Prostate cancer survivorship patient overview

Overview

Survivorship means looking after your health and wellbeing from the time you are diagnosed with prostate cancer through the rest of your life. It includes dealing with the physical and emotional effects of treatment, adjusting to changes, and finding ways to live as full and active a life as possible.

Yes, prostate cancer is very common. It is the most frequently diagnosed cancer in men in the UK and in many other countries. Millions of men are prostate cancer survivors.

Prostate cancer affects men, usually over the age of 50. Black men, men with a family history of prostate cancer, and older men are at higher risk. Survivorship concerns apply to anyone diagnosed, regardless of age.

Symptoms

Common symptoms

• Long-term urinary changes, such as leaking or needing to urinate more often
• Erectile dysfunction or changes in sexual function
• Feeling more tired than usual (fatigue)
• Hot flushes or body changes from hormone therapy
• Numbness or tingling in the legs or feet (sometimes after surgery)

Symptoms in children

• Prostate cancer does not affect children.

Symptoms in older adults

• Older adults may have the same survivorship symptoms as other men, but they can also face challenges from other age-related conditions.
• Weakness, balance problems, or trouble with daily activities may become more noticeable.

Causes

Main causes

• Prostate cancer starts when cells in the prostate gland grow out of control. The exact cause is not known, but changes in a man's DNA (genes) play a key role.
• Survivorship issues are not caused by the cancer itself but by the cancer and its treatment, including surgery, radiation, hormone therapy, and chemotherapy.

Risk factors

• Getting older (especially being over 50)
• Being of African or Caribbean descent
• Having a father, brother, or son who had prostate cancer
• Carrying certain gene changes, such as BRCA mutations
• Obesity and an unhealthy diet may also increase risk

When to see a doctor

See a doctor urgently if:

• You suddenly cannot urinate at all
• You have severe back, hip, or pelvis pain that is new or very bad
• You notice blood in your urine or semen
• You have a fever with chills

Book a routine appointment if:

• Keep all your scheduled follow-up appointments with your specialist or doctor.
• Tell your doctor about any new symptoms or side effects, even if they seem minor.
• Ask your doctor about a PSA blood test if you have concerns about recurrence.

Diagnosis

Prostate cancer is usually found through a PSA blood test and a digital rectal examination (DRE). If these suggest cancer, a biopsy (taking tiny samples of the prostate) is done to confirm the diagnosis. During survivorship, monitoring involves regular PSA tests and sometimes imaging scans to check for recurrence.

Tests that may be done

• PSA blood test: measures a protein made by the prostate; high levels may indicate cancer or other prostate problems.
• Digital rectal exam (DRE): a doctor feels the prostate through the wall of the rectum.
• Magnetic resonance imaging (MRI): a scan that creates detailed pictures of the prostate.
• Prostate biopsy: a needle removes small pieces of prostate tissue to look for cancer cells.
• Bone scan or CT scan: used to see if cancer has spread to other parts of the body.

What to expect at your appointment

If you are diagnosed with prostate cancer, your doctor will discuss your grade, stage, and treatment options. You will have tests to see how far the cancer has spread. Decisions about treatment depend on your age, overall health, the cancer's aggressiveness, and your personal preferences.

Treatment

Treatment for prostate cancer depends on the stage of cancer, your age, and your general health. Some men need no immediate treatment and are monitored closely. Others may need surgery, radiation, hormone therapy, chemotherapy, or a combination of these. Survivorship care focuses on managing side effects and maintaining quality of life.

Self-care at home

• Do pelvic floor exercises to help improve bladder control after surgery or radiation.
• Stay physically active to reduce fatigue and maintain strength.
• Eat a balanced diet rich in fruits, vegetables, and whole grains.
• Get enough rest, and pace your activities if you feel tired.
• Talk to your doctor about sexual health concerns — help is available.
• Keep a record of any symptoms to discuss at follow-up visits.

Medical treatments

Medical treatment may include surgery to remove the prostate, radiation therapy to kill cancer cells, hormone therapy to reduce testosterone, chemotherapy, or newer targeted therapies. The choice depends on the specific situation. Some treatments can cause side effects like urinary problems, erectile dysfunction, or hot flushes, and your healthcare team can help you manage these. Always discuss the benefits and risks of any treatment with your doctor.

When is surgery considered?

Surgery (radical prostatectomy) is an option for men with early-stage prostate cancer that has not spread beyond the prostate. It removes the whole prostate and some surrounding tissue. It is most effective when the cancer is contained.

Living with this condition

Life after prostate cancer treatment involves getting back to your normal routine while adjusting to changes. You will need to be aware of your body, manage any lasting side effects, and attend regular follow-up visits. Some men find it helpful to talk openly with partners and family about how they feel.

Lifestyle tips

• Aim to maintain a healthy weight.
• Include regular exercise such as walking, swimming, or cycling.
• Reduce alcohol and quit smoking for better overall health.
• Stay socially connected with friends, family, or support groups.

Diet and exercise

A balanced diet with plenty of vegetables, fruits, whole grains, and lean proteins can help you recover and stay strong. Limit red meat and highly processed foods. Exercise for at least 150 minutes per week of moderate activity, plus strength training twice a week, unless your doctor advises otherwise.

Mental health and emotional wellbeing

A cancer diagnosis and treatment can cause anxiety, depression, fear of recurrence, and stress. It is normal to feel this way. Speak to your doctor or a counselor if you are struggling. Your feelings matter and support is available.

Prevention

Prostate cancer cannot always be prevented. Some risk factors like age and family history cannot be changed. A healthy lifestyle may lower the risk of developing advanced prostate cancer, but the evidence is not strong enough to guarantee prevention.

Screening programmes

Screening for prostate cancer involves a PSA blood test. The decision to have a PSA test is a personal one. It can produce false alarms, and it may find cancers that would never cause symptoms. Talk to your doctor about the benefits and harms before deciding whether screening is right for you.

Complications

If left untreated

• Prostate cancer can grow and spread outside the prostate, often to the bones.
• It may cause bladder outlet obstruction, making it difficult or impossible to urinate.
• Advanced prostate cancer can cause severe bone pain, fractures, and weakness in the legs.
• Without treatment, it can ultimately be life-threatening.

Long-term outlook

The outlook for prostate cancer is often very good. Many men live many years after a diagnosis, and some men die from other causes rather than prostate cancer. Treatments today are effective and focus on both controlling the cancer and preserving quality of life. With the right follow-up and support, you can live a full and active life.

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