Prostate cancer is one of the most common cancers in men worldwide, and the International Agency for Research on Cancer reports that cases are increasing in most countries. Many prostate cancers grow slowly. What matters most is finding it early in men at risk, then choosing treatment that matches its risk level, because not every prostate cancer needs immediate treatment.
Medically reviewed by Prof. Dr. Samir Ahmed Al-Samarrai, consultant urologist. Last reviewed:
Risk factors
- Age: more common after 50.
- Family history: a father or brother with prostate cancer, especially at a young age.
- African descent.
- Inherited mutations such as BRCA2.
Symptoms
Early prostate cancer usually causes no symptoms. Urinary symptoms such as a weak stream or getting up at night are usually due to benign enlargement. Advanced disease can cause blood in the urine or semen, bone pain or unexplained weight loss.
Screening is a shared decision
European guidelines recommend offering PSA testing to men at risk after explaining its benefits and harms, such as finding slow tumours that would never need treatment:
- From age 50.
- From 45 with a family history or African descent.
- From 40 for BRCA2 carriers.
Read our PSA test guide and prostate cancer screening in Dubai.
Diagnosis
- PSA and digital rectal examination, repeating the test when PSA is slightly raised.
- Multiparametric MRI before biopsy, scored with PI-RADS, which can spare some men a biopsy.
- Prostate biopsy when needed; European guidelines prefer the transperineal route because the infection risk is lower.
- Gleason score and ISUP grade group in the biopsy report to judge how aggressive the tumour is.
- Staging scans such as CT, bone scan or PSMA PET for intermediate and high-risk disease.
Treatment options
Treatment depends on the tumour’s risk and stage, and on the patient’s age, health and preferences:
- Active surveillance for low-risk tumours: regular PSA, MRI and biopsies, with treatment if things change.
- Radical prostatectomy by open, laparoscopic or robotic surgery.
- Radiotherapy, with hormone therapy in some cases.
- Hormone therapy and newer treatments for advanced or spread disease, together with an oncologist.
- Watchful waiting for older men or those with other illnesses when immediate treatment is unlikely to help them.
Each treatment has possible side effects, such as urinary leakage and erectile dysfunction after surgery or radiotherapy, which the doctor discusses before any decision. Read prostate cancer treatment in Dubai.
In-depth series by Prof. Al-Samarrai
- Prostate Cancer, Part 1: Epidemiology and Aetiology
- Part 2: Classification
- Part 3: Diagnostic Evaluation
- Part 5: Deferred Treatment, Surgery and Radiotherapy
- Part 6: Hormonal Therapy
- Part 7: Salvage Therapy
- Amelioration of survival outcome after early prostatectomy
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Frequently asked questions
What are the symptoms of prostate cancer?
Early prostate cancer usually causes no symptoms, which is why it is found by testing. Advanced disease can cause bone pain or weight loss, while urinary symptoms are usually due to benign enlargement.
When should I start prostate cancer screening?
European guidelines advise men to discuss testing with their doctor from age 50, from 45 with a family history or African descent, and from 40 if they carry a BRCA2 mutation, after the benefits and risks are explained.
Does a high PSA mean cancer?
No. PSA can rise with enlargement, inflammation, after ejaculation or cycling. The doctor decides the next step, usually a repeat test and then MRI before any biopsy.
Does every prostate cancer need surgery?
No. Some low-risk tumours are followed with active surveillance without immediate treatment; others are treated with surgery, radiotherapy or hormone therapy depending on stage, age and general health.
Can prostate cancer be cured?
When it is found while still confined to the prostate, the chances of controlling it with suitable treatment are good. Spread disease is treated to control it, often for long periods, and the doctor discusses the outlook for each case.
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Book a consultation
Prof. Al-Samarrai and Dr. Amer Mousa assess prostate cancer screening, test results and biopsies at Prof. Al-Samarrai Medical Center, Dubai Healthcare City, and discuss the options that suit your case. Medical consultations are confidential.
This information is for health education and does not replace a medical examination. See our medical content policy.