Prostate Cancer

Prostate cancer is cancer of the prostate — a walnut-sized gland below the bladder in men. Most prostate cancers grow slowly; a minority are aggressive. Treatment has advanced rapidly, and outcomes are good when the cancer is found early, especially in men under 75.

Risk factors

• Age — mostly over 50.
• Family history — particularly multiple close relatives, or early-onset.
• BRCA2 / BRCA1 mutations — raise prostate cancer risk (yes, also in men).
• Certain ethnic backgrounds.
• Obesity, sedentary lifestyle.

Symptoms

• Often none in early stages — that's why screening matters for selected men.
• Slow urine stream, difficulty starting, frequent urination (similar to BPH).
• Blood in urine or semen.
• Persistent low-back or hip pain.
• Unexplained weight loss, bone pain (late signs).

Screening — an informed decision

The PSA blood test + digital rectal examination (DRE) is the screening tool. Benefits (catching aggressive cancers early) have to be weighed against over-diagnosis of slow cancers that would never have caused harm. From age 50 (or 45 with family history or BRCA), discuss with a Health Expert whether screening is right for you. Not a mandatory test — a conversation.

Diagnosis

• Abnormal PSA or DRE → multiparametric MRI.
• Targeted biopsy (transrectal or transperineal) if MRI is suspicious.
• Pathology gives Gleason score → risk group.
• Staging scans — bone scan, PSMA PET in some centres.

Treatment — individualised

• Low-risk cancers — often active surveillance (watchful monitoring), avoiding immediate aggressive treatment.
• Intermediate / high-risk — surgery (radical prostatectomy) or radiation + hormone therapy.
• Metastatic — hormone therapy, newer androgen-pathway drugs, chemotherapy, targeted/immunotherapy.
• Side-effects — urinary, sexual, bowel function can be affected; good centres actively manage and minimise these.
• Regional Cancer Centres, urology-oncology teams give the best outcomes.