Early (localised) prostate cancer
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Early prostate cancer is when the cancer cells are only inside the prostate. The cancer has not spread through the outer layer (capsule) that surrounds the prostate. Some early cancers may not cause any problems and may not need to be treated.
Early prostate cancer is sometimes called localised prostate cancer. We call it early prostate cancer in this information.
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Prostate cancer is the most common cancer in men in the UK. It is usually diagnosed in men over 65. Prostate cancer can affect younger men, but it is uncommon in men under 50.
We have more information about the risk factors of prostate cancer.
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Men who have symptoms usually begin by seeing their GP. The first tests used to diagnose prostate cancer are:
Your GP may refer you for other tests at the hospital:
Trans-rectal ultrasound scan (TRUS) biopsy
Multi-parametric MRI scan
Some men may have a special scan called a multi-parametric MRI scan to decide if they need another biopsy. In some hospitals they may do this scan first to see if a biopsy is necessary in the first place.
PCA3 (prostate cancer antigen 3) test
Most prostate cancers grow very slowly. Even if it takes a couple of weeks to get your results, it is unlikely that the cancer will change during this time.
Waiting for test results can be a difficult time, we have more information that can help.
Further tests after diagnosis
Whether you have any further tests will depend on the risk of the cancer growing quickly. Doctors work out your risk by looking at the PSA level, the stage, and the grade of the cancer.
You may have tests to help diagnose or stage prostate cancer:
The stage of a cancer describes its size and how far it has spread, based on your test results. Doctors often use the TNM staging system or a number staging system.
A doctor decides the grade by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.
You and your doctors can then talk about the best treatment choices for you.
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
Not everyone with early prostate cancer needs treatment straight away.
Your doctor will explain the different treatments and their side effects. They will also talk to you about the things you should consider when making treatment decisions.
The main treatments are the following:
Monitoring (active surveillance, watchful waiting)
Surgery (open surgery, keyhole surgery)
Radiotherapy (external beam radiotherapy, brachytherapy)
You may also have some treatments as part of a clinical trial.
Find out more about prostate cancer treatments.
Follow-up after treatment
You have regular follow-up appointments after treatment. Your doctor usually does a PSA test and a rectal examination.
After treatment, some men are cured of prostate cancer. But for others, cancer may come back after treatment. If this happens, you may be able to have further treatment.
You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.
Macmillan is also here to support you. If you would like to talk, you can:
Sex, relationships and fertility
Prostate cancer treatments can have a direct effect on your sex life and fertility. They can reduce your sex drive (libido) and cause difficulties getting an erection. This is called erectile dysfunction or ED. Talk to your doctor or nurse about sexual difficulties or concerns. They will be used to talking about these issues.
Well-being and recovery
Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.
Making small changes to the way you live such as eating well and keeping active can improve your health and well-being and help your body recover.
Below is a sample of the sources used in our prostate cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
European Association of Urologists. Guidelines on Prostate Cancer. 2016.
European Society for Medical Oncology. Cancer of the prostate: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 2015.
National Institute for Health and Care Excellence (NICE). Prostate cancer overview. Available from: pathways.nice.org.uk/pathways/prostate-cancer (accessed from March 2017 to November 2017).
National Institute for Health and Care Excellence (NICE). Surveillance report 2016. Prostate cancer: diagnosis and management (2014). NICE guideline CG175. 2016.
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editors, Dr Jim Barber, Consultant Clinical Oncologist and Dr Lisa Pickering, Consultant Medical Oncologist.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.