Prostate Cancer

What is prostate cancer?

Prostate cancer is a type of cancer that affects the prostate gland. Cancer arises when abnormal cells start to divide and grow in an uncontrolled way. The cells can grow into surrounding tissues or organs, and may also spread to other areas of the body. Some prostate cancer growth is too slow to cause any problems or to affect how long a person may live. Because of this, many men with prostate cancer will never need any treatment. However, some prostate cancer grows quickly, making it more likely to spread. This can cause significant problems and may need treatment to stop it from spreading.

In the UK, prostate cancer is the most common type of cancer in men, and accounts for around one fifth of all male cancers. About 1 in 6 men in the UK will get prostate cancer in their lifetime.

What are the risk factors of prostate cancer?

Prostate cancer more commonly affects men over the age of 50, and their risk of developing this type of cancer increases with age. Additionally, the risk is even higher for black men and men with a family history of prostate cancer. Weight is the second leading preventable cause of cancer after smoking. Being overweight or obese can increase your risk of developing metastatic or advanced prostate cancer.

What are the symptoms of prostate cancer?

Early prostate cancer doesn’t usually cause any symptoms. However, some men might experience noticeable urinary problems such as:

• A weakened or reduced urine flow.
• A need to urinate more often, especially at night.
• A feeling that your bladder has not emptied properly.
• Difficulty in starting to pass urine.
• Dribbling urine.
• A sudden urge to rush to the toilet – you may occasionally leak urine before you get there.

These can be mild and develop over many years and may be a sign of a benign prostate problem, rather than prostate cancer.

If prostate cancer has already spread to other parts of the body (advanced or metastatic prostate cancer), it can cause symptoms such as:

• Back or bone pain that doesn’t go away with rest.
• Tiredness.
• Weight loss for no known reason.

If you think that you might be at risk of prostate cancer or that you are experiencing any of the symptoms, please seek medical advice from your GP, or speak to a specialist.

How is advanced prostate cancer usually treated?

The choice of treatment for prostate cancer will depend on the stage of the cancer – whether it is contained within the prostate gland (localised), whether it has spread to just outside of the prostate (locally advanced), or whether it has spread to other locations within the body (advanced).

Most localised prostate cancer develops slowly and may not require treatment, nor reduce a man’s life expectancy. For those who do receive treatment for localised prostate cancer, the treatment is usually successful in getting rid of the cancer.

For men with prostate cancer that is locally advanced, treatment is primarily aimed at keeping the cancer under control rather than getting rid of it completely. For example, if you have hormone therapy as a treatment on its own to manage the cancer, this will usually help to keep it under control for several years.

While there is no cure for advanced prostate cancer, there are many treatments available that can help manage and control the cancer for an extended period of time, often for several years. These treatments can also help to manage pain, and other related symptoms. Treatment options are tailored to the individual, depending on cancer stage, overall health, and tumour characteristics. Approved treatments include:

Hormone Therapy (Androgen Deprivation Therapy, ADT): Works by reducing the levels of male hormones (androgens) in the body, which can slow the growth of prostate cancer cells. Hormone therapy can be achieved through medications or surgical removal of the testicles.

Chemotherapy: Kills cancer cells to control the disease and manage symptoms.

Targeted Therapies: Newer drugs specifically target cancer-related proteins or pathways, tailored to the patient. Examples include Olaparib.

Radiation Therapy: Targets and shrinks tumours, relieves pain, and slows disease progression.

Radiopharmaceuticals: These are drugs that contain radioactive substances and are used to treat advanced prostate cancer. Radium-223 is an example for bone-metastases.

Bone-Targeted Therapy: Medications like bisphosphonates and denosumab are used to strengthen bones and reduce the risk of fractures and bone pain in cases where prostate cancer has spread to the bones.

Palliative Care: Focuses on improving quality of life, managing pain, symptoms, and providing emotional support.

Treatment decisions are made in collaboration with the medical team who take into account the stage and aggressiveness of the cancer, as well as assessing overall health and preferences. It's important for patients to have open and informed discussions with their healthcare providers to make the best treatment choices for their specific situation.

Additionally, patients may be able to participate in clinical trials, which could include new or previously approved treatments to be tested for their type of prostate cancer in a novel way.

Your doctor or specialist nurse will review all of your treatment options with you and assist you in selecting the most appropriate treatment plan for your specific needs.

For more information about prostate cancer visit:

Prostate Cancer UK website.

Cancer Research UK website.