Prostate Cancer
Most common male cancer.
A healthy Prostate is slightly larger than a walnut. It surrounds the urethra just below the Urinary Bladder. The function of the Prostate is to store and secrete a clear fluid that constitutes 10-30% of the volume of the Seminal Fluid.
Age 50+ (75-80 Peak)
Affects 12.5%
1 in 8
1 in 4 Black Men
Family History > RIsk
Overweight > Risk
Most Common Cancer in Men
What is Prostate Cancer?
Prostate cancer is a type of cancer that develops in the prostate gland, which is a small, walnut-sized gland in men that is located just below the bladder and surrounds the top part of the urethra (the tube that carries urine out of the body).
The prostate's main function is to produce the fluid that nourishes and transports sperm (semen).
Prostate cancer occurs when cells in the prostate gland start to grow in an uncontrolled way. Many prostate cancers are slow-growing and may not cause problems or require treatment, but some are more aggressive and can spread to other parts of the body.
Urinary Symptoms
FOCUS
Focusing on the area around the Prostate helps us understand its anatomy. The Prostate doesn't exist in isolation. This is clearer on our Anatomy page.
NORMAL
A normal Prostate is free of cancer cells and symptoms and looks like this. A Prostate may enlarge, but this is not cancer and will continue to be free of cancer cells.
STAGE 1
Stage 1 Prostate cancer is the earliest stage of the disease, and it is considered a localised cancer. This means the cancer is small and entirely contained within the Prostate gland.
STAGE 2
Stage 2 Prostate cancer is still considered localised, meaning the cancer is confined entirely within the prostate gland. However, it is more advanced and carries a greater risk of progression than Stage 1.
STAGE 3
Stage 3 is often referred to as locally advanced Prostate cancer. The cancer has grown beyond the Prostate gland and involves nearby tissues. Crucially, it has not spread to distant parts of the body.
STAGE 4
Stage 4 is the most advanced stage. The cancer has spread (metastasised) to distant parts of the body. At this stage, the cancer is generally not considered curable, but it is often treatable and manageable.
Sexual Issues
Screening?
Why not?
Prostate cancer is often not screened universally because many cases are slow-growing and may not cause symptoms or threaten a man's life. Routine screening, primarily through prostate-specific antigen (PSA) tests, can lead to overdiagnosis, where cancers that would never have caused harm are identified, resulting in unnecessary treatments that carry significant side effects. Additionally, false positives can cause anxiety and lead to invasive procedures. Given these concerns, medical guidelines recommend individualised screening decisions, weighing the potential benefits against risks, rather than broad, indiscriminate screening for all men.
Screening in families?
Screening in families offers several advantages, including the potential for early detection of the disease, which can lead to more effective treatment and improved survival rates. It helps identify cancer at an asymptomatic stage, allowing for less aggressive interventions and better management options. Screening also provides reassurance to men with high-risk profiles and can guide decision-making regarding lifestyle changes or monitoring strategies. Additionally, early diagnosis through screening may reduce the risk of cancer spreading or becoming more difficult to treat later on.
More Advanced Symptoms
Cambridge Prognostic Group (CPG)
Recommended by NICE
The Cambridge Prognostic Group (CPG) is a classification system used to categorise non-metastatic (cancer that has not spread to distant parts of the body) prostate cancer into five risk groups.
The CPG system provides a more detailed and accurate prediction of how likely a man is to die from his prostate cancer. It helps recommend the most appropriate management, such as Active Surveillance versus immediate, aggressive treatment.
| Group | Risk Level | Defining Criteria | Typical Management Choice |
|---|---|---|---|
| CPG 1 | Very Low Risk | Grade Group 1 (Gleason ≤6 ) AND PSA <1 0ng/mL AND TStageT1–T2 | Active Surveillance is often recommended |
| CPG 2 | Low-Intermediate Risk | Grade Group 2 (Gleason 3+4=7) OR PSA 10–20ng/mL AND TStage T1–T2 | Active Surveillance or Immediate Curative Treatment (Surgery/Radiotherapy) |
| CPG 3 | High-Intermediate Risk | Grade Group 2 (Gleason 3+4=7) AND PSA 10–20ng/mL OR Grade Group 3 (Gleason 4+3=7) AND TStage T1–T2 | Immediate Curative Treatment (Surgery/Radiotherapy) |
| CPG 4 | High Risk | Any one of the following: Grade Group 4 (Gleason8) OR PSA >20ng/mL OR TStage T3 | Aggressive Curative Treatment (Surgery/Radiotherapy, often with Hormone Therapy) |
| CPG 5 | Very High Risk | Any combination of the CPG 4 factors OR Grade Group 5 (Gleason 9or10) OR TStage T4 | Aggressive Curative Treatment (Surgery/Radiotherapy, often with Hormone Therapy |