Understanding this cancer
Prostate cancer develops in the prostate gland. Many grow slowly, while some are aggressive. PSA level, biopsy grade group, stage, imaging, symptoms, age, health and patient preference all contribute to decisions.
Signs to discuss with a doctor
Early prostate cancer often has no symptoms. Urinary difficulty, blood in urine or semen, erectile changes or persistent bone pain need assessment, but these symptoms often have non-cancer causes.
Risk factors
Risk rises with age and is influenced by family history and certain inherited variants such as BRCA2. Risk and disease patterns also vary across populations.
Tests and diagnosis
Assessment may include PSA, examination, prostate MRI and biopsy. Pathology gives the grade group. PSMA PET/CT, bone imaging or CT may be selected for staging according to risk.
Treatment approaches
Options range from active surveillance for selected low-risk disease to surgery, radiotherapy, hormone therapy, chemotherapy, targeted treatment, radiopharmaceuticals or combinations. Side effects involving urinary, sexual and bowel function need discussion.
Prevention and screening
There is no guaranteed prevention method. Screening with PSA involves possible benefits and harms, so an informed discussion with a clinician is recommended based on age, health and risk.
Questions for your care team
What are my PSA trend, grade group and stage? Is active surveillance safe? What are the likely urinary, sexual and bowel effects of each option? Is genetic testing relevant?