Prostate cancer

Prostate cancer develops when some cells in the prostate don’t work properly. These cells start to grow out of control and form a tumour.

Not all tumours are cancer, but they need to be tested in case they are.

The prostate

All men have a prostate gland. It is about the size of a walnut and is part of the male reproductive system.

• Bladder – This is where pee/wee (urine) is kept.
• Prostate gland – This makes some of the fluid in semen.
• Urethra – A tube that takes pee/wee from the bladder to the end of the penis. The urethra also carries semen during orgasm.
• Penis – A man’s sex organ.
• Testicles – Two small, egg-shaped glands that make sperm.
• Scrotum – A pouch of skin that holds the testicles.
• Spine – This is made of bone.

You can have prostate cancer without noticing anything is wrong. Or you might notice some warning signs like:

• needing to pee or wee (urinate) often
• slow flow of pee
• feeling pain or burning when you pee
• blood in the pee
• having trouble getting an erection
• feeling pain when ejaculating (when sperm and semen come out of the penis).

These signs do not always mean you have prostate cancer, but it’s important to see your doctor if you notice any of these symptoms. Your doctor will do some tests to work out if you have cancer or what the problem is.

If prostate cancer is found and treated early, you have a very good chance of getting better.

Some of the tests you may have include a:

• Blood test – Some blood will be taken from a vein in your arm and sent to a lab to check levels of a substance called prostate specific antigen (PSA).
• Rectal examination – Wearing a glove, your doctor will put their finger into your rectum to feel if your prostate is hard or an odd shape.
• MRI scan – You will lie on a table that slides into a special machine that takes pictures of your insides.
• Biopsy – The doctor will take a tiny piece of tissue from the prostate and send it to the lab for testing. You may have medicine to make you sleepy (a sedative or general anaesthetic) while you have this test.

If you are uncomfortable about having any tests, you can ask a nurse, Aboriginal health worker or someone from your family or mob to be in the room with you.

The test results will tell the doctor if you have prostate cancer, what type it is, and if the cancer has spread (the stage).

The cancer may be:

• Localised – The cancer is small and only in the prostate gland.
• Locally advanced – The cancer is larger and has spread outside the prostate gland to the area in your abdomen (belly) between the hips.
• Advanced – The cancer has spread outside of the prostate gland to other organs or the bones.

Knowing the stage of the cancer helps the doctors work out the best treatment for you.

There are different types of treatment for prostate cancer. You may have one or more of these treatments:

Active surveillance

• The doctor regularly checks that the cancer isn’t getting worse, and only offers treatment if the cancer starts growing faster.
• It is for cancer that’s not causing you any trouble.

Surgery

• This removes the prostate gland (called radical prostatectomy).

Radiation therapy

• This uses radiation to kill or damage the cancer cells. It may be given to the outside of the body or inside the body.

Medicines

• Hormone treatment (also called androgen deprivation therapy or ADT) helps to stop your body making so much testosterone, because this hormone can make the cancer grow.
• Special types of medicine called targeted therapy may be used to treat cancer at advanced stages.

Chemotherapy

• Sometimes called “chemo”, chemotherapy is strong medicine that can kill the cancer cells.

Watchful waiting

• This is for cancer that is not likely to cause you any problems in your lifetime, or that may be very hard to treat.
• The doctor checks on the cancer and helps you manage any symptoms you may get.

It’s important to go to all of your treatment sessions. If you miss a session, it might become harder to treat the cancer.

Treatment for prostate cancer sometimes causes other problems called side effects. Some of the common ones include:

• Trouble controlling your pee – The surgery sometimes damages the muscles around the prostate.
• Trouble getting an erection – The nerves that control an erection pass through the prostate; sometimes the nerves are damaged during treatment.

There are usually things that can be done to help with these side effects. Yarn with your doctor, nurse or Aboriginal health worker if you have any of these troubles.

It is normal for you and your family to have lots of different feelings right now. Talking with your doctor, nurse or health care professional will help answer any questions you may have.

Depending on where you live, you might need to travel for treatment. You can get help to pay for travel and accommodation.

For more on this, see Getting support.