Prostate cancer: the facts

If you've just been diagnosed with prostate cancer, or you're the friend or loved one of someone who has, or perhaps you might have a few symptoms and not know what to do next, you'll no doubt have a number of questions. Read on to find out more about prostate cancer including symptoms and treatments.


Please contact your GP or local healthcare provider for more detailed information.

Prostate cancer specialists

What is the prostate?

The prostate is a gland in the male reproductive system that produces the majority of fluid that makes up semen, the thick fluid that carries sperm. The walnut-sized gland is located beneath a man's bladder and surrounds the upper part of the urethra, the tube that carries urine from the bladder. Prostate function is regulated by testosterone, a male sex hormone produced mainly in the testicles.


  • The prostate is a gland found only in males. It sits below the urinary bladder and in front of the rectum.

  • The size of the prostate changes with age. It grows rapidly during puberty, fueled by the rise in male hormones (called androgens) in the body, such as testosterone and dihydrotestosterone (DHT).

  • The prostate usually stays about the same size or grows slowly in adults, as long as male hormones are present. In younger men, it is about the size of a walnut, but it can be much larger in older men.

  • The prostate’s job is to make some of the fluid that protects and nourishes sperm cells in semen, making the semen more liquid.




What are the signs & symptoms of prostate cancer?

Different people have different symptoms for prostate cancer. Some men do not have symptoms at all, especially in the early stages.

Some symptoms of prostate cancer are:


  • Difficulty starting urination

  • Weak or interrupted flow of urine

  • The need to urinate more often, especially at night

  • Difficulty emptying the bladder completely

  • Pain or burning during urination

  • Loss of bladder control

  • Blood in the urine or semen

  • Pain in the back, hips, chest (ribs) or pelvis that doesn’t go away

  • Weekness or numbness in the legs or feet

  • Difficulty getting an erection (erectile dysfunction)

  • Painful ejaculation



If you have any symptoms that worry you, be sure to see your doctor right away. Keep in mind that these symptoms may be caused by conditions other than prostate cancer.



Who gets prostate cancer?

Prostate cancer occurs mainly in older men. The average age for a man to be diagnosed with prostate cancer is about 66. Prostate cancer in men under the age of 40 is rare.



What are the key statistics surrounding prostate cancer?

  • Prostate cancer is the most common cancer in men in the UK, Australia and New Zealand, with over 40,000 new cases diagnosed every year in the UK, 21,000 men in Australia and 3,000 men in New Zealand.

  • In Australia alone 3,000 men die of the disease in Australia every year and there are approximately 600 deaths from prostate cancer each year in New Zealand

  • About 1 in 7 men will be diagnosed with prostate cancer during his lifetime (UK). About 1 in 7 men are at risk of having prostate cancer by the age of 75 (Australia)

  • Prostate cancer occurs mainly in older men and men of African-Caribbean descent.

  • Your risks are higher if your father or brother has had prostate cancer.

  • More than 8 out of 10 men in England with prostate cancer survive for 5 years or more (UK). 95% of mean survive at least 5 years (95 out of a 100 men, 2009-2013)** (AUS)


*based on the statistics from the Ministry of Health 2007 – 2009 which show an average of 3082 registrations and 602 deaths



What causes prostate cancer?

As with all types of cancer, an exact cause of prostate cancer isn’t easy to determine. There are often many factors involved, but ultimately what leads to the growth of cancerous cells are mutations in your DNA, or genetic material. These mutations cause normal cells in your prostate to start growing abnormally.


Abnormal or cancerous cells continue to grow and divide until a tumor develops. In cases of aggressive cancer, the cells may leave the original tumor and spread to other parts of the body.



In some cases, the mutations that lead to prostate cancer are inherited. If you have a family history of prostate cancer, you’re at greater risk of developing the disease because you may have inherited damaged DNA.


Approximately 5-10 percent of prostate cancer cases are caused by inherited mutations. One such mutation is known as the hereditary prostate cancer gene 1, or HPC1. Other inherited mutations, such as BRCA1 or BRCA2, may also lead to a greater risk of developing prostate cancer.



What are the risk factors associated with prostate cancer?

It is believed that a number of things can increase your risk of developing the condition. These include:


  • Age – risk rises as you get older and most cases are diagnosed in men over 50 years of age.

  • Ethnic group – prostate cancer is more common among men of African-Caribbean and African descent than in men of Asian  descent.

  • Family history – having a brother or father who developed prostate cancer under the age of 60 seems to increase the risk of you developing it. Research also shows that having a close female relative who developed breast cancer may also increase your risk of developing prostate cancer. 

  • Obesity – recent research suggests that there may be a link between obesity and prostate cancer.

  • Exercise – men who regularly exercise have also been found to be at lower risk of developing prostate cancer.

  • Diet – research is ongoing into the links between diet and prostate cancer. There is evidence that a diet high in calcium is linked to an increased risk of developing prostate cancer. 



How is prostate cancer detected?

Two tests are commonly used to screen for prostate cancer:


1. Digital rectal exam (DRE): A doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.

2. Prostate specific antigen (PSA) test: Measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others. PSA levels also can be affected by:


  • Certain medical procedures

  • Certain medications

  • An enlarged prostate

  • A prostate infection



It is important to understand that the PSA test is not perfect. Most men with elevated PSA levels have non-cancerous prostate enlargement, which is a normal part of ageing. Conversely, low levels of PSA in the bloodstream do not rule out the possibility of prostate cancer. However, most cases of early prostate cancer are found following a PSA blood test.


If your prostate specific antigen (PSA) test or digital rectal exam (DRE) is abnormal, doctors may do more tests to find or diagnose prostate cancer.


1. Transrectal ultrasound: A probe the size of a finger is inserted into the rectum, and high-energy sound waves (ultrasound) are bounced off the prostate to create a picture of the prostate called a sonogram. This test may be used during a biopsy.


2. Biopsy: A small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.


Gleason score: This score is determined when the biopsy is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2–10. The lower the score, the less likely it is that the cancer will spread.


If prostate cancer is diagnosed, other tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. This process is called staging. Staging is a way of explaining how far the cancer has spread, if at all. It can also help to determine treatment.


Prostate cancer classified as stage 1 is present in only a tiny portion of your prostate. It is not fast growing and hasn’t spread beyond the original location. Stage 2 means the cancer is small, but fast growing. It can also mean that the tumor is large or has spread through the entire prostate gland. In stage 3 prostate cancer, cancerous cells have invaded seminal vesicles or adjacent tissues. Stage 4 means the cancer has spread from the prostate to other organs. Usually, it spreads to the lymph nodes, bones, bladder, or lungs.



What are the treatments for prostate cancer?

Depending on how advanced the cancer is, men may be offered a range of treatments, or forms of monitoring called watchful waiting or active surveillance.


Possible treatment options include:

  • Watchful waiting or active surveillance

  • Surgery

  • Radiation therapy

  • LDR & HDR brachytherapy

  • Cryosurgery (cryotherapy)

  • Hormone therapy

  • Chemotherapy

  • Vaccine treatment

  • Photodynamic Therapy


To find out more about the various treatment options, please contact your GP or local healthcare provider.



What is LDR brachytherapy?

LDR brachytherapy is a targeted form of internal radiotherapy and an effective, minimally invasive treatment for prostate cancer with significant quality of life benefits over alternative treatments such as surgery and chemotherapy. [1],[2],[3]  


Patients with suspected prostate cancer are usually referred by their GP to a surgeon. Some will need surgery to remove the prostate and/ or chemotherapy, which may mean taking weeks out of ‘normal life’ and can permanently damage sexual and bladder function.


Many patients are suitable for LDR brachytherapy, a one-stop treatment – usually day surgery – with a much lower risk of sexual and bladder problems. However, LDR brachytherapy is frequently overlooked as a treatment option, because the standard route for patients with suspected prostate cancer does not always recognise LDR brachytherapy as an option.


Click here to find out more about LDR Brachytherapy



References (The American Cancer Society)



"LDR brachytherapy is a targeted form of internal radiotherapy and an effective, minimally invasive treatment for prostate cancer"

Find out more about LDR brachytherapy