatment if necessary.

There are several ways to describe prostate cancer:

• The type: which prostate cells the cancer started in
• The grade: how abnormal the cells are, which suggests how aggressive it is
• The stage: the size and how far the cancer has spread

The prostate is made of several types of cells. They form tissues and specialised structures that allow the prostate to function.

The type of prostate cancer is named after the type of cell it starts in. 

Prostate cancer is graded by looking at the cells under a microscope. The grade measures how different the cancer cells are from normal cells.

Grades are used to understand how the cancer is expected to behave, with a higher number predicting faster growth. This helps decide the best treatment plan.

The stage of prostate cancer describes its size and whether it has spread.

A slow growing (low-grade) cancer can reach a later stage if it’s undiagnosed for a long time. Similarly, a fast-growing (high-grade) cancer may be found at an early stage. 

T1 and T2 are where the cancer cells are only in the prostate, also called localised or early-stage prostate cancer.

T3 is where the cancer has spread to the outer part of the prostate gland and tissues nearby, such as the seminal vesicles. This is called locally advanced prostate cancer.

Where the cancer has spread beyond the prostate such as the bladder and rectum.

Where the cancer has spread to lymph nodes or glands in the pelvis.

Where the prostate cancer has spread through the bloodstream or lymphatic system to other parts of the body. The most common places for prostate cancer to spread are the bones and lymph nodes.

Like all cancers, prostate cancer starts with errors in the DNA. These errors can stop cells from understanding their instructions and begin to grow uncontrollably.

There’s no single thing that leads to prostate cancer. But there are risk factors, which increase the chance of getting prostate cancer.

The known risk factors for prostate cancer are: 

1. Age - prostate cancer is rare before 40, but your risk increases significantly from age 50
2. You have a family history of prostate cancer
3. Weight - being obese or overweight
4. You have different hormone levels - research shows men with higher levels of insulin-like growth factor 1 (IGF-1) have a higher risk of developing prostate cancer
5. Your ethnicity is black - research shows, in the UK about 1 in 4 black men will get prostate cancer in their lifetime

If you’re known to have certain risk factors for prostate cancer, you may wish to have more regular prostate screening. 

There are several steps to diagnosing prostate cancer. Your consultant might do some or all of them:

A digital rectal exam and PSA blood test are the first check-ups for your prostate. They’re used to assess how likely you are to have prostate cancer. 

Prostate cancer can be managed in several ways. The results of your MRI scan and biopsy help decide the best options for you.

This could include:

• Watchful waiting, where you continue to have PSA tests and may have treatment in the future to ease symptoms or control the cancer
• Active surveillance, where your cancer is closely monitored with MRI scans or biopsies so that curative treatment can be offered if needed
• Treatments such a radiotherapy, chemotherapy, other cancer drugs, or Theranostics. Surgery to remove the prostate is also an option.

Learn more about how we treat prostate cancer at GenesisCare.

There are several treatments for prostate cancer. Your care plan typically considers the type, stage and grade of cancer, your overall health, and which treatment outcomes are most important to you.   

Recurrent prostate cancer is when the cancer returns after a treatment that aimed to cure it. This affects around 1 in 5 people.

Previously, prostate cancer treatments like surgery and radiotherapy could only offer limited options for retreatment due to the risk of damage to the bowels and bladder.

Due to the advanced technology and capabilities of the MRIdian MR linac, it’s the ideal technology for complex cancer treatment, such as repeated radiotherapy treatment (called reirradiation) for locally recurrent prostate cancer.

Learn more about reirradiation on the MRIdian MR Linac.

A complication is a medical problem caused by another condition. Sometimes prostate cancer and its treatment can cause complications, including:

• Problems getting or maintaining an erection
• Urinary incontinence
• Bowel problems

For many people, these side effects are temporary. They can often be resolved or managed with supportive care.

More serious complications from prostate cancer include metastasis, when the cancer spreads elsewhere. There’s also the risk of life-threatening complications from surgery or chemotherapy.

At GenesisCare, we routinely use and invest early in advanced treatments for prostate cancer that aim to deliver the best possible outcomes, with minimal side effects. Your consultant will always explain the benefits and risks of any treatment you’re offered.  

Like all cancers, it’s not possible to prevent prostate cancer. But it is thought being within your healthy BMI range (18.5 - 24.9) can help lower the risk of being diagnosed with advanced prostate cancer.  

We’re the UK’s leading independent provider of cancer care. We offer comprehensive prostate cancer care services from first symptoms through to complex cancer treatment.

At our 14 specially equipped outpatient centres across the UK, our multidisciplinary teams ensure you get a personalised cancer care plan tailored to you. 

Alongside treatment, we offer integrative cancer care to support you physically and emotionally. Find out how we’re changing prostate cancer care for the better.

¹Cancer Research UK