Understanding prostate health

What the prostate is

The prostate is a small gland found only in people assigned male at birth. It sits below the bladder and surrounds the tube that carries urine out of the body. It helps make semen. It often becomes larger with age, which can affect the flow of urine without being cancer.

• Benign prostate enlargement is a common, non-cancerous enlargement of the gland.
• Prostatitis means inflammation or infection of the prostate and can also cause symptoms or raise PSA.
• Only proper medical assessment can distinguish between these conditions.

Common symptoms and signs

Early prostate cancer often causes no symptoms. When urinary symptoms are present, they are more commonly caused by a non-cancerous enlarged prostate. They still need checking, especially if they are new or getting worse.

• Needing to pass urine more often, particularly at night.
• Difficulty starting, a weak flow, or a feeling that the bladder has not emptied.
• Urgency, discomfort passing urine, or blood in urine or semen.
• Persistent pain in the back, hips or pelvis, unexplained weight loss, or unusual tiredness should also be discussed with a GP.

PSA testing, explained simply

PSA is a protein made by the prostate. A PSA blood test measures the amount in your blood. A raised result can be caused by cancer, but also by an enlarged prostate, inflammation, infection and some everyday factors. A normal result does not rule cancer out completely. The test is a starting point for a decision with your GP, not a diagnosis on its own.

What may happen after a GP appointment

The pathway varies from person to person. Your GP may ask about symptoms and family history, arrange a urine test and PSA test, and offer a digital rectal examination (DRE). A DRE is not the only test, and you can discuss any concerns about it.

1. 1. Referral and MRI. If further investigation is needed, current NICE guidance recommends a multiparametric MRI scan first for suspected localised prostate cancer.
2. 2. Biopsy, if needed. If the MRI shows an area of concern, a biopsy may be recommended. Small samples are examined to confirm whether cancer is present and, if so, how active it appears to be.
3. 3. Stage and grade. If cancer is found, the team uses scans, biopsy results and PSA to describe how far it has grown and how quickly it may behave. This helps guide the next conversation.

If prostate cancer is found

There is no single best treatment for everyone. Some cancers are slow-growing and can be monitored closely through active surveillance. Others may need treatment. Your team will discuss the likely benefits, possible side effects and what matters most to you.

• Active surveillance: regular PSA tests, scans and sometimes biopsies, with treatment only if the cancer shows signs of change.
• Local treatments: surgery to remove the prostate or radiotherapy are common options for cancer that has not spread.
• Systemic treatments: hormone therapy, chemotherapy and other medicines may be used when cancer is higher risk, has spread or has returned.

Ask about continence, erections, bowel changes, fatigue and emotional support before choosing treatment. A specialist nurse can be a valuable point of contact.

Trusted next steps

Use this page to prepare for a conversation, then get personal advice from a qualified clinician. These UK resources explain the details in more depth.