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Reviewed by

Dr. Vishnu Prasad

Consultant - Urology, Uro-oncology, and Robotic Surgery

Manipal Hospitals, Malleshwaram

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Prostate Cancer: Symptoms, Risks, Diagnosis, and Modern Treatment

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Have you noticed small urinary changes and are wondering if they could mean something more? You notice a change that feels small at first. Maybe you wake more at night to pass urine. Maybe your stream is weaker. It is tempting to shrug these things off as ageing. Many men live long, healthy lives after a prostate cancer diagnosis when the disease is found early. Knowing what to watch for, who is at higher risk, and how diagnosis and treatments work gives you choices and time to plan. This article explains what the prostate does, how cancer can start there, common prostate cancer symptoms, how doctors make a diagnosis, the main prostate cancer treatment options, including modern robotic surgery, and sensible steps you can take to protect your health.

What Is Prostate Cancer?

Prostate cancer begins when normal prostate cells change and grow uncontrollably. The most common type is adenocarcinoma, which starts in the gland cells that make prostate fluid. Tumours range from slow-growing, which may never cause symptoms in a man’s lifetime, to aggressive types that spread more quickly. Understanding whether a cancer is likely to stay local or become aggressive guides the choice of treatment.

Who Is at Risk?

Risk rises with age and certain personal and family factors. You should be aware of these because they affect when you and your doctor might begin screening.

Age: Risk increases after age 50 and climbs substantially after age 65.
Family history: A father or brother with prostate cancer raises your risk.
Genetic mutations: BRCA1 and BRCA2 variants and other inherited mutations increase risk and may call for earlier screening.
Ethnicity: Certain populations have a higher incidence and worse outcomes.
Lifestyle: Obesity and diets high in red or processed meat are associated with a higher risk.

Prostate Cancer: Symptoms, Risks, Diagnosis, and Modern Treatment

Prostate Cancer Symptoms to Watch For

Many early cancers cause no symptoms, which is why screening matters. When symptoms do appear, they often involve urination or, later, pain and weight loss.

Frequent urination, especially at night
Weak urine stream or difficulty starting and stopping
Burning or discomfort while urinating
Blood in urine or semen
New lower back, hip, or pelvic pain that does not resolve
Unintended weight loss or fatigue

If you notice persistent urinary changes or any red flags above, tell your doctor promptly. Symptoms alone do not prove cancer, but they do need evaluation.

How Is Prostate Cancer Diagnosed?

Doctors use a stepwise approach that combines blood tests, physical exam, imaging, and, when needed, biopsy to confirm the diagnosis and stage the disease.

PSA blood test: Measures prostate-specific antigen in the blood. PSA is not cancer-specific but helps detect changes that may justify further testing. Interpretation varies with age and other conditions.
Digital rectal exam (DRE): A brief in-office check where the clinician feels the prostate for lumps or asymmetry.
Multiparametric MRI of the prostate: Advanced imaging that helps locate suspicious areas and can reduce unnecessary biopsies.
Prostate biopsy: The gold standard for diagnosis. Tissue samples are examined to determine cancer type and grade, which tells how aggressive the tumour is.
Staging scans: In higher-risk cases, PET/CT or bone scans check for spread beyond the prostate.

What Do PSA Results Mean?

PSA is one tool, not a definitive test. Values are interpreted alongside age, prostate size, medications, and trends over time. A single PSA above a commonly used threshold may prompt repeat testing, MRI, or biopsy. Guidelines suggest discussing screening with your clinician around age 45 to 5,0, depending on risk, and earlier if you have a strong family history or known mutations.

Treatment Options at a Glance

Treatment depends on the cancer stage, your age, general health, and your preferences. Many men with low-risk disease choose active surveillance. Others need curative therapy. Modern treatments are personalised to balance cancer control with quality of life.

Active surveillance. For small, slow-growing tumours. Regular PSA checks, MRI, and repeat biopsy monitor the cancer, so treatment begins only if it shows signs of progression. This avoids overtreatment in many men.
Surgery, radical prostatectomy. Removal of the prostate with pelvic lymph node assessment. Robotic-assisted prostatectomy is widely used and offers precise removal with less blood loss and faster recovery compared with older open approaches.
Radiation therapy. External beam radiation or brachytherapy (radioactive seeds placed in the prostate) can cure many localised cancers. Radiation is an alternative to surgery for many men.
Hormone therapy (androgen deprivation). Lowers testosterone to slow cancer growth. Often used with radiation or for advanced disease.
Chemotherapy, targeted therapy and immunotherapy. Used for advanced or metastatic prostate cancer when other measures are insufficient. Newer targeted drugs and immunotherapies offer options for specific molecular subtypes.

Robotic Surgery for Prostate Cancer

Robotic-assisted prostatectomy uses robotic instruments controlled by the surgeon to perform precise dissection in a confined pelvic space.

The typical benefits include smaller incisions, less blood loss, shorter hospital stays, and quicker return to normal activity while preserving nerve and continence structures when possible. Discuss surgical goals and expected functional outcomes with your surgeon.

Living With Prostate Cancer

Treatment can cause side effects such as urinary leakage and erectile dysfunction. You and your care team can manage these actively.

Pelvic floor physiotherapy and bladder training reduce incontinence.
Erectile function may recover over months; medications, vacuum devices or implants are options when needed.
Emotional support, counselling, and peer support groups help with anxiety and life adjustments.
Lifestyle changes, a healthy diet, physical activity, and weight control support recovery and general health.

Prevention and Early Detection Tips

You cannot eliminate all risk, but sensible measures and timely screening increase the chance of catching disease early.

Maintain a healthy weight and stay physically active.
Prefer a balanced diet with fruits, vegetables, nuts, and seeds, and limit processed and red meat.
If you have a family history of prostate cancer or genetic mutations such as BRCA1/BRCA2, discuss starting screening earlier.
Talk with your clinician about prostate cancer screening options and the pros and cons of PSA testing for you. Many organisations recommend shared decision-making for men aged roughly 45 to 55, depending on risk.

Symptoms, Tests, and Typical Next Steps

Finding	Possible meaning	Usual next steps
New urinary frequency or weak stream	Many causes, including BPH or infection, and possible prostate pathology	Urine tests, PSA, DRE; consider referral if persistent
Elevated PSA on screening	May reflect cancer, benign enlargement or prostatitis	Repeat PSA, MRI, targeted biopsy if indicated
Suspicious DRE or MRI lesion	Higher likelihood of clinically significant cancer	Prostate biopsy and pathology grading
High-grade biopsy result	Likely to need treatment	Multidisciplinary discussion for surgery, radiation or systemic therapy

Conclusion

Prostate cancer is common, especially as men age, but early detection dramatically improves outcomes. Knowing the prostate cancer symptoms to watch for, understanding risk factors, and having an informed discussion about prostate cancer screening puts you in control. If you have urinary changes, a family history of prostate cancer, or a known genetic risk, book a conversation with an experienced urologist at Manipal Hospital Malleshwaram. Modern options from active surveillance to robotic prostate surgery mean care is increasingly precise and tailored to your life and goals.