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Prostate Cancer

Everything you need to know about living well with prostate cancer

  • Introduction
  • Types
  • Symptoms
  • Daily Living
  • Support
  • Glossary

Introduction

If you, or someone you know, has been given a diagnosis of prostate cancer, this guide may help you understand more about the condition.

You may be wondering, what is prostate cancer? NRS Healthcare are here to help explain this, as well as explore prostate cancer symptoms, treatments for prostate cancer, what causes prostate cancer, and types of prostate cancer. We hope you find this guide useful, and that it helps you to better understand the signs of prostate cancer.

Introduction

What is prostate cancer?

Prostate cancer is the leading type of cancer in men. It affects the prostate gland, which men have but women do not, therefore only men can be diagnosed with this particular cancer. The function of the prostate gland is to produce the fluid that mixes with sperm. The prostate lies between the bladder and the penis, with the urethra running through it, and it produces the thick clear liquid that is essential for carrying sperm during ejaculation.

Prostate cancer affects more than 41,000 men in the UK each year and is most common in men aged over 50, but it does affect some men at a younger age. Sometimes, prostate cancer begins to develop at an earlier age, but as it grows very slowly most men are diagnosed when they are older. Some men are more at risk of developing prostate cancer than others, depending on their ethnicity and lifestyle. If you are a black man, you are more likely to develop prostate cancer than other men. If you’re overweight, you are also at higher risk of developing prostate cancer. Nobody knows why some men are more at risk than others, but it’s likely to do with genetics.

There are prostate cancer treatments available which can control the disease or cure it completely. There are many charities campaigning to raise awareness of prostate cancer symptoms, in order to ensure more men understand what prostate cancer signs to look out for, and seek medical advice if they are at risk.

There are many men living well with prostate cancer and a lot of prostate cancer support is available, which we will explore later. To find out more about prostate cancer, visit the NHS website.

What causes prostate cancer?

Cancer takes many forms and can affect various parts of the body. It is a disease that starts when the body’s cells grow and duplicate abnormally to create tumours. These are lumps of tissue that may affect the way parts of the body function. Some tumours are benign (non-cancerous). Cancerous tumours grow and may spread to other parts of the body, where they create more tumours. Cancer Research UK provides a clear explanation of what causes cancer.

Prostate cancer occurs when cells in the prostate begin to multiply in this way, causing a tumour within the prostate which may enlarge the gland and cause prostate cancer symptoms. For some people, prostate cancer will stay within the prostate, whereas for others, it may spread to the area around the prostate, or other areas of the body such as the bones. Diagnosing prostate cancer early reduces the chance of the cancerous cells spreading, which makes it more likely that your cancer can be cured or managed effectively so it does not affect your lifespan.

It’s not clear what causes prostate cancer to occur in some men and not others, but being overweight, being black and having a close family member with the disease are factors that seem to increase a man’s risk of prostate cancer developing. One of the possible causes of prostate cancer is therefore likely to be genes, but this is still being researched.

Prostate Cancer UK provides a video explanation of what causes prostate cancer.

Did you know... "Prostate cancer affects more than 41,000 men in the UK each year."

Types of Prostate Cancer

Read on to find out more about the stages and types of prostate cancer.

Prostate cancer occurs in stages according to how severe it is, if the cancerous cells have spread and how much they have spread. If you are given a prostate cancer diagnosis, your doctors will investigate what type of prostate cancer you have, to determine if and how the cancer has spread. These factors will help your doctor decide the best course of treatment for you and how effective prostate cancer treatment is likely to be. Everyone experiences prostate cancer differently, and some types of prostate cancer are more aggressive and harder to treat than others.

Introduction

The three stages of prostate cancer are:

Early (localised) prostate cancer – cancer is only within the prostate gland itself. This type of prostate cancer is highly curable with prostate cancer treatments. Prostate Cancer UK provides a helpful leaflet about this stage of prostate cancer.

Locally-advanced prostate cancer – this means the cancer started in the prostate but has begun to spread into areas of tissue surrounding the gland itself. This type of cancer also has a high survival rate. Macmillan Cancer Support provides lots of information about this stage of prostate cancer.

Advanced prostate cancer – this is the most severe of all the stages of prostate cancer, where cancerous cells have spread to other areas of the body, most likely the bones (such as the spine and pelvis), the lymph nodes, the nearby organs such as the bladder, or via the blood to other parts of the body such as the liver and lungs. Prostate cancer at this stage is not curable but may be manageable for many years. Cancer Research UK provides a wealth of information about this stage of prostate cancer.

There are multiple types of prostate cancer, which are determined by what type of cells the cancer started in. Most people are diagnosed with acinar adenocarcinoma, which develops in the cells that line the prostate gland. However, there are a few other, rarer types of prostate cancer including:

Ductal adenocarcinoma – starts in the cells that line the tubes and spreads quite quickly

Transitional cell/urothelial cancer – starts in the cells that line the urethra and spreads into the prostate

Squamous cell cancer – starts in the flat cells that cover the prostate

Small cell prostate cancer – a very rare type of prostate and neuroendocrine cancer, made up of small cells, which is aggressive but hard to detect

To understand more about the specific types of prostate cancer, you may wish to visit the Cancer Research UK website.

Did you know... "Prostate cancer is caused by cancerous cells that develop in the prostate gland (which only men have) and which is positioned between the bladder and penis."

Prostate Cancer Symptoms

Here we describe the most common symptoms of prostate cancer, including early signs of prostate cancer, and later progressive prostate cancer symptoms.

Prostate cancer often doesn’t cause many symptoms in the earliest stages, and symptoms that are there are easily dismissed as ‘getting older’. It’s important to know if you have a medium to high risk of developing prostate cancer, and to see a GP if this is the case. Charities are campaigning for people to not only know the symptoms of prostate cancer, but also for men to become aware of their level of risk for developing the disease.

Introduction

Prostate cancer risk factors include:

• Being over 50 years’ old

• Being black – 1 in 4 black men develop prostate cancer and it’s more common in black men than white or Asian men

• Being overweight – research hasn’t confirmed exactly why this is the case, but being overweight does seem to link with a higher risk of prostate cancer

• Having a family member with the disease – if your father, brother, grandfather, uncle or nephew have (or had) prostate cancer, you are almost 2-3 times more likely to develop it yourself compared to men with no prostate cancer in their family

It is important for everybody, men especially, to make themselves aware of the symptoms of prostate cancer. Men need to know what signs to look out for in themselves and the men around them and, similarly, it’s good for women to familiarise themselves so they can help make their male family members, friends and colleagues aware of prostate cancer symptoms.

Symptoms of prostate cancer in the early stages are often related to urinating. This is because as the prostate grows bigger due to the cancerous tumour, it increases the pressure on the urethra, which is the tube out of which a man’s urine travels from the bladder. Prostate cancer symptoms therefore may include:

• Needing to urinate a lot more than usual

• Needing to urinate at night

• Feeling an urgent need to urinate

• Feeling as though you have not urinated enough each time you go

• Blood in semen or urine

Incontinence

If you or someone you know has these symptoms, it’s important to get checked out because the earlier that prostate cancer is diagnosed, the better the chances that it can be successfully treated. The symptoms above are not always symptoms of prostate cancer – they may be related to other conditions or be caused by having an enlarged prostate, which is a different, non-cancerous condition.

Symptoms of prostate cancer that has advanced or spread to other parts of the body may include the above symptoms but also pain in certain areas such as the back, hip or pelvis, as well as weight loss.

Diagnosis of prostate cancer

If your GP thinks your symptoms may suggest an issue with your prostate, he or she is likely to refer you for tests. You may initially have a urine test to find out if you have an infection. There are two tests that you may be referred for:

Prostate specific antigen (PSA) blood test – measures levels of PSA, a protein that everyone has in the blood but which may be raised if you have prostate cancer. This is not a definitive test and sometimes results show a normal level of PSA, even though a person has a prostate tumour

Digital rectal examination (DRE) – this is a physical examination by a doctor, where they feel the prostate to see if it is enlarged, accessing the prostate gland by inserting their finger (digit) gently into your bum

You may have one or both tests, and your GP will discuss the results with you, although they are unlikely to confirm for definite if you have prostate cancer. If the results suggest this is a possibility, you will be referred for further investigation, usually an MRI scan and possibly a biopsy.

Many men are put off going to their GP with possible prostate cancer symptoms as there may be a chance of needing a rectal examination, but most men who have had the procedure agree that whilst uncomfortable, it’s over quickly and does not really hurt. Plus, it could certainly save your life, so if you are experiencing any of the prostate cancer symptoms you’ve read about here, it’s essential to get checked out.

To find out more about prostate cancer diagnosis processes and procedures, download this publication from Prostate Cancer UK.

Did you know... "Prostate cancer symptoms usually involve urination problems, because the cancerous, enlarged prostate gland presses on the urethra."

Living with Prostate Cancer

Many people are able to live well with prostate cancer – read on to find out more about aspects of daily life and the future if you’ve received a prostate cancer diagnosis.

Receiving a diagnosis of prostate cancer can feel daunting and worrying to you and your family. It is a serious condition that will inevitably affect your health, wellbeing and daily life in some way. The type of prostate cancer you have, the stage of prostate cancer you are at and your prognosis will determine how much your life is affected. Here, we explore several factors you may need to consider after diagnosis as well as prostate cancer support groups.

Introduction

Impact on daily living

Prostate cancer will definitely affect your life and may affect your day to day activities. Most people who have prostate cancer are able to enjoy life. Prostate cancer treatments are often successful in curing, or at least managing, the condition so it does not spread. However, they can cause some side effects which may affect daily life – read more about these here. Some men are diagnosed with advanced prostate cancer, which may have a greater effect on their daily routine and even shorten their life. Everybody experiences prostate cancer differently and the majority of men with the disease do not die from it.

Prostate cancer may affect daily life in the following ways:

Symptoms – prostate cancer symptoms can affect urination and cause feelings of anxiety, low mood, frustration or depression. Fatigue plays a big part in living with prostate cancer, and many men find they have constant tiredness or lack energy due to a number of factors, including their body using energy to fight the cancer and experiencing side effects from the treatments. Learn more about prostate cancer and fatigue

Incontinence – prostate cancer may cause incontinence or difficulty urinating for some men, which may present issues in daily life. There are a number of incontinence products available to help build confidence, which we explore here

Treatment – prostate cancer treatments may include hormone therapy, chemotherapy or taking steroids, all of which may have side effects that could affect daily life. For example, you may need time off work, you may experience fatigue or your body and sexual organs may physically change as a result of treatments for prostate cancer

Sex and relationships – some men find that their sex life changes due to their prostate cancer or treatment for prostate cancer. For example, some men find that their penis or testicles get smaller as a result of hormone therapy; some men have a reduced libido, difficulty getting or keeping an erection, difficulty reaching orgasm, or experiencing a less intense orgasm. Changes to your sexual function and sexual desire can also affect your relationships. For more information and advice on prostate cancer and sex, visit Prostate Cancer UK

Pain – men who have advanced prostate cancer may experience pain that makes daily life difficult. If you are experiencing mobility difficulties as a result of pain caused by prostate cancer, you may find daily living aids can help you stay independent

Lifestyle – you may be advised by your doctors to change some aspects of your lifestyle, such as giving up smoking, reducing alcohol intake, eating more healthily, losing weight or exercising. These changes can be challenging, but may help you feel better in the short term, and help your recovery or prognosis in the long term. Read more about prostate cancer diet and prostate cancer exercise

Emotional and mental health effects – receiving a prostate cancer diagnosis and living with the condition can be an emotional rollercoaster. If you or someone you know is struggling with their prostate cancer diagnosis, or experiencing low mood, anxiety or depression as a result of the condition, symptoms or treatments, it may be useful to speak to a mental health professional. Mind is a charity supporting people with a variety of mental health issues, and provides a wealth of information online, including an information telephone line and advice about finding a counsellor or psychotherapist in your area

Prognosis and survival – everyone affected by cancer will at some point consider the worst case scenario and fear that they may not survive the disease. This may cause fear and anxiety that affects daily life. Prostate cancer survival will depend upon many things, such as the stage at which the cancer is identified, if and how it has spread and how successful treatment is on curing or managing the disease. To understand more about prostate cancer survival rates, visit Cancer Research UK

Some men live well with prostate cancer for many, many years, controlling the cancer with treatment. Some men may be told that their advanced prostate cancer is no longer treatable and may be advised they are approaching the end of life. If this is the case for you or someone you know, you may wish to read this End of Life Guide from Macmillan Cancer Support.

Some people find it helps to read about the experiences of other people with prostate cancer to understand what it is like to live with the disease.

Prostate cancer treatments

Prostate cancer can be treated effectively for many men, resulting in it being cured or well-managed so the cancer does not spread. If you receive a prostate cancer diagnosis and the type of prostate cancer you have is at an early stage, without it having spread to other areas of the body, you may benefit from treatments. If it is caught early enough, some doctors recommend ‘watchful waiting’ or ‘active surveillance’, which are both methods of keeping an eye on cancer to see if it requires treatment. Some of the available treatments for prostate cancer include:

Radical prostatectomy – this is where the prostate is removed through surgery and is undertaken if the cancer has not spread out of the prostate itself. There are risks and after-effects to consider, such as you will no longer be able to ejaculate, and therefore will be unable to have a child through sex. This surgery may be successful at first but some men find that the cancer cells return afterwards

Radiotherapy – kills cancer cells, slows progression of the disease and helps reduce symptoms. One particular form of radiotherapy offered to prostate cancer patients is brachytherapy

Hormone therapy – often used in conjunction with other prostate cancer treatments, hormone therapy can relieve symptoms and slow down prostate cancer. This blocks testosterone production from occurring naturally in the body, because cancer cells need testosterone to duplicate. There are multiple side effects of this, and a man undergoing hormone therapy may lose their sex drive, find it difficult to maintain or get an erection, and have other physical symptoms such as weight gain, sweats, hot flushes and swelling of the breasts, due to a lack of testosterone

Men who have advanced prostate cancer may be offered chemotherapy and/or steroid tablets. Steroid treatment for prostate cancer aims to shrink the tumour and is used if hormone therapy does not work. Some men in later life choose not to treat their advanced prostate cancer, if they feel they are getting towards the end of their life and that treatment would be invasive or too much to deal with.

The NHS provides lots of information about prostate cancer treatments.

Prostate cancer products

Daily living aid products can be useful for men with prostate cancer. Prostate cancer may cause incontinence problems for some men. There are many incontinence products available to help you manage this discreetly and without embarrassment, such as:

Incontinence pads

Waterproof bedding

Waterproof chair protectors

Some men also find that using toileting aids such as a commode can help if they find they have an urgent need to urinate and struggle to get to the toilet in time:

Folding Commode

Traditional Commode

For men who have advanced prostate cancer, daily living aids can provide support around the home if mobility is challenging due to pain or discomfort around the body:

Taking a bath: Bath lift, bath rail, bath step

Having a shower: Shower stool or shower chair

Using the toilet: Toilet frame with seat, raised toilet seat, or commode

Standing for long periods: Perching stool

Getting in and out of bed: Bed rails, mattress elevators, bed ladders

Getting in and out of a chair: Rise and recline chairs, lifting cushions and chair raisers

If you are unsure what prostate cancer products may help you, contact our Occupational Therapist Product Advice team for free by calling 0345 121 8111 or emailing productadvice@nrshealthcare.co.uk

Prostate cancer diet

Eating a healthy, balanced diet is important for everybody, and if you have been given a diagnosis of prostate cancer, getting the right nutrition is essential. Certain foods and diets can increase or decrease our cancer risk. For example, eating high fibre foods and enough fruit and vegetables can help reduce our risk of cancer, whereas eating too much processed or red meat can increase the risk of certain types of cancer.

For more cancer diet advice, visit the Cancer Research UK website.

The NHS website provides lots of healthy eating information, recipes and weight loss advice you may find helpful.

Some men may be advised to take vitamin and mineral supplements for prostate cancer. This is often important if you are receiving hormone therapy treatment, because this can cause thinning of the bones, and supplements like vitamin D and calcium help protect bones. Some men may also need to take iron tablets, as their condition may make them anaemic.

There are many other supplements available which are marketed to help prevent prostate problems and prostate cancer, such as lycopene, selenium and omega-3. However, there is little scientific evidence that prostate cancer supplements reduce the risk of developing this condition. Always speak to your GP before taking supplements of any sort to ensure they will not interfere with your treatments for prostate cancer.

Exercise for prostate cancer

Regular, moderate intensity exercise is important for everyone, to help reduce the risk of many healthcare conditions and help us maintain a healthy weight.

It’s really important for men with prostate cancer to try and establish a regular exercise regime, because research shows that physical activity after cancer treatment can help reduce the risk of dying from prostate cancer and actually slow down the progression of the disease. Not only can prostate cancer exercise help with the management of this condition, it can also help reduce the risk of developing other healthcare conditions such as coronary heart disease, angina, dementia and more.

Your cancer doctor or GP may be able to refer you to a physiotherapy service, where you can seek support in developing a reasonable exercise programme that takes into account your symptoms and any physical limitations you may have. Alternatively, you may be able to access your local gym, or simply go for a regular walk or bike ride – whatever your abilities, there is a way to make your body move more. For more advice on prostate cancer and exercise visit the Prostate Cancer UK website.

Prostate cancer and employment

Many men with a prostate cancer diagnosis continue to work. It is likely you may need some time off work for prostate cancer treatments but many men find their employers are very supportive.

Your employer has to make reasonable adjustments to your working life if you require them, in order to enable you to continue working to your utmost ability and ensure the highest level of wellbeing for you.

Many men with prostate cancer experience fatigue at some stage in their journey, which can sometimes be difficult to deal with, especially if it is during their time at work. Find out more about coping with fatigue.

If you are unable to work for a short or long term period, you may wish to explore disability benefits that you are entitled to receive – for more information, visit the Money Advice Service.

For more information on prostate cancer and work, visit the Prostate Cancer UK website.

Did you know... "Some men are more at risk of developing prostate cancer than others."

Support for Prostate Cancer

Remember, you are not alone!

We hope this guide to prostate cancer has helped you understand more about the condition, whether you have the condition yourself or know someone who has it. Prostate cancer is common amongst men, and men with prostate cancer symptoms may not seek a diagnosis until the symptoms become severe, which makes it really important to raise awareness and encourage men to see their GP with any symptoms.

Introduction

There is a wealth of advice and information available online, through various charitable organisations and the NHS. If you have prostate cancer, you may find it useful to talk to other people affected by the condition, to share your experiences and hear about what others are going through. Here, we point you to prostate cancer support groups and other online resources that offer further information and advice.

Communities

Prostate Cancer UK Forum – an online community for people to share their experiences of living with prostate cancer

Prostate Cancer Support Group on Facebook – a social media support group for anyone who has prostate cancer, or is supporting someone who has prostate cancer, to share their journey

Resources

Cancer Research UK – the leading cancer charity, providing information and advice about all types of cancer, treatments and research projects, as well as a nurse-run helpline

Macmillan Cancer Support

Marie Curie – a UK charity supporting people with terminal illness and end of life care, providing lots of practical advice and tips on preparing for end of life, living with a terminal illness and a free support helpline

NHS – source of official medical advice and information about prostate cancer, symptoms, treatments and living with the condition

Prostate Cancer UK – the leading UK charity supporting people with prostate cancer and their families, with information about all aspects of the disease and living with it, as well as advice for health professionals and a helpline run by specialist nurses

Prostate Cancer Research Centre – offers online information about prostate cancer and funds research to find cures and increase survival

The Movember Foundation – a charitable organisation set up to help prevent men dying early and raise awareness of men’s health issues such as prostate cancer, testicular cancer and suicide, providing online advice about these conditions and men’s health in general

World Cancer Research Fund – information about cancer, living with the disease, and ways to live a healthy lifestyle to help prevent cancer

Did you know... "There are many treatments for prostate cancer including radiotherapy, hormone therapy and surgery."

Glossary

Unsure what something means? Checkout our Glossary section below.

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology.

Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of prostate cancer as straightforward as possible.

Introduction

Acinar adenocarcinoma

– cancerous cells in the lining of a gland such as the prostate

Benign

– a benign tumour is non-malignant/non-cancerous and will not spread to other areas of the body, but may still cause serious health problems depending on where in the body it is located and if it is interfering with any organs, nerves, blood supply, etc

Biopsy

– a medical procedure that examines human tissue to determine if it is cancerous

Brachytherapy

– a form of radiotherapy when radiation is delivered directly into a tumour

Cancer

– a disease of the body caused by abnormal cell growth which has potential to grow and spread around the body, interfering with normal bodily function and causing ill health and possibly early death

Cells

– the building blocks of the body, involved in all biological aspects of life and keeping the human body functional

Chemotherapy

– medication treatment for cancer which aims to stop cancer cells developing and spreading, which is widely used but has many side effects such as fatigue, hair loss and sickness

Ejaculation

– the process of semen (and sperm) release via the penis during sexual activity, which is essential for reproduction

Enlarged prostate

– a condition that is not cancerous but which results in a similarly enlarged prostate gland and similar symptoms to prostate cancer such as difficulty urinating

Genes

– part of human DNA which determines all our physical development, and is inherited from our biological parents

Hormone therapy

– as a treatment for prostate cancer, hormone therapy aims to reduce the risk of the cancer spreading and is often used with other treatments. It involves administering medication via injection, implant or tablet, to stop the body making the male hormone testosterone, or blocking the effects testosterone has on the body

Libido

– sex drive/desire for sex

Lymph nodes

– part of the body’s immune system, which helps fight infections, and which cancer can spread to, causing secondary cancer separate from the original, primary source

MRI scan

– a whole body scan that uses magnets to examine the internal body in great detail

Prostate specific antigen

– a protein produced in the cells of the prostate gland, which can be tested to suggest if there is a problem with the prostate

Rectal exam

– a physical examination involving a medical professional inserting their finger into the rectum (bottom) to check for problems with the prostate gland, as well as other issues related to that area of the body such as incontinence, pain/bleeding in the bottom or constipation issues

Steroids

– a type of medication that comes in many forms, which is used to treat a number of health conditions, especially those involving inflammation, and which is often used as a cancer treatment to help make chemotherapy more effective, or help control cancer symptoms

Testicles

– part of the male reproductive system which produce sperm and testosterone

Testosterone

– a male sex hormone produced by the testicles which supports sexual desire and helps regulate production of sperm, amongst other functions

Tumours

– abnormal cell growth in the body which can be cancerous or benign, or pre-cancerous with potential to spread

Urethra

– a tube that removes urine from the bladder out of the body – in men, it travels through the penis and also carries semen


Last updated on 09/05/2019

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