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Prostate cancer


Overview


Prostate cancer begins when abnormal cells in the prostate start growing in an uncontrolled way. 

The prostate is a small gland about the size of a walnut. It forms part of the male reproductive system. The prostate sits below the bladder and in front of the rectum (the end section of the large bowel). A pair of glands called the seminal vesicles attach to the back of the prostate.

The prostate is close to nerves, blood vessels, and muscles that help control erections and urination (the pelvic floor muscles and urinary sphincter). 

What the prostate does

The prostate produces fluid that helps to feed and protect sperm. This fluid forms part of semen. Semen also contains sperm made in the testicles (testes) and fluid made by the seminal vesicles.

  • Urethra – this is a thin tube that runs from the bladder and through the prostate to take urine (wee or pee) out of the body. The urethra also carries semen during orgasm.
  • Ejaculation – when an orgasm occurs, millions of sperm from the testicles move through two tubes near the prostate called the vas deferens. The sperm then join with the fluids produced by the prostate and seminal vesicles to make semen. The muscle around the prostate contracts and pushes the semen into the urethra and out through the penis.

How the prostate grows

The male sex hormone, testosterone, is made by the testicles and controls how the prostate grows. It is normal for the prostate to become larger with age. This may lead to a condition known as benign prostate hyperplasia. Sometimes an enlarged prostate can cause problems, especially when passing urine.

 

How common is prostate cancer?

Prostate cancer is the most common cancer in Australian men (apart from common skin cancers). There are about 18,100 new cases in Australia every year. About 1 in 10 men will get prostate cancer before the age of 75.

Anyone with a prostate can get prostate cancer – men, transgender women and intersex people. For information specific to your situation, speak to your doctor.

Learn more about prostate cancer statistics and trends

Symptoms

Early prostate cancer rarely causes symptoms. Even people diagnosed with advanced prostate cancer may have no symptoms.

Symptoms such as difficulty passing urine are most often due to non-cancerous changes, such as benign prostate hyperplasia. If symptoms occur, they may include:

  • frequent or sudden need to urinate
  • blood in the urine or semen
  • a slow flow of urine
  • needing to get up at night to pass urine
  • feeling like your bladder is not empty after passing urine
  • unexplained weight loss
  • pain in bones, for example the neck, back, hips or pelvis.

These are not always symptoms of prostate cancer, but you should see your doctor if you are worried or the symptoms are ongoing.

Non-cancerous changes to the prostate

A normal prostate often grows larger as you age – this is not usually due to cancer. This growth of the prostate is called benign prostate hyperplasia (BPH), and it may press on the urethra and affect how you urinate. You may have:

  • a weak stream of urine
  • to go to the toilet more often, especially at night
  • to go urgently
  • trouble getting started
  • dribbling of urine after going
  • a feeling that the bladder is not empty.

These are known as lower urinary tract symptoms (LUTS) and they can also occur in advanced prostate cancer. If you have LUTS, speak to your doctor.

Risk factors

The exact cause of prostate cancer is not known. Things that can increase the risk of developing prostate cancer include:

  • older age – over 90% of people diagnosed with prostate cancer are aged 55 and over
  • family history of prostate cancer – if your father or brother has had prostate cancer before the age of 60, your risk will be at least twice that of others
  • strong family history of breast or ovarian cancer – particularly cancer caused by a fault in the BRCA1 or BRCA2 genes
  • race – people of African-American descent have a higher risk.

While prostate cancer is less common if you are under 55, people aged 40–55 may have a higher than average risk of developing prostate cancer later in life if their prostate specific antigen (PSA) test results are higher than the typical range for their age.

Family history

Having a strong family history of cancer may increase the risk of developing prostate cancer. You may have inherited a gene that increases your risk of prostate cancer if you have: 

  • several close relatives on the same side of the family (either your mother’s or father’s side) diagnosed with prostate, breast and/or ovarian cancer
  • a brother or father diagnosed with prostate cancer before age 60.

If you are concerned about your family history, talk to your GP. They may refer you to a family cancer clinic or genetic counselling service. For more information, call 13 11 20 cancer support.

More about genetics and risk

Health professionals

Your GP will arrange the first tests to assess your symptoms. If these tests do not rule out cancer, you will usually be referred to a specialist, who will arrange further tests.

Prostate cancer is usually diagnosed by a urologist, who will talk to you about your surgical options. You will usually also see a radiation oncologist to discuss radiation therapy and you may be referred to a medical oncologist who will discuss drug treatments.

Your specialists will discuss treatment options with other health professionals at what is known as a multidisciplinary team (MDT) meeting. During and after treatment, you will see a range of health professionals who specialise in different aspects of your care, including an endocrinologist, continence nurse, pathologist and sexual health physician, among others. 

Question checklist

Asking your doctor questions will help you make an informed choice. You may want to include some of these questions in your own list:

Diagnosis
  • What type of prostate cancer do I have?
  • Has the cancer spread? If so, where has it spread? What is the grade?
  • Are the latest tests and treatments for this cancer available in this hospital?
  • Will a multidisciplinary team be involved in my care?
  • Are there clinical guidelines for this type of cancer?
Treatment
  • What treatment do you recommend? What is the aim of the treatment?
  • Have you treated a lot of people with my type of cancer?
  • Are there other treatment choices for me? If not, why not?
  • If I don’t have the treatment, what should I expect?
  • How long do I have to make a decision?
  • I’m thinking of getting a second opinion. Can you recommend anyone?
  • How long will treatment take? Will I have to stay in hospital?
  • Are there any out-of-pocket expenses not covered by Medicare or my private health cover? Can the cost be reduced if I can’t afford it? Can I be treated in the public system?
  • How will we know if the treatment is working?
  • Are there any clinical trials or research studies I could join?
Side effects and follow-up
  • What are the risks and possible side effects of each treatment? How can these be managed?
  • If I have problems with continence, what can I do to manage this?
  • Will the treatment affect my sex life and erections? What can be done about this? Which health professionals should I see?
  • Will I still be able to have children? Should I see a fertility specialist?
  • Are there any complementary therapies that might help me?
  • How often will I need check-ups after treatment?
  • If the cancer returns, how will I know? What treatments could I have?

 

Your guide to best cancer care

A lot can happen in a hurry when you’re diagnosed with cancer. The guide to best cancer care for prostate cancer can help you make sense of what should happen. It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.

Read the guide

Understanding Prostate Cancer

Download our Understanding Prostate Cancer booklet to learn more.

Download now  Order for free

 

Expert content reviewers:

A/Prof Ian Vela, Urologic Oncologist, Princess Alexandra Hospital, Queensland University of Technology, and Urocology, QLD; A/Prof Arun Azad, Medical Oncologist, Urological Cancers, Peter MacCallum Cancer Centre, VIC; A/Prof Nicholas Brook, Consultant Urological Surgeon, Royal Adelaide Hospital and A/Prof Surgery, The University of Adelaide, SA; Peter Greaves, Consumer; Graham Henry, Consumer; Clin Prof Nat Lenzo, Nuclear Physician and Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics, and Notre Dame University Australia, WA; Henry McGregor, Men’s Health Physiotherapist, Adelaide Men’s Health Physio, SA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, NSW; Dr Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW; A/Prof David Smith, Senior Research Fellow, Daffodil Centre, Cancer Council NSW; Allison Turner, Prostate Cancer Specialist Nurse (PCFA), Canberra Region Cancer Centre, Canberra Hospital, ACT; Maria Veale, 13 11 20 Consultant, Cancer Council QLD; Michael Walkden, Consumer; Prof Scott Williams, Radiation Oncology Lead, Urology Tumour Stream, Peter MacCallum Cancer Centre, and Professor of Oncology, Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC.

Page last updated:

The information on this webpage was adapted from Understanding Prostate Cancer - A guide for people with cancer, their families and friends (2022 edition). This webpage was last updated in May 2022.

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