Prostate Cancer

Prostate cancer is cancer that starts in the prostate gland, a small gland below the bladder that helps produce semen. Prostate cancer often grows slowly and may not cause symptoms for some time. When symptoms do occur, they can overlap with more common (non-cancer) prostate conditions, such as an enlarged prostate or prostatitis.

Early assessment is important if you have persistent urinary symptoms, blood in urine, or new bone pain. If prostate cancer is found early, there are often more treatment options available.

At the Royal Buckinghamshire Hospital, we offer consultant-led assessment and investigation, and we can coordinate onward specialist pathways for diagnosis, staging and treatment.

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Symptoms of prostate cancer

Many people have no symptoms in the early stages. When symptoms occur, they may include:

Urinary symptoms

• Needing to pee more often, especially at night
• Sudden urgency to pee
• Difficulty starting to pee, weak flow, or stopping/starting
• Feeling that the bladder does not empty fully
• Pain or burning when peeing (can also be due to infection)

Blood and sexual symptoms

• Blood in urine
• Blood in semen (less common)
• Problems getting or keeping an erection (can have many causes)

Symptoms of advanced disease (needs prompt assessment)

If cancer spreads outside the prostate, symptoms can include:

• Persistent back, hip or pelvic pain
• Unexplained weight loss or fatigue

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Risk factors

Your risk is higher if you:

• Are older (risk rises with age)
• Have a close relative with prostate cancer
• Are of Black African or Black Caribbean heritage (higher risk)
• Have certain inherited gene changes (e.g., BRCA variants)

Even without risk factors, prostate cancer can occur—so symptoms should be assessed on their own merits.

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Diagnosis at Royal Buckinghamshire Hospital

Assessment usually includes a combination of history, examination and tests.

Initial assessment

• Review of symptoms, family history and risk factors
• Examination as appropriate (which may include a rectal examination

PSA blood test

A PSA test measures prostate-specific antigen in the blood. A raised PSA can be caused by several prostate conditions and does not confirm cancer on its own—it is used as a helpful signal to guide further tests.

Further tests (if needed)

Depending on findings, you may be referred for:

• MRI scan of the prostate to help identify areas of concern
• Prostate biopsy (tissue samples) to confirm whether cancer is present and how aggressive it appears (Gleason/grade group)
• Additional tests to check whether cancer has spread (e.g., CT, MRI, PET, bone scan)

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Treatment options

Treatment depends on the cancer’s stage/grade, your symptoms, overall health, and your preferences. Options can include:

Monitoring approaches (selected early cancers)

• Active surveillance: close monitoring with PSA tests, scans and sometimes repeat biopsies, with treatment offered if there are signs the cancer is growing.
• Watchful waiting: typically a less intensive monitoring approach aimed at controlling symptoms if they arise (often used when cure-focused treatment isn’t the best option).

Curative treatments (aimed at curing cancer)

• Surgery to remove the prostate (prostatectomy)
• Radiotherapy (external beam radiotherapy and/or brachytherapy in selected cases)

Treatments for locally advanced or advanced prostate cancer

• Hormone therapy (to reduce testosterone, which prostate cancer cells often rely on
• Radiotherapy combined with hormone therapy (common in certain stages)
• Additional systemic treatments may be considered in specialist pathways (depending on staging and tumour biology)

Your consultant will talk you through benefits, risks, side effects, recovery time and likely outcomes for each approach.

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When to seek urgent help

Seek urgent same-day medical advice if you have:

• Blood in urine that is heavy, persistent, or with clots
• Inability to pass urine, severe lower abdominal pain, or acute urinary retention
• Severe back pain with leg weakness, numbness, or bladder/bowel changes
• Unexplained severe bone pain or sudden difficulty walking
• Feeling very unwell with fever and urinary symptoms (possible infection)

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If you have urinary symptoms that are persistent, blood in urine, or you’re concerned about prostate cancer risk (including family history), contact Royal Buckinghamshire Hospital for assessment and advice. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.