What Is the Prostate?

The prostate is a small gland that plays a key role in male fertility. It sits just below the bladder and in front of the rectum, surrounding the upper part of the urethra — the tube that carries urine out of the body.

Its main job is to produce a milky fluid that mixes with sperm to form semen. This fluid helps sperm survive and move effectively.

As men get older, the prostate naturally tends to grow larger. This can sometimes cause problems with urination, but in most cases, it’s a normal part of ageing and not a sign of cancer.

What Is Prostate Cancer?

Prostate cancer develops when some of the cells in the prostate start dividing and growing more rapidly than normal. These abnormal cells can form a lump or tumour inside the gland. Over time, if left untreated, they may spread beyond the prostate to nearby organs or bones.

It’s important to note that not every prostate enlargement is cancer. A condition called Benign Prostatic Hyperplasia (BPH) causes the gland to grow in size but does not involve cancerous cells. Because both prostate cancer and BPH can produce similar urinary symptoms, only proper medical evaluation and testing can tell the difference.

Common Symptoms of Prostate Cancer

In many men, prostate cancer causes no symptoms in its early stages. When symptoms appear, they often relate to changes in urination, such as:

Needing to urinate more frequently, especially at night
Feeling an urgent or sudden need to urinate
Difficulty starting urination
A weak or interrupted urine stream
The sensation that the bladder isn’t completely empty after urinating

These signs don’t always mean cancer, as they can also occur with non-cancerous conditions like BPH or urinary tract infections. However, it’s important not to ignore persistent urinary problems and to discuss them with a doctor.

Early Detection and Screening

There isn’t a single rule for prostate cancer screening that applies to everyone. Instead, men should make informed decisions based on their age, family history, and overall health.

Screening typically includes two simple assessments:

PSA (Prostate-Specific Antigen) Test: A blood test that measures the amount of PSA, a protein made by the prostate. Higher levels may indicate prostate irritation, enlargement, or cancer.
Digital Rectal Examination (DRE): A quick examination where a doctor feels the prostate through the rectum to check for any hard or uneven areas.

Men between 50 and 70 years old are often advised to discuss screening every couple of years. Those with a family history of prostate or breast cancer may consider starting earlier. Regular screening helps detect prostate cancer before symptoms develop, improving the chances of successful treatment.

How Prostate Cancer Is Diagnosed

If screening suggests that something isn’t normal, your doctor may recommend additional tests to confirm whether cancer is present and determine how far it has spread. These may include:

MRI Scan of the Pelvis: Creates detailed images of the prostate and nearby structures.
Transrectal Ultrasound (TRUS)–Guided Biopsy: A small probe is used to take tissue samples from the prostate, which are then examined under a microscope.
PSMA PET-CT Scan: A specialised scan that detects whether cancer cells have spread to other parts of the body.

A confirmed diagnosis comes from the biopsy results, which also indicate how aggressive the cancer is — information that helps guide treatment choices.

Treatment Options for Early Prostate Cancer

The right treatment depends on several factors, including age, overall health, PSA level, tumour stage, and possible side effects. For early-stage prostate cancer, common approaches include:

1. Radical Prostatectomy

This surgery removes the prostate gland entirely and is typically recommended when the cancer is localised. Newer robotic-assisted techniques have improved precision and reduced recovery time.

2. Radiotherapy (With or Without Hormone Therapy)

Radiation is used to destroy cancer cells inside the prostate. In some cases, hormone therapy is added for a period of two to three years to enhance results and reduce recurrence risk.

3. Active Surveillance

For men with low-risk or slow-growing prostate cancer, immediate treatment may not be necessary. Instead, regular monitoring with PSA tests, MRIs, and occasional biopsies is done, and treatment starts only if the cancer shows signs of progression.

Treatment Options for Advanced Prostate Cancer

When cancer has spread beyond the prostate, treatment focuses on controlling the disease, reducing symptoms, and maintaining quality of life.

1. Hormone Therapy

Also called androgen deprivation therapy, this approach reduces or blocks the effects of testosterone, which prostate cancer cells rely on for growth. It can be done with tablets, injections, or surgery to remove the testes.

2. Chemotherapy

Chemotherapy is used when prostate cancer spreads to other organs or stops responding to hormone therapy. It helps slow the disease and ease symptoms.

3. Radiotherapy

For advanced disease, radiotherapy can help manage pain and control cancer in specific areas, such as the bones.

4. Bone-Strengthening Therapy

Injections such as zoledronic acid or denosumab can strengthen bones, relieve pain, and lower the risk of fractures in men whose cancer has spread to the skeleton.

Lifestyle and Prevention

Although prostate cancer cannot always be prevented, certain lifestyle habits can support prostate health and lower overall risk. A diet rich in fruits, vegetables, and whole grains, combined with regular physical activity, can have protective effects. Avoiding smoking, limiting alcohol, and maintaining a healthy body weight also contribute to better long-term outcomes.

Conclusion

Prostate cancer is a serious condition, but with early diagnosis and modern treatments, most men recover well and continue to lead full, active lives. The key lies in awareness and timely action — recognising symptoms, undergoing appropriate screening, and consulting a specialist when needed.

Taking care of your prostate health is not just about treating disease; it’s about ensuring a better quality of life as you age.