What is prostate cancer?
Prostate cancer is a cancer of the prostate gland, which is part of the male reproductive system. The prostate is a walnut-shaped gland that sits below the bladder and wraps around the urethra (the tube urine and semen pass through).
The prostate gland produces prostate fluid, which is found in semen, and prostate-specific antigen (PSA), which can be detected in the blood.
If the DNA of a cell in the prostate randomly changes (mutates), it can continue to divide and grow until it forms a tumour. As the tumour grows, it can press on the bladder and urethra, leading to symptoms such as needing to urinate more often, especially at night or a weak urine flow.
Prostate cancer is most commonly found in men over 50, with around 52,000 men diagnosed every year in the UK.1 There are different types of prostate cancer with most being a type called acinar adenocarcinoma, which grow very slowly.
In some cases, prostate cancer can grow very quickly, needing treatment as soon as possible to control its growth and prevent spread. The earlier you’re diagnosed, the sooner you can take the right treatment path for you and your prostate cancer.
This page covers prostate cancer treatment. To learn more about the condition, including symptoms, stages, and causes, visit our prostate cancer condition page.
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Our friendly team are available to help you with your prostate cancer treatment.
Diagnosing prostate cancer
To diagnose prostate cancer, your doctor may use a combination of tests and scans.
Initial tests may involve a PSA blood test and a digital rectal exam (DRE). Further testing may include an MRI scan and a biopsy. An MRI can help decide whether a biopsy is required to confirm the presence of cancer cells.
Usually, MRI results can take 1 to 2 weeks and biopsy test results can take 2 to 4 weeks. However, private results can be much faster. MRI results can come back within 48 hours and biopsy results within seven days.
If prostate cancer is detected, further tests may be recommended and can involve a CT scan, PET-CT scan, or a bone scan.
If you're concerned about prostate cancer or experiencing symptoms, we provide fast access to appointments with leading urologists and the latest prostate cancer diagnostics for fast results.
At your appointment the urologist will discuss your symptoms, medical history and undertake an examination and carry out any tests or scans required. Find out more about our private prostate assessment service.
Book an appointment
Flexible appointments often within 24 hours - Monday to Friday at varying weekday and evening times.
Overview of prostate cancer treatment
Treatment for prostate cancer usually involves a combination of therapies including surgery, radiotherapy, and chemotherapy. Your treatment plan will depend on your cancer stage, how fast your tumour is growing, and your overall health.
The stage describes the size and spread of cancer. Different therapies can be more or less suitable at different stages of prostate cancer. Your doctor may refer to your stage as:
- Localised – only in the prostate
- Locally advanced – spread to surrounding areas e.g. the seminal vesicles
- Advanced – spread elsewhere in the body e.g. the bones
How fast the cancer grows is a key factor in determining your treatment course. If it’s slow, you and your doctor may decide to delay your treatment and monitor the cancer’s growth instead.
This can be watchful waiting (tracking PSA levels over time) or active surveillance (regular MRI scans and biopsies). This helps to reduce the potential impact of side effects by only starting treatment when it’s necessary.
If you and your multidisciplinary team (MDT) decide on active treatment, there are now options available for all stages of prostate cancer.
Radiotherapy
Radiotherapy uses high-energy beams of radiation to kill cancer cells. It’s a suitable treatment for prostate cancer in early stages (localised or locally advanced) and aims to get rid of cancer completely. Radiotherapy can be delivered in the following ways:
Most people will have external beam radiotherapy. It involves a radiologist using a specialised machine to deliver radiation in 20 to 39 sessions over 4 to 8 weeks. Each session usually takes a few hours.
Though this is standard, there are now innovative alternatives available with shorter treatment times and reduced side effects for selected patients, such as Stereotactic ablative radiotherapy (SABR).
We’re the UK’s leading independent provider of Stereotactic ablative radiotherapy (SABR) and if you choose to have your prostate cancer radiotherapy with us, you’ll receive advanced treatment as standard by a team of expert radiologists using the latest-generation technology, such as MRI-guided SABR delivered on the MRIdian MR linac.
The MRIdian MR Linac is exclusively available to patients across the UK at our GenesisCare centres in Oxford and London. This cutting-edge technology combines live MRI imaging with powerful radiotherapy beams to provide controlled and accurate treatment.
With it’s precision targeting and automated beam control which automatically pauses treatment if the tumour moves even slightly out of position, surrounding healthy tissue are protected, leading to fewer side effects. Treatment can also be completed in just five sessions generally administered over 2 weeks, minimising disruption to your daily life.
You can also have radiotherapy on the MRIdian if you’ve already received radiotherapy to your prostate. Find out more about prostate reirradiation here.
Volumetric modulated arc therapy (VMAT) is a form of external beam radiotherapy that directs beams of radiation while the machine moves in an arc across your body. The machine, called a Linac, adjusts the shape of the radiation beam and intensity of the radiation dose as it moves.
This means it can accurately target the prostate cancer cells and avoid areas such as the rectum and bladder as much as possible.
We offer VMAT as standard to all eligible patients with early-stage prostate cancer.
Internal radiotherapy (brachytherapy) is when a radiation source (seed) the size of a rice grain is inserted into your prostate (low-dose-rate). There, it releases radiation gradually over a few months to kill cancer cells. The radiations half-life is approximately 2 months.
Brachytherapy can also be delivered using high-dose-rate radiation. This involves inserting catheters into the prostate to deliver radiation directly to the tumour in a session that lasts 10–15 minutes.
Radiotherapy side effects
Radiotherapy side effects can happen during or after treatment and vary between individuals. They’re usually temporary and pass with time, but your doctor can help you manage them with medication if necessary.
Side effects can include:
- Urinary problems such as needing to urinate more often or leaking urine
- Changes in bowel habits such as diarrhoea, flatulence, and needing to go to the toilet more often
At GenesisCare, we specialise in advanced techniques that are designed to be safe and effective and minimise side effects to the bladder and the bowel for patients undergoing prostate cancer radiotherapy.
Rectal spacers are an effective technique to reduce the bowel, urinary and erectile dysfunction side effects of prostate radiotherapy. They protect your rectum during radiotherapy treatment by moving it away from the prostate gland and the radiation beam.
We offer spacers at no extra cost if you’re having VMAT for prostate cancer and your clinician considers you suitable.
Fiducial markers are very small gold or platinum objects the size of a grain of rice, inserted into your prostate by a urologist prior to receiving prostate radiotherapy.
These are clearly visible on CT scans and help improve treatment set up. This ensures the prostate radiotherapy is delivered with consistent accuracy across all treatment days, reducing the amount of radiotherapy to surrounding healthy organs, leading to fewer side effects.
Depending on the proposed treatment, the fiducial markers and rectal spacer can be inserted in a single procedure under local anaesthetic at one of our outpatient centres prior to treatment.
Freezing or heating prostate tissue
It’s possible to destroy cancer cells using extreme cold or extreme heat at specialist clinics or as part of a clinical trial.
- Cryotherapy – multiple needles are inserted into the prostate where they release a gas to freeze and kill cancer cells
- High-intensity focused ultrasound (HIFU) – a HIFU probe is inserted into your rectum to produce high-frequency sound waves that heat up and destroy cancer cells
Both procedures are performed under general anaesthetic and can treat the entire prostate (whole-prostate) or parts (focal). Generally, they’re suitable for prostate cancer that’s localised, locally advanced (if the cancer has only slightly broken past the prostate barrier) or has come back after radiotherapy.
Side effects with freezing or heating prostate tissue
It’s possible to destroy cancer cells using extreme cold or extreme heat at specialist clinics or as part of a clinical trial.
- Difficulty getting and maintaining an erection
- Troubles controlling your bladder and urine flow
Symptoms are usually temporary but the time it’ll take varies between people. You can ask your doctor for medication to help you maintain an erection if you’d prefer.
Prostate surgery
Surgery involves removing the whole prostate in a procedure called a radical prostatectomy. It’s usually performed as a keyhole or robot-assisted surgery under general anaesthetic. The operation can take two to four hours and most people go home within one to five days, with routine check-ups in the following weeks.
Generally, surgery is only suitable when the cancer has not spread outside the prostate gland (localised cancer). But your doctor may consider surgery if your prostate cancer is locally advanced and has not spread too far.
If your cancer is localised and you decide with your doctor that surgery is the best option for you, we can conveniently arrange this at one of our partner hospitals. You’ll continue receiving your other treatment and care at your local GenesisCare outpatient centre.
Side effects of prostate surgery
A radical prostatectomy is a major surgery so you may have side effects in the weeks following the procedure.
- Urinary incontinence after the catheter is removed
- Problems with getting and maintaining a strong erection
It’s also normal to have constipation due to the painkillers given after your operation. Things should return to normal after a few weeks.
Hormone treatment
Prostate cancer relies on testosterone so hormone therapy is often used alongside chemotherapy and radiotherapy to control cancer growth and manage symptoms. It aims to either stop testosterone production or block cancer cells from it.
Treatment can come as tablets or injections. They can be taken for a long time, sometimes years. Your doctor will monitor your condition and discuss changes with you as necessary. In rarer cases, surgery to remove your testicles (orchidectomy) may be considered to help rapidly decrease testosterone levels.
If your GenesisCare consultant decides hormone therapy is the best treatment for you, you can have it either as tablets, injections, implants or by removing your testicles. Your consultant will work with you to develop a personalised care plan based on your specific diagnosis and personal choice.
Throughout your treatment, our teams of highly trained nurses and oncology pharmacists who are experts in this treatment will support you. You'll have regular follow-ups, including PSA tests, to check how your treatment is working and manage any side effects.
Side effects of hormone therapy
- Hot flushes, night sweats
- Strength and muscle loss
- Impotence
- Increased risk of cardiovascular disease
- Increased risk of bone fracture and dementia
Side effects usually pass once you stop hormone therapy. But there are ways to manage them whilst you’re undergoing treatment which you can discuss with your doctor.
What happens when hormone treatment for prostate cancer stops working?
Hormone therapy may stop working after months or years. If or when this happens, there are different treatment options available.
Depending on your previous treatments, symptoms, specific diagnosis and personal preferences your doctor might recommend a different type of hormone therapy in the form of tablets or treatment such as chemotherapy, Radium-223 or even new treatments available through clinical trials.
Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It’s usually done in a hospital setting through an intravenous drip every few weeks. It may be suitable if you’re having hormone therapy, or your cancer no longer responds to hormone therapy.
It’s often used in advanced prostate cancer care with the aim of shrinking the cancer and slowing its growth. This can improve your daily life by easing symptoms and prolonging life.
At GenesisCare, we offer the latest chemotherapy and hormone treatment for prostate cancer at our Macmillan accredited treatment centres with on-site private chemotherapy suites and a 24/7 on-call service with a dedicated cancer specialist nurse for anything you may need.
Chemotherapy side effects
- Infection due to a weakened immune system
- Extreme fatigue which may affect your day-to-day life and activities
Your doctor will be able to offer you support groups and therapies to help manage side effects of chemotherapy. That way you can continue with your daily life as much as possible.
Immunotherapy
Your immune system is your body’s natural defence mechanism. Cancer cells often damage your immune system and make it harder produce an immune response. Immunotherapy aims to help your immune system recognise and fight cancer cells.
It can include:
- Monoclonal antibodies – lab-made proteins that look and act like human antibodies
- Checkpoint inhibitors – stop cancer cells from turning off your immune system
Currently, immunotherapy for prostate cancer treatment is only available as part of a clinical trial.
Immunotherapy side effects
- Breathlessness and an itchy rash from a mild allergic reaction
- Flu-like symptoms for a few days after
Your doctor will be able to offer you support groups and therapies to help manage side effects of chemotherapy. That way you can continue with your daily life as much as possible.
Targeted drug therapy
Targeted drug therapy involves drugs that target specific processes cancer cells use to repair and grow. For example, PARP is a protein that certain cancers rely on to repair damaged DNA. Olaparib is a drug that targets PARP so cancer cells can’t repair their own DNA, leading them to die.
Targeted drug therapy aims to control cancer growth and spread. So it’s most suitable for people whose cancer has spread to other parts of the body (advanced) or no longer responds to hormone treatment but only if they have a genetic mutation that can be targeted by these type of drugs (BRCA 1-2).
Target therapy side effects
- Nausea and vomiting
- Appetite loss
Treatment for advanced prostate cancer
If prostate cancer has spread to other parts of the body, it’s called advanced prostate cancer or metastatic prostate cancer. There are various treatment options for advanced prostate cancer. The best treatment for advanced prostate cancer depends on your specific situation, including your general health, diagnosis, and previous treatments.
At GenesisCare we provide the following advanced prostate cancer treatments:
Radium-223 therapy
Radium-223 therapy is a treatment for prostate cancer that has spread (metastasised) to your bones and is causing you pain.
Your consultant may recommend Radium-223 therapy if your cancer has become resistant to hormone therapy or other treatments are unsuitable. This kind of cancer can’t be completely eradicated, so the aim of Radium-223 therapy is to ease pain and slow down the progress of the disease.
This highly personalised therapy is available in our state-of-the-art treatment centres in Oxford, Surrey and Windsor.
Palliative radiotherapy
Palliative radiotherapy can be used for cancer that has spread, for example, into the pelvis. In this case, we offer VMAT radiotherapy to improve pain and mobility, usually within 8 hours of a treatment planning scan.
Clinical trials
GenesisCare conducts internationally recognised, high-quality cancer research and clinical trials.
Our doctors and research staff have a wealth of knowledge and expertise that’s helping to improve healthcare in the UK and around the world, investigating new treatments and how to prevent disease. Find out more about the clinical trials we are currently offering.
Why choose GenesisCare
We provide exceptional prostate cancer care no matter where you are in your cancer journey. We offer a range of options for people with advanced or metastastatic prostate cancer, or when conventional treatments are no longer working.
Our aim is to ease symptoms, improve or maintain your quality of life, and prolong life through shrinking or slowing cancer progression.
We understand prostate cancer can have a lasting impact on your physical and emotional wellbeing outside of the treatment room. That’s why we offer all our patients tailored exercise medicine plans, and wellbeing sessions through our unique partnership with Penny Brohn UK, at no extra cost.
Make an enquiry
We’re recognised by all private medical providers, including Bupa, AXA PPP, Aviva and Vitality. Self-pay options are also available. Contact our team to help guide you through the process.
FAQs
Like all cancers, it’s possible for prostate cancer to spread to other parts of the body. This is known as advanced prostate cancer. It’s also called metastatic prostate cancer, secondary prostate cancer, or metastases.
The most common place for prostate cancer to spread is to the bones, but it can spread anywhere. Your treatment plan will take into account how much the cancer has spread and how far. It may focus on controlling the spread and slowing progression to reduce symptoms and improve or maintain your quality of life.
Initial tests to check your risk of having prostate cancer include PSA blood tests and a digital rectal scan.
Further tests are needed to investigate prostate cancer, including a biopsy to confirm if cancer is present. This may include a combination of test and scans:
Prostate cancer screening is when you are tested for signs of prostate cancer without having any symptoms. This usually involves a PSA test.
There is no nationwide screening for prostate cancer in the UK. But, you’re entitled to ask for a PSA test if you’re over 50 years old.
If you have certain risk factors, such as a family history of prostate cancer or are of Black ethnicity, you may be able to ask for one from the age of 45.
Your outlook depends on many factors such as your cancer stage, how aggressive it is, and your overall health. Your doctor will be able to take into account your individual circumstance to give you an idea of your outlook or prognosis.
Generally, treatments for prostate cancer can cure it or help control the cancer so that life can be prolonged, often for several years. According to Cancer Research UK, around 80 out of 100 people survive their cancer for 10 years or more.2
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