Prostate cancer

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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 males1. There are around 19,500 cases of prostate cancer diagnosed each year in Australia, representing about 1 in every 770 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 urinate2. 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.

Causes or 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 genes3.

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 503.

Diagnosis of prostate cancer

Your doctor will perform a digital rectal examination (DRE) and order a blood test to measure your PSA level. Both tests are useful for identifying men at risk of prostate cancer2.

If your PSA level is higher than normal, or the DRE reveals an abnormal nodule in your prostate, your doctor will refer you to a urologist for further testing with a prostate MRI. If the MRI shows any areas suspicious for cancer, you’ll be sent for a prostate biopsy.

Definite diagnosis of prostate cancer requires microscopic analysis of a biopsy sample of prostate tissue, collected using a needle4.

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, a ‘watchful waiting’ 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 disease4.

If prostate cancer spreads to other parts of the body, androgen deprivation therapy (ADT) is the usual first line of treatment. However, the cancer can become resistant to this treatment over time. Combination therapy with both ADT 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 it3.

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). However, 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 diagnosed5. 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 else4.

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 support5.

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.

What questions should I ask my doctor about prostate cancer?

  • Do you think it’s worthwhile for me to have a PSA test?
  • What are the possible consequences for my health of testing for prostate cancer?
  • What can I do to prevent my cancer from growing or spreading?
  • Who can I talk to to help me deal with my diagnosis?
  • Are there new treatments for prostate cancer that might be suitable for me?
References

[1] Australian Institute of Health and Welfare, 2019. Cancer in Australia 2019

[2] Merriel et al., 2018. Prostate Cancer in Primary Care. Advances in Therapy

[3] Pernar et al., 2018. The Epidemiology of Prostate Cancer. Cold Spring Harbor Perspectives in Medicine

[4] Litwin & Tan, 2017. The Diagnosis and Treatment of Prostate Cancer. JAMA

[5] https://www.prostate.org.au/support/

Resources

Androgen Deprivation Therapy Fact Sheet Tile Image

Fact Sheet Fact sheet

Androgen deprivation therapy fact sheet

Prostate Cancer Diagnosis Fact Sheet Tile Image

Fact Sheet Fact sheet

Prostate cancer diagnosis fact sheet

Prostate Cancer Treatment Fact Sheet Tile Image

Fact Sheet Fact sheet

Prostate cancer treatment fact sheet

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