Prostate cancer in men

Prostate cancer begins when abnormal cells in the prostate start growing in an uncontrolled way. In most cases prostate cancer grows more slowly than other types of cancer. This might mean that you do not need treatment straightaway. However, some prostate cancers can grow and spread quickly, so it is important to investigate any symptoms or unusual tests promptly.

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How common is prostate cancer?

Prostate cancer is the most common cancer in Australian men. There are about 3900 new cases in Queensland every year. One in six men in Australia are at risk of developing prostate cancer by the age of 85. The risk of prostate cancer increases with age. It is uncommon in men younger than 50, although the risk is higher for younger men with a strong family history of prostate cancer, breast cancer or ovarian cancer, than those without a family history.

Risks factors of prostate cancer

While the causes of prostate cancer are unknown, your risk of developing prostate cancer increases:

  • As you get older – prostate cancer is most commonly diagnosed in men aged 60-79.
  • If your father or brother has had prostate cancer – your risk will be twice that of other men.
  • If you have a strong family history of breast or ovarian cancer, particularly BRCA1 and BRCA2 gene mutations.
  • If you have an inherited gene that increases your risk – multiple relatives on the same side of the family with prostate, breast and/or ovarian cancers; a brother or father diagnosed with cancer prostate cancer before the age of 60.

If you are concerned about your family history, your GP can advise you on the suitability of PSA testing for you and your family. For more information call Cancer Council 13 11 20.

Symptoms of prostate cancer

Early prostate cancer rarely causes symptoms. Even when prostate cancer is advanced at the time of diagnosis there may be no symptoms. Where symptoms do occur, they are often due to non-cancerous conditions, such as benign prostate hyperplasia (BPH).

Symptoms of advanced prostate cancer may include:

  • Unexplained weight loss
  • Frequent or sudden need to urinate
  • Blood in the urine
  • Pain in the lower back, hips or pelvis

These symptoms are not always signs of prostate cancer, but you should see your doctor if you have any of these symptoms.

Diagnosis

There is no single, simple test to detect prostate cancer.

Two commonly used tests are:

  • PSA Blood test – to measure prostate specific antigen (PSA).
  • Digital rectal examination – the specialist inserts a gloved finger into your rectum to feel the back of the prostate.

These tests, used separately or in combination, only show changes in the prostate. They do not diagnose cancer. If either test shows an abnormality, your GP will refer you to a urologist for further evaluation.

Further tests include :

  • Biopsy – small amounts of tissue are taken from different parts of your prostate using a special needle and are then sent to a laboratory where a pathologist examines the tissue for cancer cells.
  • Blood tests – you may have regular blood tests to check your PSA, prostate cancer activity and general health.
  • Bone scan – this scan can show whether the cancer has spread to your bones.
  • MRI scan.
  • CT scan.
  • PET scan.

Some tests may be repeated during or after treatment to check how well the treatment is working. Waiting for the test results can be a stressful time. It may help to talk to a friend or family member, a healthcare professional, or call Cancer Council on 13 11 20.

Treatment of prostate cancer

There are different options for managing and treating prostate cancer. For some men immediate treatment is not necessary or may not be appropriate. Your treating specialist will let you know your options based on the stage and grade of the prostate cancer, as well as your general health, age and preferences.

  • Active surveillance is a way of monitoring prostate cancer that isn’t causing any symptoms or problems. It may be suggested if the cancer is small (low volume) and slow-growing (low grade), and is unlikely to spread or cause symptoms (low risk, or in some cases, intermediate risk). Typically, active surveillance involves PSA tests every 3-6 months, digital rectal examination every six months, mp-MRI scans, and biopsies at 12 months and three years.
  • Watchful waiting is a way of monitoring prostate cancer. It involves regular PSA tests and clinic check-ups. It may be suitable for older men where the cancer is unlikely to cause a problem in their lifetime. Some men choose watchful waiting instead of immediate cancer treatment if the cancer is already advanced. It can also be an option for men with other health problems that would make it hard to handle treatments such as surgery or radiation therapy.
  • Radical prostatectomy may be suggested if you have early prostate cancer and are fit enough for surgery. This operation aims to remove the cancer by completely removing the prostate, part of the urethra and the seminal vesicles. For more aggressive cancer, the nearby lymph glands may also be removed.
  • Radiation therapy
  • Brachytherapy
  • Androgen deprivation therapy – slowing the production of testosterone may slow the growth of the cancer or shrink it temporarily. It is also known as hormone therapy.

For more information on the management or treatment of advanced prostate cancer please refer to the Understanding Prostate Cancer booklet.

Prognosis

Prognosis means the expected outcome of a disease. In general, the prognosis is better when the prostate cancer is diagnosed while it is localised and at a lower grade. You may wish to discuss your prognosis with your specialist. However, it is not possible for anyone to predict the exact course of the disease.

Test results, whether the cancer has spread, how quickly it might grow, and factors such as your age, level of fitness, medical history and family history are all important in assessing your prognosis.

Prostate cancer often grows slowly and even the more aggressive cases of prostate cancer tend to grow more slowly than other types of cancer. Compared with other cancers, prostate cancer has one of the highest five-year survival rates. For many men, prostate cancer grows so slowly that it never needs treatment. They live with prostate cancer for many years without any symptoms and without it spreading.

Support

Whether you have been diagnosed with prostate cancer, or have a family member or friend who is affected by cancer, there are times when you may need support. Our professional services and support programs are here to help you.

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You don’t have to face cancer alone – we’re here to help.

For more information on prostate cancer please refer to the Understanding Prostate Cancer booklet. You can download the PDF or order a hard copy.