Prostate cancer is a cancer that starts in the prostate gland, when the abnormal cells begin to divide in an uncontrolled way. Prostate cancer does not usually develop in just one area of the prostate. It is often present in different areas, which is known as multifocal prostate cancer.
The prostate gland is part of the male reproductive system. It is a small gland located just below the bladder and in front of the rectum (back passage). The main function of prostate is to produce fluids to liquify semen as well as supporting the bladder.
Prostate cancer does not usually cause any symptoms in the early stages. Most men report urinary symptoms as they get older. This often is not directly related to prostate cancer; it is usually caused by the benign enlargement of the prostate.
There are therefore no specific symptoms that can be reliably attributed to early prostate cancer.
Symptoms of prostate cancer usually only develop when the cancer has spread beyond the prostate, known as advanced or metastatic prostate cancer.
Common symptoms of metastatic prostate cancer may include:
- Pain in the bones
- Unexplained weight loss
- Blood in the urine
There are different types of prostate cancer:
- Early (localised) prostate cancer – When the cancer is only inside the prostate gland.
- Locally-advanced prostate cancer – When the cancer has spread through the capsule surrounding the prostate gland and may have started to spread into tissue or organs close by.
- Advanced (metastatic) prostate cancer – When the cancer has spread to other parts of the body, such as the bones.
Treatment for prostate cancer at CUH
The treatment you have depends on several factors, which include:
- The stage of the cancer
- The grade of the cancer (grade group or Gleason score)
- Your age
- Your general health
All of these factors are incorporated into a classification system called the Cambridge Prognostic Group (CPG). This helps to decide the most appropriate way to manage your prostate cancer. For men with early-stage prostate cancers, an online tool called Predict Prostate is also used to assess the individual risk associated with a new cancer diagnosis.
A team of specialists at CUH will meet to discuss your condition and to make a recommendation about the best possible treatment or management for you, based on the type of prostate cancer, Cambridge Prognostic Group and Predict Prostate results.
You, along with your clinician, will then discuss the recommendations at the clinic appointment and decide on the right treatment or management plan for you. Your clinician will explain the different treatment options and possible side effects.
For many people with prostate cancer, no treatment will be necessary.
The treatment for prostate cancer can include:
- Active surveillance
- Watchful waiting
- Brachytherapy
- Robotic assisted radical prostatectomy
- Radical radiotherapy with anti-hormone treatment
- Stereotactic body radiotherapy
- Androgen deprivation therapy or anti-hormone treatment (for metastatic disease)
- Chemotherapy (for metastatic disease)
Other forms of treatment may include focal therapies. This approach targets the main cancer tissue area within the prostate gland, rather than eradicating all the cancer. CUH however, does not currently provide focal therapy services. Patients wishing to explore this treatment option can be referred to specialist centres elsewhere.