Prostate cancer is the fourth most common cancer worldwide, and around 1.4 million new cases are diagnosed every year. The majority of cases (60%) occur in people aged 65 or over, and around 1 in 8 men will get prostate cancer in their lifetime.

Read on to find out more about prostate cancer – and remember that you can connect to a network and community of carers and other people who are living with the condition by joining Carecircle.

What is prostate cancer?

Prostate cancer is cancer of the prostate gland, which sits beneath the bladder and is roughly the size of a walnut. This gland surrounds the initial part of the urethra, the tube that carries urine from the bladder to the penis, and it produces a protein known as prostate-specific antigen (PSA). The prostate’s main function is to add fluid to sperm.

Prostate cancers tend to initially form in the outer edge of the prostate, and typically grow slowly. But if they are untreated, they can sometimes spread to other parts of the body (in other words, cancer becomes metastatic).

Types of prostate cancer

There are several types of prostate cancer that form in different cells:

• Adenocarcinoma of the prostate – This is where the cancer develops in the tubes and gland cells that line the prostate and accounts for 95–99% of prostate cancers.
  • Acinar adenocarcinoma of the prostate is by far the most common type of prostate cancer, and it occurs in the Acini cells that line the prostate’s fluid-secreting glands.
  • Ductal adenocarcinoma of the prostate (also known as prostatic ductal adenocarcinoma) is less common, and it’s where the cancer develops in the tubes and ducts of the prostate.
• Transitional cell carcinoma of the prostate – This is much rarer than adenocarcinoma of the prostate, and it’s where the cancer forms in the urethra. Often it begins in the bladder and then moves to the prostate, but can form the other way around.
• Squamous cell carcinoma of the prostate – This is when the cancer begins in the thin, flat squamous cells that surround the prostate.
• Small cell prostate cancer – a rare and particularly aggressive type of cancer that develops in neuroendocrine cells, which interact with the nervous system.

In addition, there are other, much rarer types, including sarcomas and lymphomas.

Prostate cancer symptoms

Prostate cancer can grow for quite some time before the person experiences any symptoms. Symptoms usually only begin to show when the cancer has grown large enough to put pressure on the urethra, the tube that carries urine from the bladder. These symptoms include:

• Needing to urinate more frequently and/or urgently
• Difficulty in passing urine, and taking a long time
• Weak flow of urine
• A feeling that your bladder is not completely empty
• Blood in urine or semen
• Sudden onset of erectile dysfunction

Warning signs of prostate cancer

The main warning sign of prostate cancer is difficulty in passing urine and the need to go for a wee more frequently. If you experience this, you should consult your doctor. However, note that these symptoms aren’t necessarily a sign of prostate cancer: they can also be caused by benign prostate enlargement, as the prostate gets bigger with age.

Prostate cancer stages

There are a number of different ways in which doctors track the progression of prostate cancer. The Gleason score is where the cancer is given a grade according to how much the cancer cells look like healthy tissue. The Cambridge Prognostic Group (CPG) is a system used in the UK to sort cancers into five risk groups. And the TNM staging system is where the cancer is assigned to four stages on the basis of the size and location of the tumour, whether it has spread to the lymph nodes, and whether it has spread to other parts of the body (metastasis). Below is a rough guide to the TNM staging system.

Stage I prostate cancer

This is where the cancer has not spread and cannot be felt by a doctor. The cells look healthy, PSA levels are low, and the cancer only affects a small part of the prostate.

Stage II prostate cancer

This is where the tumour remains small and is still localised to the prostate. The level of PSA in the blood is medium. This stage is subdivided into IIA, IIB and IIC – at stage IIA the tumour is still too small to be felt, but by stages IIB and IIC it is big enough to be detected.

Stage III prostate cancer

At this stage, PSA levels have risen to high, and the cancer is beginning to spread to nearby tissues. This stage is divided into IIIA, IIIB and IIIC – by the later stage, the cancer cells start to look very different from normal, healthy cells.

Stage IV prostate cancer

At stage IVA, the cancer has spread to nearby lymph nodes, and at stage IVB it has moved to distant lymph nodes or even other parts of the body.

Join Carecircle for free and find help, hope and control with your prostate cancer diagnosis. Our global network for health makes you part of a worldwide community where your voice matters. Together, we can work towards a better future.

What causes prostate cancer?

Research is ongoing into what actually causes prostate cancer, but there are a number of things that increase the risk of developing the disease:

• Age – Most cases of prostate cancer occur in people aged 50 or older.
• Ethnicity – Prostate cancer is more common in black men than in white men, and is less common in asian men.
• Family history – The risk of developing prostate cancer is higher if a close relative, such as a father or brother, has had the condition. The gene BRCA2 in particular is associated with a higher risk of prostate cancer.
• Obesity – Research seems to indicate that being very overweight can increase the risk of developing prostate cancer.

Various other factors have also been proposed to have a link with prostate cancer, including levels of the hormone IGF-1 and exposure to the metal cadmium, which occurs in tobacco smoke and some foods. However, research into these factors is ongoing.

How is prostate cancer diagnosed?

If you’re worried about the symptoms of prostate cancer, speak to your doctor. They will usually carry out a urine test to detect signs of infection that might explain your symptoms, as well as PSA blood test and a prostate exam, also known as a digital rectal examination, where they will insert a gloved finger into your rectum to feel your prostate.

If your PSA levels are elevated and/or the doctor feels a lump on your prostate, you will probably be referred for further tests, which are likely to involve an MRI scan and a biopsy sample.

PSA test

The PSA test is a blood test designed to detect increased levels of prostate-specific antigen (PSA), which can occur in prostate cancer. However, the test can be unreliable, and high levels of PSA do not necessarily indicate prostate cancer; likewise, around 1 in 7 people with prostate cancer have normal PSA levels.

PSA levels chart by age

The levels of PSA in your blood increase with age. Below is a chart showing normal levels of PSA:

Age	PSA level
50-59 years	Up to 3 ng/ml
60-69 years	Up to 4 ng/ml
70-79 years	Up to 5 ng/ml

What to do if you have prostate cancer?

Depending on the stage of the disease, there can be few symptoms associated with prostate cancer, but it can take a big mental toll.

• If you’re having problems with urinary incontinence, you can try pelvic floor exercises to strengthen the control you have over your bladder.
• Anxiety and depression can be common after a diagnosis of prostate cancer. Make sure to talk about your issues with others. Charities like Macmillan and Prostate Cancer UK can offer some useful advice and a chance to talk with other men going through the same experience, and you can connect with others who have been diagnosed with prostate cancer by joining Carecircle.

Join Carecircle for free and find help, hope and control with your prostate cancer diagnosis. Our global network for health makes you part of a worldwide community where your voice matters. Together, we can work towards a better future.

Prostate cancer treatment

If the cancer is in its early stages with few or no symptoms, and particularly if the patient is very old, sometimes the treatment is watchful waiting, where any intervention is delayed to see whether the cancer develops further. A step up from this is active surveillance, where the patient has regular PSA tests, MRI scans and sometimes biopsies to keep an eye on the cancer.

If the cancer looks aggressive or shows signs of spreading, your health-care team might decide to surgically remove the prostate.

Alternatively, you might take a course of radiotherapy, where radiation is used to kill the tumour cells. Another version of this is brachytherapy, where tiny radioactive seeds are planted directly into the tumour to minimise damage to surrounding tissue. Radiotherapy is often used in conjunction with hormone therapy to reduce the rate of growth of the prostate cells.

Other treatments for prostate cancer include cryotherapy, where the cancer cells are frozen; high-intensity focused ultrasound, where the cells are killed with sound waves; and trans-urethral resection of the prostate, which doesn’t cure the cancer, but makes it easier to urinate through removal of parts of the prostate.

In cases of advanced prostate cancer where the tumours have spread to other parts of the body, you might be given chemotherapy.

Prostate cancer survival rates

The good news is that survival rates for prostate cancer have increased steadily over the decades. In England, the survival rates have tripled over the past 40 years, and the overall survival rates are 86.6% after five years, and 77.6% after ten years.

If the cancer is diagnosed early, the survival rates are even higher: the five-year survival rate for people diagnosed with stage I prostate cancer is 100%.

Prostate cancer FAQs

Below are a few answers to some of the most commonly asked questions about prostate cancer.

What is a dangerous PSA level?

If you’re aged between 50 and 59, a raised PSA level is anything over 3 ng/ml. However, a raised PSA level isn’t necessarily an indication of prostate cancer: in fact, around 3 in 4 men with a raised PSA level do not have cancer.

Do women have a prostate?

No, but women have something called the Skene’s glands in the vagina, which function in a similar way to the prostate. In extremely rare cases, it is possible to develop cancer in these glands. Trans women also have a prostate, as do non-binary people who were assigned as male at birth and some intersex people.

What is a prostate?

The prostate is a gland that sits beneath the bladder and adds fluid to sperm during ejaculation.

What does PSA mean?

PSA stands for prostate specific antigen, an enzyme that is produced by the prostate.

Is prostate cancer curable?

Yes, if detected in the early stages, prostate cancer can often be cured, and the survival rate for people who are diagnosed at stage I is 100% after five years.

How to check for prostate cancer at home?

It is not recommended to check for prostate cancer at home. If you’re worried about symptoms such as difficulty passing urine, consult your doctor.

What is a dangerous PSA level?

If you’re aged between 50 and 59, a raised PSA level is anything over 3 ng/ml. However, a raised PSA level isn’t necessarily an indication of prostate cancer: in fact, around 3 in 4 men with a raised PSA level do not have cancer.

Do women have a prostate?

No, but women have something called the Skene’s glands in the vagina, which function in a similar way to the prostate. In extremely rare cases, it is possible to develop cancer in these glands. Trans women also have a prostate, as do non-binary people who were assigned male at birth and some intersex people.

What is a prostate?

The prostate is a gland that sits beneath the bladder and adds fluid to sperm during ejaculation.

What does PSA mean?

PSA stands for prostate specific antigen, an enzyme that is produced by the prostate.

Is prostate cancer curable?

Yes, if detected in the early stages, prostate cancer can often be cured, and the survival rate for people who are diagnosed at stage I is 100% after five years.

How to check for prostate cancer at home?

It is not recommended to check for prostate cancer at home. If you’re worried about symptoms such as difficulty passing urine, consult your doctor.

Join Carecircle for free and find help, hope and control with your prostate cancer diagnosis. Our global network for health makes you part of a worldwide community where your voice matters. Together, we can work towards a better future.

Prostate cancer resources

Below are a few links to websites that can provide information about prostate cancer:

• Prostate Cancer UK
• NHS: Prostate Cancer
• Cancer Research UK
• Macmillan Cancer Support
• American Cancer Society
• National Cancer Institute

We hope that this guide has been useful if you or someone close to you has been recently diagnosed with prostate cancer, or if you suspect you or someone close to you shows symptoms. If you’re concerned about any of the symptoms mentioned in this article, speak with your doctor. And remember that there’s a whole community out there on Carecircle who can provide support.

Guide sources

• Prostate Cancer UK
• NHS: Prostate Cancer
• Cancer Research UK
• Macmillan Cancer Support
• National Cancer Institute
• Medical News Today: What to know about prostate cancer
• American Cancer Society
• Cancer.net
• Centers for Disease Control and Prevention
• ProstateCancer.net
• Medical News Today: Can women get prostate cancer?