Prostate cancer is one of the most common types of cancer. It usually develops slowly so there may be no symptoms for many years. Most cases are in men aged 50 and over.
Around 1 in 8 men will develop prostate cancer during their lifetime.
It is more common in Black men – around 1 in 4 Black men will develop prostate cancer.
About prostate cancer
The prostate is a small gland in the pelvis in people who are born male. It is part of the male reproductive system and its main function is to produce a thick white fluid that becomes semen when mixed with sperm produced by the testicles.
Prostate cancer develops after a change in the DNA of the cells in the prostate. (DNA is the genetic material that tells cells what to do.) As these faulty cells divide and multiply, they eventually cause a cancer.
- Most cases of prostate cancer are diagnosed at an early stage, when the cancer remains within the prostate gland. This is called ‘localised prostate cancer’.
- Other cases are diagnosed with very early spread, e.g. to the seminal vesicles or pelvic lymph glands. This is called ‘locally advanced prostate cancer’.
- Cancer which has spread further, e.g. to bones or lymph nodes beyond the pelvis, is termed ‘advanced’ or ‘metastatic prostate cancer’.
Your chances of developing prostate cancer increase as you get older.
Men with a close family relative who had prostate cancer are at slightly higher risk and some men might have inherited specific malfunctioning genes which puts them at a significantly higher risk. This inherited risk of prostate cancer accounts for a relatively small proportion of all cases of prostate cancer.
Black men are more likely to develop prostate cancer than those from other ethnic backgrounds.
Recent research suggests obesity may increase the risk of prostate cancer.
Some men with prostate cancer may not have any symptoms. However some may notice:
- An increased need to pee, including at night
- Straining or taking a long time to pee
- Needing to rush to the toilet to pee
- Finding it difficult to start to pee
- Weak flow
- Feeling like your bladder is not empty after peeing
- Problems with erections
- Blood in your urine or semen
These symptoms do not mean you definitely have prostate cancer – they can be caused by an enlarged prostate.
However, it is important to see a health professional if you have symptoms, especially if they last more than a couple of weeks.
Your GP may carry out tests such as:
- A urine test to check for infection
- A blood sample for a PSA test – this checks the level of prostate-specific antigen (PSA)
- A physical examination to check your prostate gland
Treatment at The Clatterbridge Cancer Centre
Not all prostate cancers need treatment straight away. When you are diagnosed, your care will be discussed at a multidisciplinary team meeting (MDT) where different specialists will consider your treatment options. Your doctor will discuss this with you so you can decide what is right for you.
Treatment depends on a range of factors including:
- The size and position of the cancer
- How advanced it is (the ‘stage’ of cancer)
- Your general health
Treatment options can include one or more of the following:
- Surgery – robotic assisted laparoscopic prostatectomy
- Radiotherapy – external beam radiotherapy or brachytherapy (internal radiotherapy)
- Hormone therapy
- Chemotherapy
- Radioisotope therapy
- Targeted biological therapy
Depending on the type and stage of your prostate cancer, you may receive a combination of these treatments.
Genomics is the study of a person’s genes (or ‘genome’) – the material in DNA that makes each person unique. Cancer is caused by changes in the DNA of a cell and tell it to multiply out of control.
Understanding where this change has occurred – for example, which gene is faulty – can help us know which treatment will give you the best chance of killing the cancer cells and stopping new ones from growing.
Your clinical team will ask you regarding your personal and family history of cancer. Other factors such as age at diagnosis and ethnicity may increase the risk of inherited prostate cancer.
If there is a suspicion that you might have inherited prostate cancer, you will be counselled and offered genomic testing by your oncologist. More complex cases may be referred to our colleagues in Clinical Genetics.
At The Clatterbridge Cancer Centre, we provide specialist non-surgical treatment for prostate cancer. We also work closely with surgical teams in other hospitals to plan and coordinate your care every step of the way.
Radiotherapy
Radiotherapy and surgery are the two main treatment for localised and locally advanced prostate cancer. Depending on the stage and grade of the cancer, radiotherapy may be combined with hormone therapy. We use different types of radiotherapy, depending on the size, location and stage of the cancer.
The radiotherapy treatments we offer for prostate cancer include:
- External beam radiotherapy – where radiation is delivered from outside the body. The beam is shaped around the target (the prostate), avoiding the normal tissues as much as possible. Treatment is usually delivered Monday to Friday, over 4 weeks.
- Brachytherapy – a single internal treatment of high dose rate brachytherapy may be combined with external beam radiotherapy.
- Stereotactic ablative radiotherapy (SABR) – a type of external beam radiotherapy which delivers a higher dose per treatment. This means the overall number of treatments is reduced to five, given over one week. We have extensive experience of this technique in the PACE trials and are working towards offering SABR for routine NHS use for all those who are suitable.
We now offer a rectal spacer service for patients who may be at higher risk of bowel side-effects after prostate radiotherapy, e.g. those with inflammatory bowel disease. A biodegradable gel is inserted between the prostate gland and the rectum, which separates the two organs and this gap means little, or no, bowel receives the high dose of radiation.
Follow-up after radiotherapy is focused on monitoring the PSA test and checking if any pelvic side-effects have developed. In many cases this can be done remotely by our PSA Tracker team of specialist nurses and cancer support workers.
Find out more about Radiotherapy at The Clatterbridge Cancer Centre.
Systemic anti-cancer therapy (SACT)
SACT is a term used to describe the different drug therapies for cancer.
Prostate cancer is a hormonally-driven cancer. Reducing the level of the male hormone testosterone is therefore the backbone of SACT for prostate cancer.
Hormone therapy is given in the form of an injection every few months, or orally (by mouth) in tablet form. It is common to get both forms together as a combined treatment.
In advanced prostate cancer the cancer cells eventually can no longer be controlled by hormone therapy - this means other types of SACT are required. These may include:
- Chemotherapy – an intravenous infusion which aims to kill cancer cells.
- Radioisotope therapy – radioactive treatments which are injected into the vein and seek out the cancer cells, resulting in radiation damage to their DNA leading to cell kill.
- Targeted therapies – genomic medicine is now routine in prostate cancer treatment. Biopsy samples are tested for faulty genes (genomic mutations) which can be exploited by new drugs.
Find out more about systemic anti-cancer therapies (SACT) at The Clatterbridge Cancer Centre.
Research and trials of new cancer treatments are an important part of our work. Your consultant will tell you about any clinical trials that may be suitable for you.
You are also very welcome to ask us about clinical trials during your appointments. We will be happy to answer any questions you have.
Find out more about clinical trials at The Clatterbridge Cancer Centre.
We have a multi-site model where we visit hospitals across Cheshire and Merseyside to provide treatment and consultations closer to patients’ homes.
We provide systemic anti-cancer therapies (e.g. hormone therapy and chemotherapy) for prostate cancer at the following sites:
- Clatterbridge Cancer Centre – Liverpool
- Clatterbridge Cancer Centre – Wirral
- Marina Dalglish Centre, Aintree University Hospital
- Halton – CANtreat unit
- Southport and Ormskirk Hospital
- St Helens – Lilac Centre
- Outreach services to the Isle of Man
We provide radioisotope therapy at the following sites:
- Clatterbridge Cancer Centre – Liverpool
- Clatterbridge Cancer Centre – Wirral
We provide external beam radiotherapy for prostate cancer at the following sites:
- Clatterbridge Cancer Centre – Aintree
- Clatterbridge Cancer Centre – Liverpool
- Clatterbridge Cancer Centre – Wirral
High dose rate brachytherapy and clinical trials for prostate cancer are delivered at Clatterbridge Cancer Centre – Liverpool.
Our team
The team consists of clinical oncologists, consultant radiographers, advanced nurse practitioners, clinical nurse specialists, radiographers, pharmacists, research practitioners, administrative support and cancer support workers.
Our operational management team makes sure the service runs smoothly.
Clinical Oncologists
Dr Shaun Tolan (clinical lead)
Virtual tour of Radiotherapy unit (CCC-Liverpool)
Information and support
Our Cancer Information and Support Centres can provide individualised help and support for patients and families affected by cancer. The team’s main base is in Clatterbridge Cancer Centre – Liverpool but they also work at our Aintree and Wirral hospitals.
There are also local Macmillan services in other hospitals across our region.
External sites that offer extra support include:
Prostate cancer (Macmillan Cancer Support)