What is Prostate Cancer?
Prostate cancer is one of the most common cancers affecting men. Understanding what it is, how it develops, and how it is detected can help reduce uncertainty and support informed decisions.
What is prostate cancer and how does it develop?
Prostate cancer begins in the prostate gland — a small gland found only in men, located just below the bladder. The prostate helps produce fluid that forms part of semen.
Cancer develops when cells in the prostate begin to grow in an uncontrolled way. Normally, cells grow, divide and die in a balanced cycle. When this process becomes disrupted, some cells multiply more than they should. Over time, this build-up of abnormal cells can form a tumour.
Doctors assess how prostate cancer behaves by looking at several factors, including how the cells appear under a microscope (often referred to as the “grade”), how far the cancer has spread (the “stage”), and PSA levels over time.
Slow-growing prostate cancer
Many prostate cancers are slow-growing. In these cases, doctors may recommend careful monitoring — sometimes called active surveillance — rather than immediate treatment. This approach allows men to avoid unnecessary side effects while staying closely monitored.
More aggressive prostate cancer
Some prostate cancers grow more quickly or have a higher risk of spreading. In these cases, treatment options such as surgery, radiotherapy, or hormone therapy may be discussed. Treatment decisions are always individual and based on clinical findings.
If you have recently been diagnosed, it is important to remember that prostate cancer is highly treatable, especially when detected early. Your healthcare team will guide you through the next steps and explain your options clearly.
Symptoms of prostate cancer
In its early stages, prostate cancer often causes no noticeable symptoms. Many men are diagnosed through a PSA blood test before they experience any changes.
When symptoms do occur, they are usually related to changes in urinary function. These symptoms can also be caused by non-cancerous conditions such as benign prostate enlargement.
Urinary symptoms
- Difficulty starting urination
- Weak or interrupted urine flow
- Needing to urinate more frequently, especially at night
- A feeling that the bladder is not fully empty
Less common symptoms
- Blood in the urine or semen
- Persistent pelvic discomfort
- Unexplained lower back pain (in advanced cases)
If you notice persistent changes or symptoms that concern you, speak to a healthcare professional. Most urinary symptoms are caused by benign conditions, but assessment ensures appropriate care and reassurance.
Risk factors & causes of prostate cancer
In most cases, there is no single identifiable cause of prostate cancer. It develops due to changes in prostate cells over time. However, certain factors can increase a man's likelihood of developing the disease.
Age
Age is the strongest risk factor. Prostate cancer is uncommon in younger men and becomes more common after the age of 50.
Family history
Having a father, brother, or close relative diagnosed with prostate cancer increases risk. Genetic factors may play a role in some families.
Ethnicity
Studies show that prostate cancer risk can vary between populations. Some ethnic groups may have a higher risk or develop more aggressive forms.
Lifestyle factors such as diet and physical activity are being studied, but there is currently no proven way to completely prevent prostate cancer. Regular monitoring and informed testing remain important for early detection.
How prostate cancer is diagnosed
Diagnosis usually happens in stages. If you have recently been told you may have prostate cancer, it is completely normal to feel uncertain. Each step in the process helps your medical team build a clearer and more accurate understanding before any treatment decisions are made.
1. PSA blood test
A PSA test measures prostate-specific antigen in the blood. A raised PSA does not automatically mean cancer. Doctors interpret the result alongside your age, medical history and symptoms.
PSA trends over time are often more important than a single result. You can learn more here: PSA testing in Gibraltar.
2. Clinical assessment
Your clinician may ask about urinary symptoms and general health. In some cases, a digital rectal examination (DRE) may be performed to assess the prostate. This is a short and routine clinical step.
3. MRI scan
An MRI scan provides detailed images of the prostate. It helps identify areas that may need closer examination and guides decisions about whether a biopsy is required.
4. Biopsy (if necessary)
A biopsy involves taking small tissue samples from the prostate. These samples are examined under a microscope to confirm whether cancer is present and to determine how the cells behave.
Understanding your results
If cancer is confirmed, your team will explain:
- Grade – how abnormal the cells look.
- Stage – whether the cancer is confined to the prostate.
- Risk level – likelihood of growth or spread.
Many prostate cancers are slow-growing and may not require immediate treatment. Decisions are personalised and based on careful evaluation.
Is prostate cancer always serious?
Hearing the word “cancer” can feel overwhelming. However, prostate cancer behaves differently from many other types of cancer. In many cases, it grows slowly and may never cause serious harm.
Slow-growing prostate cancer
A large proportion of prostate cancers are slow-growing. In these cases, doctors may recommend active surveillance. This means regular monitoring through PSA tests, scans and clinical reviews without immediate treatment. The goal is to avoid unnecessary side effects while keeping the cancer under control.
More aggressive prostate cancer
Some prostate cancers grow more quickly or have features that increase the risk of spreading. When this happens, treatment options such as surgery, radiotherapy or hormone therapy may be recommended. Treatment decisions are tailored to the individual.
The seriousness of prostate cancer depends on factors such as grade, stage, PSA level and overall health. Your medical team will explain what your specific diagnosis means and guide you through the options available.
Frequently Asked Questions about Prostate Cancer
Take the next step with confidence
Whether you are considering a PSA test, waiting for results, or have recently been diagnosed, you are not alone. Early detection, informed decisions and the right support can make a meaningful difference.