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Frequently asked questions about prostate cancer

Questions about  

Our Specialist Nurses receive thousands of emails and phone calls each year from men, their families and friends and health professionals asking for information about prostate cancer. Below we give answers to some of the most common questions we receive, including questions about prostate screening, prostate cancer risk factors, and having a prostate mpMRI scan.

If you would like to speak to our Specialist Nurses, in confidence, call 0800 074 8383 or fill in our email contact form.

Please note responses are based on UK practice. We hope this information will add to the medical advice you have had. Please do continue to talk to your doctor if you are worried about any medical issues.

Prostate problems

  • What does 'benign prostatic enlargement' mean?  

    Benign prostatic enlargement (BPE) is the medical term for an enlarged prostate. It means an increase in the size of the prostate that isn't caused by cancer.

    You might also hear it called benign prostatic hyperplasia (BPH). Hyperplasia means an increase in the number of cells. It is this increase in cells that causes the prostate to grow.

    An enlarged prostate is very common in men over the age of about 50. It is the most common cause of urinary symptoms in men as they get older. Possible symptoms include:

    • a weak flow when you urinate (pee)
    • a feeling that your bladder hasn't emptied properly
    • difficulty starting to urinate
    • dribbling urine after you finish urinating
    • needing to urinate more often, especially at night
    • a sudden urge to urinate – you may sometimes leak before you get to the toilet.

    You may not get all these symptoms, and some men with an enlarged prostate don’t get any symptoms at all. These symptoms can be caused by other things, such as cold weather, anxiety, other health problems, lifestyle factors, and some medicine.

    Having an enlarged prostate is not the same as having cancer. Read more about the symptoms, diagnosis and treatment of an enlarged prostate.

    Last updated January 2018
    To be reviewed January 2020

Risk factors

  • Am I more likely to get prostate cancer if my father had it?  

    Inside every cell in our body is a set of instructions called genes. These are passed down (inherited) from our parents. Genes control how the body grows, works and what it looks like. If something goes wrong with one or more genes (known as a fault or mutation) it can sometimes cause cancer.

    • You are two and a half times more likely to get prostate cancer if your father or brother has had it, compared to a man who has no relatives with prostate cancer.
    • Your chance of getting prostate cancer may be even greater if your father or brother was under 60 when he was diagnosed, or if you have more than one close relative (father or brother) with prostate cancer.

    Last updated August 2019
    To be reviewed August 2021

  • Is it true that black men are more likely to get prostate cancer?  

    Black men are more likely to get prostate cancer than other men. We don’t know why, but it might be linked to genes. In the UK, about 1 in 4 black men will get prostate cancer in their lifetime.

    Read more about the risk in black men or download our leaflet, What do you know about your prostate? Information for black men.

    Last updated August 2019
    To be reviewed August 2021

  • Does masturbating increase my risk of prostate cancer?  

    There isn’t a lot of research into sexual activity or masturbation and the risk of prostate cancer, and there’s no strong evidence to show any link. As far as we’re aware, masturbation has no effect on your risk of prostate cancer.

    Read more about who is at risk.

    Last updated April 2017
    To be reviewed April 2020

  • Does drinking alcohol increase my risk of getting prostate cancer?  

    Drinking alcohol increases the risk of some types of cancer but we don't know if it has any specific effect on your risk of getting prostate cancer. We do know that drinking too much alcohol can make you put on weight. Being overweight may increase your risk of being diagnosed with advanced or aggressive prostate cancer. Being overweight also increases your risk of other health problems such as heart disease, type-2 diabetes and some other cancers.

    The UK Government recommends drinking no more than 14 units of alcohol a week. This is about six pints of average-strength beer or six small glasses (175ml) of average-strength wine. It's best to spread your drinks out over the week and have some alcohol-free days every week.

    If you're having treatment for prostate cancer, your doctor or nurse can tell you whether alcohol may affect your treatment. If you have urinary problems after treatment, try to cut down on alcohol as it can irritate the bladder and make these problems worse.

    You can find out more about alcohol units and managing how much you drink on the NHS website.

    Last updated April 2019
    To be reviewed March 2020

  • Is there anything I can do to prevent getting prostate cancer?  

    No one knows how to prevent prostate cancer, but staying a healthy weight may be important. Being overweight may increase your risk of being diagnosed with aggressive or advanced prostate cancer. Eating a healthy, balanced diet and keeping physically active can help you stay a healthy weight, and so might help to lower your risk.

    A healthy lifestyle can also improve your general well-being and reduce your risk of other health problems such as type-2 diabetes, heart disease and some other cancers.

    For more information, read our page on diet, physical activity and your risk of prostate cancer.

    Last updated April 2019

    To be reviewed March 2020

  • Does red wine help to prevent prostate cancer?  

    Red wine contains natural compounds called antioxidants that may help prevent damage to cells. Antioxidants are found in the skin and seeds of grapes as well as other fruits and vegetables. Red wine contains more antioxidants than white wine because it is made with grape skin, but white wine is not.

    Although some studies suggest that red wine may help to lower a man’s risk of prostate cancer, no studies have found red wine to be effective at reducing risk of prostate cancer. This means there isn’t enough evidence to say that red wine helps to prevent prostate cancer.

    Drinking alcohol also increases your risk of some other cancers and health problems such as high blood pressure and stroke. If you do drink alcohol, you should aim to stay within the recommended limits. Find out more on the NHS website.

    If you would like to know more about how diet may affect your risk of prostate cancer, read our pages about healthy living.

    Last updated April 2019

    To be reviewed March 2020

     

  • Do vitamin E and selenium protect against prostate cancer?  

    Vitamin E

    Some research has found that vitamin E supplements might help prevent prostate cancer and help protect against advanced cancer. But other studies have found that vitamin E has no effect on prostate cancer at all.

    Unfortunately, the way the studies have looked at the effect of vitamin E on prostate cancer is quite different. For example, some studies have looked at the effect of vitamin E supplements only on prostate cancer, while other studies have just looked at the effect of levels of vitamin E in blood rather than the vitamin E in diet. Some studies were in humans, some in human cells grown in a laboratory, while other studies were in mice. Because the studies are all so different, it is not possible to compare the results. This means we can’t say for sure whether taking vitamin E supplements can help or not. 

    You do need vitamin E in your diet - like all vitamins, it is vital for good health. The best way to get enough vitamin E is through a balanced diet, without taking supplements.

    Vegetable oils, nuts, seeds and green leafy vegetables are all rich in vitamin E.

    Selenium

    Selenium is an important nutrient found in Brazil nuts, fish, seafood, liver and kidney poultry and eggs.

    Evidence suggests that selenium supplements don't help to prevent prostate cancer. They may even be harmful for men with prostate cancer who already get enough selenium in their diet. However, this isn't likely to be a problem as most of us in the UK don't have much selenium in our diet.

    Visit our pages on diet and prostate cancer for more information on improving your diet.

    Last updated June 2018
    To be reviewed June 2020

Diagnosis

  • Why is there no screening programme for prostate cancer?  

    Screening programmes aim to spot the early signs of cancers in people who do not have any symptoms. By finding cancer early, it could be treated in time to cure it. In the UK there are screening programmes for breast, cervical and bowel cancer.

    There is currently no screening programme for prostate cancer. One reason for this is that the PSA test isn’t good enough at finding prostate cancer to be used as part of a screening programme – read about the disadvantages of the test.

    It’s important that the benefits of a screening programme outweigh any disadvantages. But it’s not clear that screening with the PSA test would have more benefits than disadvantages.

    Some studies have found that screening with the PSA test could mean fewer men die from prostate cancer. But it would also mean that a large number of men would be diagnosed with a slow-growing cancer that wouldn’t have caused any symptoms or shortened their life. And a large number of these men would have treatment they didn’t need which could cause side effects. Other studies have found that screening doesn’t reduce the number of deaths from prostate cancer.

    Although there's no screening programme for prostate cancer, many men who are worried about it want a PSA test. So the Prostate Cancer Risk Management Programme was set up. This programme gives men over 50 who want a PSA test the right to have one on the NHS - as long as they have talked through the pros and cons with their GP.

    Last updated January 2018
    To be reviewed January 2020

  • My GP won’t give me a PSA test, what should I do?  

    If you’re over 50, you should be able to have a PSA test – as long as you’ve talked through the pros and cons with your GP or practice nurse. But we know that some men have trouble getting the test.

    Your GP might have a good reason for not recommending the PSA test. For example, you may have other serious health problems that would cause you more problems than prostate cancer would.

    If your GP or practice nurse won’t give you a PSA test but you still want to have one, read our information about what to do next. You can also speak to our Specialist Nurses.

    What if I'm under 50?

    Prostate cancer isn't common in men under 50. If you’re under 50 and don’t have any symptoms, your GP doesn’t have to give you a PSA test. But you may still want to talk to your GP about having a test if you’re over 45 and you’re at higher risk – for example if you have a family history of prostate cancer or you’re Black.

    We’ve been working with health professionals across the UK to develop agreement about when men should be able to have a PSA test, if they want one. Read more about this work.

    Last updated March 2016
    To be updated March 2018

  • What is a baseline PSA test?  

    This involves having a single PSA (prostate specific antigen) blood test while your risk of getting prostate cancer is still low – for example in your 40s. The aim of a baseline test is not to help diagnose prostate cancer, but to help work out your risk of getting prostate cancer in the future.

    There is some research suggesting that your PSA level in your 40s could be used to predict how likely you are to get prostate cancer, or fast-growing (aggressive) prostate cancer, later in life. If the test suggests you’re at higher risk, you and your doctor may decide to do regular PSA tests in the future. This might be a good way to spot any changes in your PSA level that might suggest prostate cancer.

    However, we don’t yet know exactly what PSA level in your 40s would show an increased risk of prostate cancer, or how often you should have more tests. Because of this, baseline testing isn’t very common in the UK.

    For more information about baseline testing, speak to your GP.

    Last updated March 2016
    To be updated March 2018

  • What is a multi-parametric MRI (mpMRI) scan?  

    A multi-parametric magnetic resonance imaging (mpMRI) scan is a special type of scan that creates more detailed pictures of your prostate than a standard MRI scan. It does this by combining up to four different types of image. These images give your doctor information about whether or not there is any cancer inside your prostate, and how quickly any cancer is likely to grow.

    If you’ve just been diagnosed with prostate cancer, you may have a standard MRI scan to find out if the cancer has spread outside your prostate. This helps your doctor to work out the most suitable treatment options for you.

    But in most hospitals, you will now have an MRI scan at an earlier stage.

    There are two main ways that an mpMRI scan may be useful before having a prostate biopsy.

    • It can help your doctor decide if you need a prostate biopsy.
    • If you do need a biopsy, it should be possible to use the scans to make the biopsy more accurate.

    Helping to decide if you need a biopsy

    Research has shown that an mpMRI scan can accurately show whether there is anything unusual in the prostate, or the area around it, that might be cancer. If there’s anything unusual on the scan, you’ll be offered a prostate biopsy to find out whether you have cancer.

    Importantly, an mpMRI scan is less likely than a biopsy to pick up a slow-growing or non-aggressive cancer that probably wouldn’t cause any symptoms or problems in your lifetime. It usually only picks up areas of faster-growing cancer that do need treating. If you have a slow-growing cancer, it’s less likely to show up on the scan. So if your scan is clear, you’re unlikely to have prostate cancer that needs to be treated, and your doctor might decide that you don’t need to have a biopsy. This means you’d avoid the possible side effects of a biopsy. And you’d avoid being diagnosed with a slow-growing cancer and possibly having treatment that you didn’t need.

    Making prostate biopsies more accurate

    An mpMRI scan may still be useful, even if you do need to have a biopsy. This is because the doctor may be able to use the scans to decide which areas of the prostate to take samples from. This is known as a targeted biopsy.

    If you haven’t had an mpMRI scan, the doctor will usually use a thin needle to take 10 to 12 small pieces of tissue from different areas of the prostate. But if you’ve had an mpMRI scan, they may just put the biopsy needle into the areas of the prostate that look unusual on the scan. This means they’re more likely to find the cancer, if there is any. It also means they may be able to use fewer needles and take fewer pieces of tissue from the prostate.

    Some doctors might decide to do both a targeted biopsy and the usual 10 to 12 sample biopsy. Your doctor will discuss this with you.

    Other possible benefits

    Another possible advantage of having an mpMRI scan before a biopsy is that, if the biopsy finds cancer, you probably won’t need another MRI scan to find out if your cancer has spread. Your doctor can probably look at your previous scan results to find this out. This means you and your doctor can start discussing suitable treatment options as soon as you get your biopsy results.

    Doing an MRI scan before your biopsy, rather than after, means the images are clearer and your doctor will have a better idea about whether or not your cancer has spread. This is because biopsies cause bleeding and swelling in the prostate that can make the MRI less clear. If you haven’t already had an MRI scan, you’ll usually have to wait four to six weeks after your biopsy before having one. Some men feel anxious waiting for a scan to find out if their cancer has spread.

    Will I have an mpMRI scan before a biopsy?

    Research showing the benefits of doing an mpMRI scan before a biopsy was published in January 2017. mpMRI scans before biopsy are now available in most UK hospitals. If you’re having tests for prostate cancer, ask your doctor about having an mpMRI scan. If your hospital doesn’t do mpMRI scans before biopsy, your doctor may be able to refer you to one that does.

    If none of the hospitals in your local area do mpMRI scans before biopsy, and your doctor recommends having a prostate biopsy, this can still help to find prostate cancer. Read more about having a prostate biopsy.

    Last updated: January 2019
    To be reviewed: January 2021

  • What does 'Gleason score or 'grade group' mean?  

    Your biopsy results will show how aggressive the cancer is – in other words, how likely it is to spread outside the prostate. You might hear this called your Gleason grade, Gleason score, or grade group.

    The higher your Gleason score or grade group, the more aggressive the cancer and the more likely it is to grow and spread out of the prostate.

    Read more about Gleason scores and grade groups, and what they mean.

    Last updated May 2019
    To be updated May 2021

  • What is the 'stage' of my cancer and what does this mean?  

    Your doctor will use your scan results to work out the stage of your cancer – in other words, how far it has spread. This is usually recorded using the TNM (Tumour-Nodes-Metastases) system.

    • The T stage shows how far the cancer has spread in and around the prostate.
    • The N stage shows whether the cancer has spread to the lymph nodes.
    • The M stage shows whether the cancer has spread (metastasised) to other parts of the body.

    Your TNM stage is used to work out if your cancer is localised, locally advanced or advanced.

    Last updated May 2019
    To be updated May 2021

  • Where can prostate cancer spread to?  

    If prostate cancer spreads outside the prostate, it can spread to the area just outside the prostate (locally advanced prostate cancer) or to other parts of the body (advanced prostate cancer).

    Locally advanced prostate cancer

    Locally advanced prostate cancer is cancer that has started to break out of the prostate, or has spread to the area just outside the prostate. It may have spread to your:

    • prostate capsule, which is the outer layer of the prostate
    • seminal vesicles, which are two glands that sit behind your prostate and store some of the fluid in semen (the fluid that carries sperm)
    • pelvic lymph nodes, which are part of your immune system and are found near your prostate
    • bladder, which is the part of the body where urine (wee) is stored
    • back passage (rectum).

    Read more about locally advanced prostate cancer.

    Advanced prostate cancer

    This is cancer that has spread from the prostate to other parts of the body. It develops when prostate cancer cells move through the blood stream or lymphatic system.

    Prostate cancer can spread to any part of the body, but most commonly to the bones and lymph nodes. Lymph nodes (sometimes called lymph glands) are part of your lymphatic system, which is part of the body’s immune system. Lymph nodes are found throughout the body including in the pelvic area, near the prostate.

    Read more about advanced prostate cancer.

    Last updated October 2019
    To be reviewed October 2021

  • What is the PCA3 test?  

    This is a urine test that measures the activity of a gene called PCA3, which is unusually active in prostate cancer cells.

    Your doctor or nurse will use a finger to massage your prostate through the wall of the back passage. They will then ask you to give a urine sample. Cells from the prostate pass into the urine where they can be looked at with a special test that looks at your genes.

    This test might be useful for monitoring men who’ve already had a biopsy, or it might help specialists decide which men should have a biopsy.

    At the moment the PCA3 test is only available in a few private hospitals and clinics, as we still need more research about how well it works.  Read more about the tests to diagnose prostate cancer.

    Last updated May 2019
    To be reviewed May 2021

  • What is a multi-disciplinary team (MDT)?  

    This is the team of health professionals involved in your care. The team may include:

    A specialist nurse: A nurse who specialises in a particular medical condition or group of conditions. They may have another name, such as a clinical nurse specialist (CNS) or urology nurse specialist.

    A urologist: A doctor who specialises in conditions affecting the urinary and reproductive systems, including prostate cancer. Urologists are surgeons and carry out prostate surgery.

    An oncologist: A doctor who specialises in cancer treatments other than surgery, such as radiotherapy or chemotherapy.

    A radiologist: A doctor who specialises in diagnosing medical conditions using X-rays and scans.

    A radiographer: A person who takes X-rays and scans of the body.

    A pathologist: A doctor who specialises in studying cells and tissues under a microscope to identify diseases. A pathologist examines prostate biopsy samples to see if there is any cancer in your prostate.

    Key worker: This is your main point of contact. This is usually your clinical nurse specialist but might be someone else. They help to coordinate your care and can guide you to the right team member or sources of information.

    Some MDTs may be larger than this and include other health professionals, such as a dietitian, counsellor, physiotherapist or a palliative care nurse.

    Last updated April 2019
    To be reviewed November 2020

Treatments

  • How will I know if my cancer is spreading if I'm on active surveillance?  

    Active surveillance involves monitoring your prostate cancer with regular tests, rather than treating it straight away. This means you can avoid unnecessary treatment, or delay treatment and the possible side effects.

    The tests aim to find any changes that suggest the cancer is growing. If this happens, you’ll be offered treatment that aims to cure the cancer – for example, surgery or radiotherapy.

    Last updated May 2019
    To be reviewed May 2021

  • How can I find out if my consultant is a good surgeon?  

    Research suggests that surgeons who perform a lot of prostatectomies each year get better results and fewer side effects. Your surgeon should be able to tell you how many operations they have done, as well as the results of these operations and the rates of side effects.

    You can look at information on surgeons and centres that do radical prostatectomies online. This includes the number of operations they’ve done, and whether they were open, keyhole or robot-assisted. It also includes rates of complications (such as the risks of surgery above) but not side effects.

    It’s important to remember that some surgeons operate on ‘higher risk’ patients who could be more likely to have complications (for example, if they are overweight) or do more difficult operations, which can affect their results. You can see the information at www.baus.org.uk

    Last updated May 2017
    To be reviewed May 2019

  • Is robot-assisted surgery better than keyhole surgery by hand?  

    There are several ways of removing the prostate:

    •    open surgery
    •    keyhole surgery by hand
    •    robot-assisted keyhole surgery.

    Although robot-assisted keyhole surgery is the newest way of doing surgery, the most recent research suggests all three techniques are as good as each other for treating prostate cancer. They also have similar rates of side effects such as urinary problems and problems getting an erection.

    The advantages of keyhole surgery, both by hand and robot-assisted, are that you are likely to lose less blood, have less pain, spend less time in hospital, and heal more quickly than with open surgery.

    Robot-assisted surgery is not available in all hospitals in the UK because it uses specialist equipment that isn’t available everywhere. The type of operation you have will depend on lots of things, including what’s available at your hospital or where you are prepared to travel to, and what your surgeon recommends.


    Last updated May 2017
    To be reviewed May 2019

  • Should I have surgery or radiotherapy?  

    If you have cancer that hasn’t spread outside the prostate (early or localised prostate cancer), you may be offered treatments that aim to get rid of the cancer. Your treatment options may include surgery, external beam radiotherapy or brachytherapy.

    There may be more than one treatment that is suitable for you. Your choice of treatment will depend on several things, including:

    • how far the cancer has spread and how quickly it’s growing
    • your age and general health
    • what the treatment involves and the possible side effects
    • how you feel about different treatments – some men prefer to have their prostate removed others may not
    • how the treatment you choose will affect any future treatment options if the cancer comes back or spreads – for example, you may not be able to have surgery if you’ve already had radiotherapy.

    There’s no overall best treatment, and each one has its own pros and cons. All treatments have side effects, such as leaking urine and erection problems. Treatments will affect each man differently, and you might not get all the possible side effects. But it’s important to think about how you would cope with them when choosing a treatment.

    Your doctor or nurse will explain all your treatment options and help you choose the right treatment for you. You can also speak to our Specialist Nurses.

    Last updated December 2018
    To be reviewed February 2021

  • How do oestrogens treat prostate cancer?  

    Oestrogens are a type of hormone therapy that can be used to treat prostate cancer that is no longer responding to other types of hormone therapy. It isn’t normally given as a first treatment. Oestrogen is a hormone found in both men and women, but women usually produce more.

    Oestrogens can be given as a tablet called diethylstilbestrol (Stilboestrol®), or through a patch that sticks to your skin like a plaster. But they are used less often than other treatments.

    The side effects can be similar to the side effects of other types of hormone therapy, and can include breast swelling and tenderness.

    Diethylstilbestrol can also increase your risk of circulation problems, such as blood clots, which can be serious. But this can usually be managed using drugs such as aspirin or warfarin to reduce your risk of getting blood clots. You may not be able to take diethylstilbestrol if you have a history of high blood pressure, heart disease or strokes. Talk to your doctor or nurse if you’re worried about blood clots.

    Read more about side effects of hormone therapy.

    Last updated August 2019
    To be reviewed August 2021

  • Will I have to have chemotherapy?  

    Chemotherapy is usually only an option if you’ve been diagnosed with prostate cancer that has spread from your prostate to other parts of your body (advanced or metastatic prostate cancer).

    Chemotherapy won’t get rid of your prostate cancer, but it aims to shrink it and slow down its growth. This helps some men to live longer, and can help to improve or delay symptoms such as pain.

    Chemotherapy isn't used to treat prostate cancer hasn’t spread outside the prostate (early or localised prostate cancer) because there are other treatments that work better, such as surgery and radiotherapy.

    If you would like to know more about treating prostate cancer with chemotherapy, read our page about chemotherapy. Or, if you are unsure about the stage of your cancer and your treatment options, read our treatment pages.

    Last updated August 2018
    To be reviewed September 2020

Side effects

  • Can I have side effects from radiotherapy several years after treatment?  

    Like all treatments, radiotherapy can cause side effects. Side effects happen when the healthy tissue near the prostate is damaged by radiotherapy. Most healthy cells recover, so side effects may only last a few weeks or months. But some side effects can start much later – several months, or even years after finishing treatment. If this happens, these side effects can last a long time.

    These side effects might be similar to problems you had during treatment, such as urinary problems or bowel problems. They may also include problems getting or keeping an erection.

    Talk to your doctor or nurse about your own risk of late side effects. You might be more likely to get them if:

    • you’re older
    • you have diabetes
    • you’re very overweight
    • you’ve had bowel or prostate surgery in the past
    • you’ve had bladder, bowel or erection problems in the past.

    Last updated: December 2018
    To be reviewed: February 2021

  • When will I stop leaking urine after surgery?  

    Surgery to remove the prostate can damage the muscles and nerves that control when you urinate. These include the pelvic floor muscles, which stretch below the bladder and help support it. This can cause you to leak urine.

    You might just leak a few drops if you exercise, cough or sneeze (stress incontinence). Or you might leak more and need to wear absorbent pads, especially in the weeks after your surgery.

    Leaking urine usually improves with time. Most men start to see an improvement one to six months after surgery. But some men leak urine for a year or more and others never fully recover. This can be hard to deal with, but there are things that can help, and things you can do yourself.

    There are treatments available that can help manage urinary problems, as well as things that you can do yourself. Your doctor or nurse may suggest you do pelvic floor muscle exercises for a few weeks before the operation. These might help you recover more quickly from any urinary problems after surgery.

    Last updated January 2017
    To be reviewed March 2020

  • How can I manage incontinence when travelling abroad?  

    Urinary or bowel problems after prostate cancer treatment can affect your travel plans. This should not stop you from travelling but it might affect where you go and what sort of things you do while you're away. Here are some tips for planning your trip.

    • Pack enough pads and medicine and a few extra in case of delays to your trip.
    • Plan ahead to help you manage urinary or bowel problems. For example, book an aisle seat close to the toilets and find out where the nearest public toilets are in advance.
    • Try using a toilet whenever you have the chance, whether you need to go or not.
    • Tell your travel company about any special needs you have. They may be able to help or give you a seat close to the toilet.
    • Find out how you can have your clothes washed if needed at your destination.
    • Use our Urgent toilet card to help you get to a toilet quickly. If you are visiting a non-English speaking country, you can buy an international travel version from the IBS network.
    • If you are worried about leaking during the night, ask your hotel or accommodation if they can provide a protective sheet for the bed.
    • Drink a little less while you are on holiday but take care to stay hydrated, especially if it is hot weather.

    If you use a catheter:

    • take a spare catheter with you
    • take plenty of extra drainage bags and catheter valves
    • speak to your specialist nurse about caring for your catheter while you are away
    • ask your doctor for a letter that explains what your equipment is for. This is called a medical validation certificate and it might make things easier if customs officials decide to search your bag.

    Find out more about preparing for your trip.

    Last updated April 2019

    To be reviewed January 2022

  • Is there anything I can do before and after surgery to help keep my erections?  

    If you have surgery to remove the prostate there is a risk that you will have problems getting an erection afterwards, but there are things that can help.

    There are two bundles of nerves attached to the prostate that help you get erections. If you have surgery these nerves may need to be removed or they could be affected. This often causes problems getting or keeping an erection after surgery (erectile dysfunction).

    Your surgeon will try to save these nerves if it’s possible. This is called nerve-sparing surgery. Speak to your surgeon about this before the operation.

    There are treatments available to help with erection problems. These include

    •    tablets called PDE5 inhibitors (brand names: Viagra®, Cialis®, Levitra® or Spedra®)
    •    vacuum pumps
    •    injections
    •    pellets or cream
    •    implants.

    Your doctor may suggest starting treatment for erection problems before surgery or in the first few weeks afterwards, even if you aren’t ready to have sex yet. Starting treatment soon after surgery may improve your chances of getting erections later on. This is known as penile rehabilitation. If you had nerve-sparing surgery this may include tablets, and if you didn’t it may involve a vacuum pump.

    Even with nerve-sparing surgery it can take anything from a few months to three years for erections to return and they may not be as strong as before. Some men will always need medical help to get erections, and some men might not be able to get erections even with medical help.

    How likely you are to have erection problems will depend on several things, such as:

    • your age and weight
    • the strength of your erections before surgery
    • other health problems such as high blood pressure or diabetes
    • any medicines you take
    • whether you smoke.

    Last updated June 2017
    To be reviewed June 2020

  • How can I get an erection after treatment?  

    Some treatments for prostate cancer can damage the nerves and blood vessels that are needed for an erection. Treatments that can have this effect include surgery, radiotherapy, brachytherapy, high-intensity focused ultrasound (HIFU) and cryotherapy.

    Hormone therapy can also reduce your desire for sex (libido), which may also make it difficult to get and keep an erection.

    There are a number of treatments available which work in different ways. Treatments include:

    • tablets
    • vacuum pump
    • injections, pellets or cream
    • implant
    • testosterone replacement therapy.

    How well each treatment works and whether your erections recover varies from man to man. Your overall health, your ability to get erections before cancer treatment, the treatments you try and your age can all play a role. Try different things and stick with them for a while to find the best option for you.

    Because getting an erection also relies on your thoughts and feelings, tackling any worries or relationship issues as well as having medical treatment for erection problems often works well. There are lots of ways to do this, so pick what works best for you. It may be talking to someone close to you, speaking to your nurse or getting some counselling or sex therapy.

    Read our information about sex and relationships to find out more about treatments for erection problems.

    Last updated June 2017
    To be reviewed June 2020

  • Does stopping hormone therapy from time to time help to reduce the side effects?  

    If you’re on life-long hormone therapy and having problems with side effects, you might be able to have intermittent hormone therapy. This is where you stop hormone therapy when your PSA level is low and steady, and start it again if your symptoms get worse or your PSA starts to rise. It may help to give you a break from some of the side effects, such as hot flushes and sexual problems, and you may feel better in yourself. But it can take several months for side effects to improve, and some men never notice any improvement.

    There is a risk that having a break from treatment may mean your cancer might grow. Speak to your doctor or nurse about the advantages and disadvantages of intermittent hormone therapy and whether it might be an option for you.

    Read more about hormone therapy side effects and what can help.

    Last updated June 2019
    To be reviewed December 2021

  • Why do I feel so low now that I'm having hormone therapy?  

    Hormone therapy can affect your mood. You may feel more emotional than usual or just ‘different’ to how you felt before. Some men find they cry a lot or get mood swings, such as getting tearful and then angry.

    Some men experience low moods, anxiety or depression. This could be directly caused by the hormone therapy itself, or because you’ve been diagnosed with prostate cancer. It could also be due to the impact that treatment is having on you and your family.

    Read more about how hormone therapy might affect your mood and things that may help.

    Last updated June 2019
    To be reviewed December 2021

  • How can I manage hot flushes?  

    Hot flushes are a common side effect of hormone therapy and can affect men on LHRH agonists or anti-androgens.

    If your hot flushes are mild or don’t bother you, you may not need treatment. But speak to your doctor or nurse if you find them disruptive or difficult to deal with.

    Ways to manage hot flushes can include lifestyle changes, medicines, and complementary therapies.

    Read more about how to manage hot flushes.

    Last updated June 2019
    To be reviewed December 2021

  • What causes lymphoedema and how can I stop the swelling?  

    If the cancer spreads to the lymph nodes it could lead to a condition called lymphoedema – caused by a blockage in the lymphatic system. The lymphatic system is part of your body’s immune system, carrying fluid called lymph, around your body.  If it is blocked, the fluid can build up and cause swelling (lymphoedema). Cancer itself can cause the blockage, but so can some treatments such as surgery or radiotherapy.

    Lymphoedema in prostate cancer usually affects the legs, but it can affect other areas, including the penis or scrotum (which contains the testicles).

    Symptoms in the affected area can include swelling, pain, discomfort or heaviness.

    Lymphoedema can affect your daily life. You might find that you are less able to move around and it’s harder to carry out everyday tasks.

    What can help?
    Speak to your nurse or GP if you have any symptoms. Treatments can help reduce or stop the swelling and make you more comfortable and are most effective if started early. You may be referred to a specialist lymphoedema nurse.

    There are a variety of treatments which might help such as having a special massage, or wearing compression bandages or stockings to help encourage the fluid to drain from the affected area.

    Read more about lymphoedema and ways to manage it in our booklet, Advanced prostate cancer: Managing symptoms and getting support.

    Last updated March 2017
    To be reviewed August 2019