PSA North of England makes every effort to ensure that this website reflects up-to-date, objective and accurate facts about prostate cancer. It is our hope that these will complement your medical advice and help you to make any decisions that you may face. The information provided on this website is designed to support, not replace, the relationship that may exist between you and your doctor.

What is cancer?

Your body is made up of millions of cells which continuously renew themselves to replace old or damaged tissue. When the renewal process gets out of control and begins to invade healthy tissue it is called cancer.

Cancers are described as ‘malignant'. Other words for cancer are tumours and neoplasms. Sometimes cancer cells can break away from the original site and settle in other parts of the body causing further damage. When this happens the cancers that have spread are called ‘metastases or ‘secondaries'.

What and where is the prostate?

The prostate is a gland found only in men and is just below the bladder. When you pass urine it flows through a tube (urethra) and out through the penis. The urethra has to pass through the prostate before reaching the penis. This is why some men have problems with urinating when they have an enlarged prostate.

Can Prostate Cancer be cured?   Can anything be done?

If detected at an early stage, prostate cancer can be relatively straightforward to treat and there is a good chance that it can be dealt with once and for all. Prostate cancers are not the same in all men.   Some are fast growing and spread quickly others grow very slowly.   Several different treatment options may be open to you.

I need to talk to someone!

Our confidential helpline (0845 456 0678) is manned from 9am-5pm Monday-Friday.   We are waiting to take your calls and listen to your concerns.

What treatment is there?

There are many treatments. You should discuss the options with your Consultant/doctor.

Some of the treatments are as follows:-

Surgery (radical prostatectomy)

The whole prostate is removed with the seminal vesicles, the deferent canals (conducting the sperm), part of the bladder neck and the surrounding lymph nodes.
At the early localized stage (stages T1 & T2 see below), the radical prostatectomy is the reference treatment. This surgical intervention is complex (general anesthesia for 3 to 4 hours).

External radiotherapy

This treatment involves the use of very high energy rays directed at the prostate gland. Radiotherapy does not require anesthesia, and the treatment is usually done during a regular hospital visit: patients are usually treated five days per week in an outpatient center over a period of four to eight weeks, with each session lasting a few minutes.

Brachytherapy

During this technique 50 - 150 radioactive seeds are implanted directly into the prostate gland through the perinea using 20 - 40 needles. This is done under general anesthesia (2 to 3 hours). It is recommended that the patient avoid close contact with children and pregnant women for two months after seed implant.

Cryotherapy

In cryotherapy, the prostate is frozen solid under ultrasound guidance to control the extent of the freeze. The procedure is done under anesthesia and requires at least an overnight stay in the hospital.

HIFU : Transrectal High Intensity Focused Ultrasound

The latest treatment available in the UK (currently undergoing trials at Stockport) is a medical device (the Ablatherm) piloted by a computer, designed to treat localized prostate cancer using high intensity focused ultrasound (HIFU). The energy is delivered through an endorectal probe. The ultrasound waves travel through the rectal wall and are focused in the prostate. This focusing produces intense heat and provokes the destruction of the tissue inside the targeted zone without dammaging surronding tissues. The treatment (1 to 3 hours) can be performed under spinal anesthesia. To date the technique has been carried out in a variety of European countries, also Canada and the USA

Hormone therapy

Cancer of the prostate is dependent on the male hormone, testosterone, produced by the testicles, for its growth.   By reducing the amount of testosterone in the body it is possible to slow down or stop the growth of the cancer cells.   It can shrink down the tumour and symptoms will often disappear completely.   Treatments can take the form of an operation to remove the part of the testicles that produce testosterone orby using drugs as tablets or injections.   Hormone therapy may be given before or after surgery or radiotherapy and will not get rid of all the cancer cells if it is the only treatment given.

I have been given a choice – operation or radiotherapy – how can I decide

This will follow shortly.

In the meantime, call our helpline. W e can help by putting you in touch with others who are living with prostate cancer and who have had to make similar choices.

We can also provide leaflets/booklets etc. to help in your decision

Watchful waiting – are they saying this because of my age?

No – as some cancers are slow growing and non-aggressive the specialist may recommend watchful waiting where the cancer is monitored by regular PSA tests rather than being treated.   The advantage is that there are no side effects.   You do not have to choose this option if you are unhappy with it.  

What is PSA?           How often should I get a test?

Prostate Specific Antigen is a protein made by the prostate gland, which naturally leaks out into the bloodstream.   The PSA test measures the level of PSA in the blood.   The test is not always reliable as PSA levels also increase as men get older and due to other conditions of the prostate. Your urologist will be able to advise you how often you should have a test   - if watchful waiting – prob 6-12 months – following successful radiotherapy or surgery prob every 3-6   months for first two years and annually thereafter.  

Is brachytherapy better than radiotherapy?

Brachytherapy is a procedure involving only one treatment session, whereas radiotherapy will involve hospital visits every weekday for a number of weeks, which can cause tiredness during and after the treatment.   It is thought that Brachytherapy has a lower risk of bowel problems than radtiotherapy but higher risk of incontinence, inflammation of the urethra and cystitis.    Both treatments carry risk of impotence.   If cancer returns after brachytherapy treatment, ‘salvage surgery' has a very high risk of complication.   It is common to feel mild soreness and some bruising for a few days after the procedure.   It provides a quick return to normal life but is only suitable for early or small prostate cancers.   It involves having an anesthetic and overnight stay in hospital and is only available at certain treatments centres.    

Is the operation (Radical Prostatectomy) the best course?

Radical prostatectomy is the usual surgical option for early prostate cancer.   It involves having a general anaestetic and staying in hospital for approximately 6 days.   You will be infertile afterwards and may have temporary incontinence and impotence, which is often treatable.   The operation may be followed up with radiotherapy or hormone therapy to deal with any remaining cancer cells.

What is the best treatment?

Depending on your individual circumstances, not all treatment options may be available/suitable for you.   Discuss with your urologist.

My husband (partner) will not talk about it!

What treatment can he get?

How can I get him to get treatment and advice?

Quite common reaction particularly in the early days after diagnosis.   Allow him to talk when he is ready and be prepared to listen to his concerns.   Get support for yourself – ring helpline /book appointment with GP – arm yourself with information for when he is ready to talk.

Can I get complimentary therapy? Or are there alternative therapies?

This will be updated shortly.

In the meantime, there are many complimentary therapies available. If you contact our helpline we can provide you with information and leaflets on available organisations

We also have information on appropriate diets .

Information: What sources of information are there?

Refer to our links page.

We also have information booklets and a library service available

Carer: What can I do to help/look after the patient?

Be a good listener – support them in their decisions about their treatments

Accompany them to appointments /support group meetings.   Encourage healthy diet and exercise where appropriate.