Prostate cancer survivorship in adults

Overview

Prostate cancer survivorship means living with and beyond a diagnosis of prostate cancer. It focuses on your health and quality of life after treatment, including managing side effects, staying well, and finding support.

Prostate cancer is the most common cancer in men in many countries. Thanks to better treatments, thousands of men are living longer and well.

Survivorship affects all men who have had prostate cancer, usually those over 50. It also affects their partners, families, and caregivers.

Symptoms

Common symptoms

• Bladder control problems, like leaking urine
• Bowel changes, such as diarrhea, urgency, or bleeding
• Erectile dysfunction or other changes in sexual function
• Long-lasting tiredness (fatigue)
• Anxiety, stress, or low mood

Symptoms in children

• This condition does not affect children.

Symptoms in older adults

• Older adults may have more treatment side effects and also manage other health conditions like heart disease or arthritis. It is important to keep up with check-ups.

Causes

Main causes

• The exact cause of prostate cancer is unknown. It develops when cells in the prostate gland grow abnormally. Survivorship care is about managing the effects of the disease and its treatment, not finding a cause.

Risk factors

• Age (most common over 50)
• Family history of prostate cancer (father or brother)
• Family history of breast cancer
• Being of African or Caribbean descent
• Certain inherited gene changes, such as BRCA

When to see a doctor

See a doctor urgently if:

• If you have severe bleeding, chest pain, or sudden weakness, call your local emergency number without delay.
• Contact your doctor or out-of-hours service for a fever, severe pain, or inability to urinate.

Book a routine appointment if:

• Keep all follow-up appointments for PSA checks and physical exams, even if you feel fine.

Diagnosis

For patients already in survivorship, diagnosis usually happened before. But during survivorship, doctors use tests to look for signs that cancer has returned or to check for long-term side effects.

Tests that may be done

• PSA blood test, which measures a protein made by the prostate
• Digital rectal exam, where a doctor feels the prostate
• Imaging scans like MRI, CT, or bone scan
• Biopsy, if a suspicious area is found (rare)

What to expect at your appointment

Your doctor will talk with you about the results and what they mean. You will get a clear follow-up plan and have time to ask questions. Regular tests can feel stressful, but they are an important part of staying healthy.

Treatment

Treatment for prostate cancer may include surgery, radiation, hormone therapy, or sometimes chemotherapy. In survivorship, the focus shifts to managing side effects and preventing future problems. You will work with your care team to find what suits you.

Self-care at home

• Do pelvic floor exercises to help with bladder control
• Stay active and try to keep a healthy weight
• Eat a variety of healthy foods and drink enough water
• Talk to your partner or a counselor about sexual changes
• Reach out to friends, family, or a support group if you feel low

Medical treatments

Your doctor may recommend medicines to control side effects such as bladder or bowel problems, pain, or depression. They may also offer treatments for erectile dysfunction, such as oral medicines, injections, or vacuum devices. Always ask your healthcare team about your options and their risks and benefits.

When is surgery considered?

Surgery to remove the whole prostate may be offered if the cancer is thought to be confined to the prostate. You and your surgeon should discuss whether this is right for you, considering your age, health, and treatment goals.

Living with this condition

Your daily routine may need small changes at first. Build in rest when you need it. Plan activities for times when you have energy. Ask for help from family or friends if you find things harder than before. Over time, most men find a rhythm that works for them.

Lifestyle tips

• If you smoke, quit. This is one of the best things you can do for your overall health.
• Limit alcohol, and stick to a healthy diet.
• Take time to relax and do things you enjoy.
• Stay connected with loved ones.

Diet and exercise

Try to eat a balanced diet with plenty of fruits, vegetables, and whole grains. This may support your energy and weight. Aim to be active most days. Walking, swimming, and cycling are good options. If you have health conditions or concerns, ask your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Survivorship can bring mood changes. You may feel anxious about cancer coming back, uncomfortable with changes in your body, or worried about sex and relationships. These feelings are normal. If low mood, anxiety, or fear lasts for more than a couple of weeks, talk to your doctor or a mental health professional. You can also join a support group. If you ever feel like hurting yourself, call your local emergency number or a crisis line right away.

Prevention

There is no known way to prevent prostate cancer, but after treatment, you can reduce the chance of other health problems by staying active, eating well, and going to follow-up visits.

Screening programmes

Screening for prostate cancer with a PSA test is a personal choice. Guidelines vary between countries. Ask your doctor about the benefits and risks of PSA testing, especially if you have a family history or other risk factors.

Complications

If left untreated

• Cancer may spread to the bones, causing pain or fractures
• Urinary blockage that can harm the kidneys
• Blood in the urine or persistent bleeding

Long-term outlook

The outlook for prostate cancer survivors is often very good. Many men live for many years after diagnosis, especially when cancer is found early. If cancer returns, there are still treatments that can control the disease and help you enjoy a good quality of life. Focus on the things that matter to you, and take things one day at a time.

Find support

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