Definition Prostate cancer: A malignant tumour that originates in the prostate gland, typically in the peripheral zone. Epidemiology Most common cancer in men in the UK. Risk increases with age, especially after age 50. Higher prevalence in black men and those with a family history. Pathophysiology Most are adenocarcinomas (arising from glandular cells). Genetic mutations, hormones (especially testosterone), and inflammation are implicated in development. Clinical Presentation Often asymptomatic in early stages. Lower urinary tract symptoms (LUTS): Difficulty urinating, frequency, nocturia. Erectile dysfunction. Hematuria or haematospermia. Bone pain if metastasised. Investigations PSA testing: Elevated in prostate cancer, but also other conditions like prostatitis. Digital rectal examination (DRE): Prostate may feel hard or irregular. Prostate biopsy: Confirms diagnosis and grades the tumour. MRI and bone scans: Evaluate spread. Management Depends on staging, grade, and patient’s health and age. Active surveillance for low-risk cancers. Prostatectomy for localised cancers. Radiation therapy: External beam or brachytherapy. Androgen deprivation therapy for advanced cancers. Chemotherapy in metastatic cases. Prognosis Generally good for localised prostate cancer. Depends on Gleason score, PSA levels, and stage at diagnosis. Complications Metastasis to bones, lungs, and liver. Urinary incontinence and erectile dysfunction post-treatment.
