Male prostate cancer: what to know

The prostate sits below the bladder and surrounds part of the urethra. Cancer can remain within the prostate or extend into nearby tissues and, in some cases, other parts of the body. A prostate cancer diagnosis is based on the examination, prostate-specific tests and, when advised, tissue sampling. The grade describes how the cells look and helps the team discuss how active the disease may be. Difficulty passing urine can occur with prostate cancer, but urinary symptoms also have other causes, so a symptom alone cannot establish the diagnosis.

Assessment may include a rectal examination, blood testing, imaging and a biopsy. The result guides whether monitoring, surgery, radiotherapy, medicine or a combination is appropriate.

Arrange a medical review for new urinary difficulty, blood in the urine, persistent pelvic discomfort or an unusual change in urinary flow. Bring a list of medicines and describe when the change began, whether it is worsening, and whether you have bone pain or unexplained weight change.

If cancer is confirmed, ask how far it has spread, what the grade means and whether more tests are needed. Options can include prostate removal surgery, radiotherapy, brachytherapy or targeted radioisotope therapy. Bone-strengthening therapy may be discussed when cancer or its treatment affects bone health. Robotic cancer surgery is one surgical approach that may be considered.

Seek urgent medical help if you cannot pass urine, have severe lower abdominal pain, heavy blood in the urine, new leg weakness or numbness, or loss of bladder or bowel control. These problems can signal blockage, bleeding or pressure on nerves and need prompt assessment. Contact your oncology team quickly for fever during treatment, new severe pain, or a sudden change in strength or sensation.

Ask: What do my grade and stage show? Do I need a biopsy or scans? What are the aims and likely effects of each option? How could treatment affect urine control, erections, fertility and bowel function? Which symptoms should prompt an urgent call?