Prostate cancer: the facts, the myths and getting checked

Anyone with a prostate gland can get prostate cancer. That includes men, trans (transgender) women and people assigned male at birth. Doctors do not know the exact causes of prostate cancer but there are some risk factors that can increase your chance of getting it such as:

• Age - Your risk of prostate cancer increases from the age of 50. Prostate cancer is uncommon under the age of 50 and more common over the age of 75.
• Ethnicity - Black men are more likely to be diagnosed than other men, and more likely to be diagnosed at a younger age.

Family history - Prostate cancer can be more common in some families. The risk can be higher if you have close relatives, such as a father or brother, who have been diagnosed with prostate cancer. Or if you have a family history of breast or ovarian cancer.

Learn more about prostate cancer risk factors.

Not always. Symptoms usually happen when cancer in the prostate is large enough to press on the tube you pee (pass urine) through. This is called the urethra. The prostate can also become enlarged due to a non-cancerous condition called benign prostatic hyperplasia (BPH). BPH can develop as you get older.

The symptoms of benign prostate conditions and prostate cancer are similar. If you have any of these symptoms, it is important to have them checked by your GP:

• needing to pee more often than usual, especially at night
• difficulty peeing – for example, a weak flow or having to strain to start peeing
• feeling like you have not completely emptied your bladder
• an urgent need to pee
• blood in your urine
• blood in your semen
• pain when peeing or ejaculating – this is rare.

Sometimes prostate cancer can cause other symptoms, such as problems getting or keeping an erection (erectile dysfunction). It can also cause loss of appetite and weight loss.

When prostate cancer spreads, it can spread to the bones. This may cause pain in the bones, such as in the back. Even if it spreads to other parts of the body, it is still prostate cancer.  

It’s true that prostate cancer is more common as you get older, but younger men can be affected too, particularly if a close relative, like a father or brother, has had it.

If you are over 45 and have a family history, or if you’re Black, talk to your GP about your risk. They can discuss whether a PSA blood test might be right for you.

Prostate-specific antigen (PSA) is a protein made in the prostate. Some PSA leaks into the blood and can be measured in the PSA test. The PSA can be used with other tests to help diagnose prostate cancer.

There are benefits and disadvantages to having a PSA test. Your GP will talk to you about these before you have a test. They can also talk to you about your own personal risk. 

Anyone with a prostate can get prostate cancer. People who have a prostate include men, trans (transgender) women and people assigned male at birth. If you are a trans woman and have had genital gender affirming surgery as part of your transition, you will still have a prostate. It is important to talk to your GP or nurse if you are worried about prostate cancer or have symptoms.

Prostate cancer often causes a raised level of PSA. But the test is not always reliable. A raised level of PSA does not mean you have prostate cancer. Naturally, as you get older, the level of PSA in the blood slowly rises. Your doctor can tell you what they think the normal level of PSA should be for you.

A raised PSA can also be caused by other things, including urine infections or an enlarged prostate.

Screening for prostate cancer

Screening uses tests to try to find cancer early in people who do not have any symptoms. In the UK, there are screening programmes for breast, bowel and cervical cancer.

There is currently no UK national screening programme for prostate cancer. One reason for this is that the PSA test on its own is not accurate enough. It may suggest that a person has prostate cancer when they do not. A PSA test may find prostate cancers that are very slow growing and are unlikely to cause any problems.

Professor Hashim Ahmed, Chair of Urology at Imperial College, says more research is needed to determine the potential value of screening:

"The problem is we can often find disease that doesn't need to be treated and we end up causing harm...and my concern at the moment is that harm to benefit equation isn't quite right ." BBC News

If you are unsure about PSA testing, talk to your GP or a specialist nurse. They can explain what is best for you.

If you or someone you know is affected by prostate cancer, you don’t have to face it alone. Support is available for your medical, emotional and everyday needs. You can:

• Find local cancer support services near you with our simple online search.
• Call the Macmillan Support Line for free on 0808 808 00 00, if you have any questions.
• Use our Online Chat
• Visit our Prostate cancer forum  to talk with people who have been affected by cancer, share your experience, and ask an expert your questions.

Other organisations who can help

• Maggie’s offers support for people going through hormone therapy, including space to talk about side effects and find ways to manage them.
• Prostate Cancer UK provides information and support to men with prostate cancer and their families. They have offices in London, the Midlands, Scotland, Wales and Northern Ireland. You can call their helpline on 0800 074 8383.
• Cancer Black Care helps ensure Black men and men of colour feel seen, supported and informed.

This information has been written, revised and edited by Macmillan's Digital Content Editor team. Learn more about our Digital Content Editors and how we produce our cancer information. 

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