In its early stages, prostate cancer often presents no symptoms. When symptoms do appear, they can include:
Urinary Issues:
Difficulty initiating urination
A weak, slow, or interrupted urine stream
A sensation of incomplete bladder emptying
Increased frequency of urination, especially at night (nocturia)
Pain or a burning sensation during urination (dysuria)
Other Symptoms:
Blood in the urine (hematuria) or semen (hematospermia)
Erectile dysfunction
Pain during ejaculation
Persistent pain in the back, hips, or pelvis (often indicates advanced disease)
Note: These symptoms can also be caused by benign conditions like Benign Prostatic Hyperplasia (BPH). A formal diagnosis from a urologist is essential.
While adenocarcinoma accounts for over 95% of cases, other rare types exist:
Small cell carcinoma: A rare, aggressive form of neuroendocrine cancer.
Ductal adenocarcinoma: Begins in the ducts of the prostate gland and is typically more aggressive than common adenocarcinoma.
Transitional cell (urothelial) carcinoma: Usually starts in the bladder or urethra and spreads to the prostate.
Squamous cell carcinoma: A rare type that develops from flat cells and tends to be aggressive.
Sarcoma: Originates in the muscle or connective tissue of the prostate.
A definitive diagnosis involves a multi-step process to confirm the presence of cancer and determine its characteristics.
PSA Blood Test: Measures the level of Prostate-Specific Antigen (PSA) in the blood. Elevated levels can indicate cancer but may also be caused by BPH or prostatitis. PSA velocity (the rate of increase over time) is also a key indicator.
Digital Rectal Examination (DRE): A physical examination where a physician feels the prostate for hard, lumpy, or abnormal areas.
Prostate MRI: A Multiparametric MRI (mp-MRI) provides detailed images of the prostate, identifying suspicious areas and helping to guide a biopsy. It is a critical tool for risk assessment.
Prostate Biopsy: The definitive diagnostic test. Small tissue samples are taken from the prostate and examined by a pathologist to confirm cancer and determine its Gleason score (a measure of aggressiveness, now often reported as a Grade Group from 1 to 5).
Staging describes the extent of the cancer’s spread. This, combined with the Grade Group and PSA level, determines the risk category, which guides treatment decisions.
Localised Prostate Cancer: Cancer is confined entirely within the prostate gland.
Locally Advanced Prostate Cancer: Cancer has spread just outside the prostate capsule, possibly to the seminal vesicles.
Metastatic Prostate Cancer: Cancer has spread to distant lymph nodes, bones, or other organs.
The choice of treatment depends on the cancer’s risk group, stage, the patient’s age, overall health, and personal priorities.
| Treatment Modality | Description | Best Suited For | Key Considerations / Potential Side Effects |
| Active Surveillance | Close monitoring of the cancer with regular PSA tests, DREs, MRI scans, and periodic biopsies. Treatment is initiated only if the cancer shows signs of progressing. | Very low-risk and low-risk localised prostate cancer in select patients. | Avoids treatment side effects. Requires strict adherence to follow-up schedule. Carries a small risk of missing the window for curative treatment. |
| Radical Prostatectomy | Surgical removal of the entire prostate gland and seminal vesicles. Can be performed via open, laparoscopic, or robotic-assisted techniques. | Localised and some locally advanced prostate cancers with curative intent. | Robotic-assisted surgery offers enhanced precision and potentially faster recovery. Risks include urinary incontinence and erectile dysfunction. |
| Radiation Therapy | Uses high-energy rays (like X-rays) to kill cancer cells. Can be delivered externally (EBRT) or internally (brachytherapy). | Localised or locally advanced disease. Can be an alternative to surgery. | Can be combined with hormone therapy. Side effects may include urinary irritation, bowel problems, and erectile dysfunction, which can develop over time. |
| Hormone Therapy (ADT) | Androgen Deprivation Therapy (ADT) lowers the level of male hormones (androgens) that fuel prostate cancer growth. | Higher-risk, locally advanced, or metastatic disease. Often used with radiation. | Effectively controls cancer growth. Side effects include hot flashes, loss of libido, erectile dysfunction, fatigue, and potential for bone density loss over the long term. |
| Chemotherapy & Systemic Treatments | Use of drugs to destroy cancer cells throughout the body. Includes chemotherapy, targeted therapy, and immunotherapy. | Metastatic prostate cancer, or cancer that has become resistant to hormone therapy. | Used to control advanced disease and manage symptoms. Side effects vary by drug but can include fatigue, nausea, and increased risk of infection. |
Our patient care pathway is structured to ensure comprehensive, evidence-based, and personalized treatment.
Urological Team: Led by specialists with over 25 years of collective experience in urological oncology.
Diagnostic Imaging: Access to 3-Tesla Multiparametric MRI for high-resolution imaging to improve diagnostic accuracy and staging.
Surgical Technology: Specialization in minimally invasive procedures, including Robotic-Assisted Radical Prostatectomy using the Da Vinci surgical system for enhanced precision, smaller incisions, and potentially shorter recovery times.
Multidisciplinary Care: A coordinated approach between urologists, medical oncologists, and radiation oncologists to formulate a consensus-based treatment plan.
Institutional Support: Equipped with 24×7 ICU and Critical Care backup for comprehensive patient safety.
Patient Environment: Private consultation rooms and a discreet care setting are maintained.
Diagnosis Confirmation: A thorough review of all diagnostic data (PSA, biopsy with Grade Group, MRI) to confirm the diagnosis and stage.
Treatment Planning: A detailed discussion between the specialist and the patient about all suitable treatment options, including the benefits and risks of each, to facilitate shared decision-making.
Procedure & Recovery: If surgery is chosen, it is performed under general anesthesia. Post-procedure, patients typically have a temporary urinary catheter and a defined hospital recovery period.
Follow-up Care: A long-term follow-up plan is established, centered on regular PSA testing to monitor for recurrence. Additional imaging or treatment is advised if PSA levels rise.
A single elevated PSA level is not a diagnosis of cancer. A urologist evaluates the PSA value in the context of your age, prostate size, PSA trend over time, DRE, and MRI findings. A biopsy is required for a definitive diagnosis.
When diagnosed at a localised stage, prostate cancer can often be treated with curative intent via surgery or radiation. The probability of a cure is high for low-grade, organ-confined disease. For advanced or metastatic cancer, treatment focuses on long-term control of the disease.
Hospital stay is typically a few days. A urinary catheter is usually in place for 1-2 weeks. Full recovery of urinary control can take several weeks to months. Recovery of sexual function is variable and can take longer. Your surgeon will provide a personalized recovery timeline.
Consult a urologist for any persistent urinary symptoms, blood in urine or semen, or concerns about prostate cancer risk. Men with a family history of prostate cancer or those in high-risk groups should discuss a screening schedule with a doctor, typically starting around age 45-50.
