Medically reviewed by
Luke Mitchell, Nurse Practitioner
What is prostate cancer?
Prostate cancer means there is a potentially harmful growth of cells in the prostate gland .
Prostate cancer is the most common type of cancer to affect Australian males. There are around 29,000 cases of prostate cancer diagnosed each year in Australia, representing about 1 in every 455 Australian males.
Symptoms of prostate cancer
Prostate cancer doesn’t usually cause symptoms, especially in the early stages of the disease.
If symptoms do occur, the most common ones are lower urinary tract symptoms (LUTS), such as a weak urine flow or frequent need to urinate. However, these are also symptoms of benign enlargement of the prostate, so if you have any of these symptoms, it doesn’t mean you have prostate cancer.
Symptoms of prostate cancer that has spread commonly include pain in the pelvis, hips, back and ribs.
Over 2.4 million Australian men and boys live with incontinence.
Causes of prostate cancer
Prostate cancer results from abnormal growth of cells in the prostate gland. These are usually the cells that line the glandular spaces where prostatic fluid is produced. Exactly why cells in the prostate become cancerous is unknown.
A person’s genetic makeup contributes to their risk of developing prostate cancer, as shown by higher rates in men with a family history of prostate cancer, some racial and ethnic groups, and those who have specific genes.
The incidence of prostate cancer increases with age. Prostate cancer is very rare in men aged under 40, but the incidence drastically increases with age after 50.
Diagnosis of prostate cancer
To be sure whether you have prostate cancer, microscopic analysis of a biopsy sample of prostate tissue, collected using a needle, is performed. The pathway to getting the biopsy depends on the starting point.
Some people choose to try and detect prostate cancer early by having a blood test to measure prostate-specific antigen (PSA), which can be organised by a general practitioner. In this situation, if there’s a high PSA level for a person’s age a second test is done 1-3 months later. If the PSA level is high for the second test, the patient is referred to a urologist for further investigation. A low PSA test requires no action, but your doctor will offer to repeat the test every 2 years.
Some people may present to a general practitioner with symptoms of prostate cancer (e.g. urinary problems). In this case, the GP will usually order a blood PSA test and urine test. If the examination and/or PSA results are abnormal, the GP will refer the patient to a urologist for further investigation.
A urologist will perform a physical examination, order a multiparametric magnetic resonance imaging (MRI) scan, which helps to see where in the prostate the cancer might be. After this, they may take biopsy samples for analysis. A PSMA-PET/CT (prostate specific membrane antigen-positron emission tomography/computed tomography) scan is usually performed to detect cancerous cells and see if the cancer is localised to the prostate or has spread.
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Treatment of prostate cancer
For men whose lives are unlikely to be affected by their prostate cancer, such as those in old age or with low-grade disease, receiving no treatment might be the best option for them.
In these cases, an ‘active surveillance’ approach may be taken, which involves regularly monitoring the cancer and treating any symptoms, but avoids the possible side effects of cancer treatment.
Surgery or radiation therapy are effective treatments to cure prostate cancer in men with more aggressive but localised disease, and are also for advanced prostate cancer.
Androgen deprivation therapy (ADT) is standard treatment for advanced prostate cancer. It may be used in combination with androgen receptor pathway inhibitors (ARPIs)
However, the cancer can become resistant to this treatment over time.
Combination therapy with both ADT, ARPI and chemotherapy drugs is often used when metastases (prostate cancer that has spread to other parts of the body) are widespread.
Prevention of prostate cancer
There’s not much you can do about your age or genetics, so preventing prostate cancer might not be possible.
However, a healthy diet, regular exercise and not smoking will help you stay healthy and reduce your likelihood of developing advanced prostate cancer or dying from it.
There’s no screening test that’s offered to all men to identify those most at risk or with early stages of the disease (like there is for bowel cancer, for example). Instead, early detection of prostate cancer is the goal, based on individuals’ situations.
Measuring the level of prostate specific antigen (PSA) in a blood sample is commonly used to help determine a man’s likelihood of having prostate cancer.
If you’re concerned about prostate cancer, talk with your doctor about PSA testing so you understand the implications of the test.
Health effects of prostate cancer
Almost all men with prostate cancer survive for at least five years after they’re diagnosed. Ten-year survival rates range from 82-97%, depending on the stage of prostate cancer. Men diagnosed with low-grade prostate cancer are more likely to die of something else.
If you’re diagnosed with prostate cancer, coming to terms with your diagnosis and treating your disease may affect your physical and mental health. Medical, psychological and behavioural interventions can help you deal with these effects.
What to do about prostate cancer
A cancer diagnosis can be confronting, so finding health professionals who can help you understand the disease and its impact on you is important. There are many options for support.
If you have symptoms of prostate cancer, this doesn’t mean you have the disease. However, it’s important to talk to your doctor so they can rule out prostate cancer as the cause and help you manage whatever is causing your symptoms.
Even if you don’t have symptoms, early-stage prostate cancer may be present. If you’re concerned about prostate cancer, talk to your doctor about getting a PSA blood test, especially if you have a family history of prostate cancer.
