Worried About Prostate Cancer? Know All About Symptoms, Diagnosis & Treatment Options

• Increasing age – the older you are, the higher the risk
• Family history
• Smokers
• Men from an Afro-Caribbean heritage

Many people have no symptoms at all in the early stages. That's one reason prostate cancer is often found after tests for urinary issues or through a check-up conversation with a GP.

Symptoms can overlap with non-cancer prostate problems (like an enlarged prostate), but they still deserve medical attention. Common warning signs include:

• Needing to pee more often (especially at night)
• Trouble starting to pee, or a weak flow
• Dribbling at the end
• Feeling like you can't fully empty your bladder
• Blood in urine or semen
• Pain when peeing

A PSA test measures a protein made by the prostate. A higher PSA can be linked to prostate cancer, but it can also rise due to infections, an enlarged prostate, or even recent exercise. So PSA is a clue and raises suspicion, but is not diagnostic.

A clinician may also do a digital rectal exam (DRE) to feel the prostate for changes.

If the PSA is elevated, many pathways now use multiparametric MRI (mpMRI) to look for suspicious areas and decide whether a biopsy is needed. The National Institute for Health and Care Excellence includes MRI in diagnostic pathways for suspected prostate cancer.

If cancer is confirmed, you may need tests such as MRI, CT, PET, or bone scans to see whether cancer has spread beyond the prostate.

• How aggressive does it look?
  It helps predict the cancer stage and how likely the cancer is to grow or spread.
• Is it localised or has it spread?
  Localised cancers may be treated with surgery or radiotherapy. If cancer has spread, treatment may focus on controlling it and protecting quality of life.

This is why two people with "prostate cancer" can end up with totally different plans, because it's not one-size-fits-all.

"As with many chronic diseases, if you have risk factors, then getting tested as early detection can effectively lead to a cure. Delaying PSA testing by waiting for symptoms to appear often has a poorer prognosis.
Once diagnosed, the staging of the cancer will determine the treatment approach needed – here, speed is of the essence and delays can lead to the prostate cancer worsening."

If the cancer is slow-growing, doctors may recommend active surveillance, regular PSA tests, scans, and sometimes repeat biopsies. The goal is to avoid or delay side effects from treatment while still acting quickly if the cancer changes.

This is a less intensive monitoring approach, often used when the aim is symptom control rather than cure.

A radical prostatectomy removes the prostate gland (and sometimes nearby tissue). In many UK centres, this is often done using robotic surgery (keyhole surgery controlled by a surgeon).

• Can be a strong option for cancer that's still localised
• Provides detailed tissue information after removal

• Urinary incontinence from bladder valve damage (often improves, but can take time)
• Erectile dysfunction (risk depends on age, nerves spared, and other factors)

• External beam radiotherapy (EBRT)

  Radiotherapy uses focused radiation to kill cancer cells.

• Brachytherapy

  Brachytherapy places radiation inside or very close to the prostate. Some types use "seeds."

• Urinary or bowel irritation
• Fatigue
• Sexual side effects over time