Prostate cancer treatments for trans women
If you are a trans woman or a non-binary person assigned male at birth and have been told that you have prostate cancer, your doctor will have done tests to find out more about your cancer. You may have been told:
- your PSA level
- your Gleason score
- the stage of your cancer.
Read about what your test results mean.
Does having prostate cancer mean I can’t take hormones?
If you are taking hormones, it is very unlikely these would be stopped although they may be altered depending on what prostate cancer treatment you have.
What are the treatments for a trans woman with prostate cancer?
There are different ways to treat or monitor prostate cancer in trans women. Some treatments aim to get rid of the cancer completely and others aim to control it – or you may not need treatment at all and have your cancer monitored instead.
The treatment you have will depend on the stage of your cancer. Read about what will affect your treatment options and the treatments available at different stages of cancer.
We have information on what each treatment for prostate cancer involves and what the side effects might be.
As well as the stage of cancer affecting what treatment a trans woman can have, the stage of transition can affect the treatments available. Some treatments are not advised before or after genital reconstructive surgery.
It’s up to you how much of your trans history you share with health professionals. But by telling them about any hormones or surgery you’ve had, this can help them find the right treatment for you.
Can I have genital reconstructive surgery if I have prostate cancer?
If you are planning to have genital reconstructive surgery, this might need to be delayed until after treatment for prostate cancer.
Some types of genital reconstructive surgery might be more difficult or not possible after some prostate cancer treatments. These include surgery to remove the prostate (radical prostatectomy), external beam radiotherapy and brachytherapy. You should ask the doctor planning your treatment to discuss this with your genital surgeon.
Some trans women decide to have an orchidectomy (surgery to remove the testicles). This is sometimes used as a treatment for prostate cancer, so you may be offered this.
What are the side effects of treatment in trans women?
All prostate cancer treatments have possible side effects – and this can affect which treatment you choose. At each appointment after your treatment your doctor or nurse will ask you about any symptoms or side effects you’re having. They can help you manage the side effects or refer you to someone else who can.
Side effects can include:
- sexual problems
- urinary or bowel problems.
Read about how these side effects may affect you and ways to manage them. Certain side effects may be welcomed by some trans women. For example, hormone therapy used to treat prostate cancer can cause muscle loss, breast swelling, erection problems and loss of body hair.
What happens after treatment?
You’ll have regular appointments after your treatment to check how well your cancer has responded. It’s also a chance to deal with any side effects and ask any questions you may have. This is often called follow-up.
This may involve having blood tests to measure your level of PSA (prostate specific antigen). The PSA test is used to check how well your treatment has worked or is working. Find out about how the PSA test is used during follow-up.
Feminising hormones, testosterone blockers and orchidectomy can lower PSA levels. So your doctor will need to take this into account when using PSA to monitor your cancer.
You may also have other tests to check how your cancer has responded to treatment. These include a prostate biopsy, MRI scan, CT scan, bone scan or PET scan.
Dealing with a prostate cancer diagnosis
A diagnosis of cancer can be hard to deal with. We have information about dealing with your diagnosis and the emotional impact of living with prostate cancer. This information applies to you whether you are trans, cis or non-binary.
If you’re a trans woman or non-binary person assigned male at birth you may have additional worries and fears about a diagnosis of prostate cancer. Some people worry about being treated as male. Others may feel pressured to be outed. Some trans women may feel embarrassed to sit in a waiting room full of men in a urology clinic.
There are things that can help if you feel this way. If you feel able to speak to your GP, you could ask them to share your trans history with other health professionals so you don’t have to explain your situation over and over again. You’ll need to give your GP permission to do this as they’re not allowed to disclose these details about you without your permission.
You may also ask to be seen at the start or end of a clinic, or to attend a clinic where there is a more mixed waiting room.
Ask your GP to refer you to a counsellor if you need support with your feelings. If you’re not already under the care of a gender identity clinic, you can ask to be referred to one for more support.
Many health professionals won’t know a lot about prostate problems in trans women so you could suggest they contact a gender identity clinic for expert guidance.
Read our tips on talking to a health professional about prostate problems.
Where can I get support as a trans woman with prostate cancer?
Read about the things that might help you manage day-to-day life.
Prostate Cancer UK’s services are free and open to everyone. Partners and family members can also use our services.
Our Specialist Nurses
Our Specialist Nurses can help answer your questions and explain your diagnosis and treatment options. They have time to listen, in confidence, to any concerns you or those close to you have.
Our online community
Our online community is a place to talk about whatever’s on your mind – your questions, your ups and your downs. Anyone can ask a question or share an experience. The online community is open to all, but there’s also a section for trans women. It’s a place to talk to others who may share or understand your experiences of prostate cancer.
Support groups
At support groups, people can share their experiences of living with prostate cancer. You can ask questions, share worries and know that someone understands what you’re going through. There are some support groups for gay and bisexual men with prostate cancer that also encourage trans women with prostate cancer to attend:
Organisations that support trans and non-binary people
You may find it helpful to contact organisations that support trans and non-binary people, such as:
References and reviewers
Updated: October 2020. To be reviewed: October 2022.
- Ellent E, Matrana MR. Metastatic Prostate Cancer 35 Years After Sex Reassignment Surgery. Clinical Genitourinary Cancer. 2016;14(2):e207-e209. doi:10.1016/j.clgc.2015.11.007
- Deebel NA, Morin JP, Autorino R, Vince R, Grob B, Hampton LJ. Prostate Cancer in Transgender Women: Incidence, Etiopathogenesis, and Management Challenges. Urology. 2017;110:166-171. doi:10.1016/j.urology.2017.08.032
- Holz LE, Goodman M. Epidemiology of advanced prostate cancer: Overview of known and less explored disparities in prostate cancer prognosis. Current Problems in Cancer. 2015;39(1):11-16. doi:10.1016/j.currproblcancer.2014.11.003
- Sharif A, Malhotra NR, Acosta AM, et al. The Development of Prostate Adenocarcinoma in a Transgender Male to Female Patient: Could Estrogen Therapy Have Played a Role?: Estrogen and Prostate Cancer Development. The Prostate. 2017;77(8):824-828. doi:10.1002/pros.23322
- Wassersug RJ, Gray R. The health and well-being of prostate cancer patients and male-to-female transsexuals on androgen deprivation therapy: A qualitative study with comments on expectations and estrogen. Psychology, Health & Medicine. 2011;16(1):39-52. doi:10.1080/13548506.2010.516364
- James Bellringer, Consultant Gender and Urological Surgeon, Parkside Hospital, London
- Alison May Berner, Specialist Registrar and Clinical Research Fellow in Medical Oncology and Adult Gender Identity, Tavistock and Portman NHS Foundation Trust, London
- Frank Chinegwundoh, Consultant Urological Surgeon, Barts Health NHS Trust
- Jonny Coxon, Speciality Doctor, Gender Identity Clinic, London
- Oliver Hulson, Consultant Radiologist, Leeds Teaching Hospitals NHS Trust
- Chidi Molokwu, Consultant Urologist & Honorary Senior Clinical Lecturer, Urology & Cancer Therapeutics, Bradford Teaching Hospitals NHS Foundation Trust & University of Bradford
- Joe O'Sullivan, Consultant Prostate Oncologist, Queen's University Belfast
- Tina Rashid, Consultant in Functional Urology and Genital Reconstruction, Imperial College Healthcare NHS Trust, London
- Vijay K. Sangar, Consultant Urological Surgeon, The Christie NHS Foundation Trust & Manchester University NHS Foundation Trust
- Our Specialist Nurses
- Our Volunteers.