Bladder, kidney and prostate cancers

Prostate cancers are very common, especially in older men. Most of these cancers do not cause problems and do not need treatment. 

If you are a male and over 50, or over 40 with a family history of prostate cancer, you should discuss the risks and benefits of prostate checks with your doctor. 

Early detection

A prostate-specific antigen (PSA) test can diagnose men with no symptoms of prostate cancer, but it has limitations and needs to be used carefully. 

If the PSA is abnormal you may need to have an MRI scan, but the only way to diagnose prostate cancer is with a prostate biopsy. This will be decided by a urologist.

Symptoms

Most men will not have symptoms until they have advanced prostate cancer. You should go to your doctor if you notice any of the following:

• needing to empty your bladder a lot, especially at night
• your urinary stream is weak
• a feeling that you haven't emptied your bladder.

These symptoms can indicate prostate disease but do not necessarily mean you have prostate cancer. 

Your doctor will do some tests such as a rectal exam or prostate specific blood test, and may refer to you to a surgeon for more tests and diagnosis. 

Initial diagnosis

Prostate cancer can only be diagnosed with a biopsy. 

If you live in the Top End

The surgeon will discuss your case with other specialists at the Royal Darwin Hospital.

If you live in Central Australia

The local surgeon will refer you to the visiting urologist if appropriate or a medical oncologist for drug therapy.

Treatment

Most prostate cancers are low risk and do not require treatment. Many can be managed with observation. 

If you do need treatment, you may undergo one or more of the following:

• surgery
• radiotherapy
• another drug therapy.

Surgery

There are three types of surgery you may have:

• removal of your prostate 
• partial removal of the prostate via the urethra
• removal of your testicles.

Radiotherapy

Your surgeon can refer you to a radiation oncologist to discuss radiotherapy options. 

You can have either: 

• radiation as the initial therapy without surgery with the intent to cure the cancer - usually for six weeks
• or radiation as well as surgery to target any remaining cancer cells - usually for 12 weeks.

Your radiotherapy will be at the Alan Walker Cancer Care Centre.

Drug therapy

Hormone therapy may be used if you are at high risk of recurrence. Length of treatment is usually five years.

Bisphosphonate therapy may be used if your cancer has spread to your bones. Treatment is ongoing. 

Chemotherapy may be used in some cases to target cancer cells that have spread. Length of treatment is about three to six months. 

Resources on prostate cancer

For more information, read cancer journeys - prostate cancer or go to the Prostate Cancer Foundation of Australia website.

For more information on investigations, diagnosis and treatment of prostate cancer, go to the outline of the cancer pathway for prostate cancer on the Cancer Council website.