Prostate cancer is the most common cancer in men in the UK, with over 60,000 new cases diagnosed each year. The cancer starts in the cells of the prostate, a small gland located just below the bladder.
Public awareness of prostate cancer has increased in recent years — partly because of prominent people such as Sir Chris Hoy and the former prime minister David Cameron sharing their personal stories about their diagnoses in the media.
Who is most at risk?
Prostate cancer is most common in men over 50, and the risk increases with age. Black men and those with a family history of prostate cancer, particularly in a father or brother, also have a raised risk. Some prostate cancers grow slowly and may never cause problems. Others grow more quickly and need treatment.
Stages of prostate cancer
Early (localised) prostate cancer — where the cancer is only present inside the prostate gland. Locally advanced prostate cancer — where the cancer has spread beyond the prostate gland into nearby tissue organs. Advanced prostate cancer (or metastatic prostate cancer) — where the cancer has spread to other parts of the body, such as the bones.
Lord Cameron revealed in November 2025 that he was treated for prostate cancer.
Symptoms
In its early stages, prostate cancer will often have no symptoms. When the cancer is large enough to press on the tube that carries urine from the bladder (urethra), men may develop symptoms such as having to rush to the toilet to pass urine, passing urine more often or getting up at night to pass urine, difficulty starting urination or a weak or interrupted flow.
Other symptoms can include feeling that the bladder has not emptied fully, and blood in the urine or semen. Cancer that has spread may cause persistent back or bone pain or unexplained weight loss.
The prostate gland can also become enlarged due to a non-cancerous condition called benign prostatic hyperplasia, and many men with urinary symptoms won’t turn out to have cancer after they have been investigated. However, you should see your GP if you have new or persistent urinary symptoms or blood in your urine.
How is prostate cancer diagnosed?
If you are concerned about prostate cancer, your GP will ask about your symptoms and family history. They may carry out a rectal examination to examine your prostate and discuss a prostate-specific antigen (PSA) blood test.
PSA is a protein produced by the prostate. A raised level may be a sign of cancer, but it can also be caused by a non-cancerous enlargement or an infection. Also, bear in mind that some men with a normal PSA result may turn out to have prostate cancer.
Depending on the findings, you may be referred to a urologist — a specialist in the urinary system. Further assessment often includes an MRI scan. You may also need a biopsy, where small samples are taken from the prostate to check for cancer.
After assessment, many men will turn out not to have prostate cancer. Others may have a localised cancer that does not need immediate treatment.
Treatment options
There is a range of treatments for prostate cancer, which your specialist will discuss with you. The options will vary based on how far the cancer has spread and how quickly it is likely to grow, along with your age, medical history and personal preferences.
For some localised cancers, active surveillance may be recommended. This involves regular tests and sometimes further scans or biopsies, with treatment aimed at curing the cancer if there are signs it is progressing. Watchful waiting is a different approach, usually involving fewer tests. Treatment may be offered if symptoms develop, with the aim of controlling the cancer and relieving symptoms rather than curing it. Other options include surgery, radiotherapy, hormone therapy and chemotherapy.
Treatment can cause side effects, including problems with erections. Your specialist will help you consider the likely benefits and possible harms. Even when prostate cancer cannot be cured, treatment may help control its growth and relieve symptoms.
Screening for prostate cancer
Because early prostate cancer often has no symptoms, there has been extensive discussion about whether the NHS should have a screening programme, as it does for bowel and breast cancer.
PSA testing may help find cancer earlier. However, it can also lead to further investigations and the identification of cancers that would never have caused problems. Some men may then receive treatment they did not need.
The UK National Screening Committee does not currently recommend screening for all men. It does recommend PSA testing every two years for men aged 45 to 61 who have a confirmed BRCA2 gene change that increases cancer risk and a family history of breast, ovarian, pancreatic or prostate cancer. This targeted programme is expected to begin in England in 2027.
If you have symptoms, you should seek medical advice regardless of whether you qualify for screening. You can also discuss the pros and cons of PSA testing with your doctor.
Dr Azeem has been a GP for over 30 years and is also a professor of primary care and public health at Imperial College London’s School of Public Health.
