Prostate cancer is a condition in which abnormal cells develop within the prostate gland — a small, walnut-sized organ located beneath the bladder in men. It typically develops gradually over many years, often beginning with subtle changes at a cellular level long before any noticeable signs appear. Understanding prostate cancer symptoms, the underlying causes of prostate cancer, and how prostate cancer starts can help men make more informed decisions about preventive screening. This article provides an educational overview of the condition, its stages, risk factors, and the role of PSA blood testing in supporting early awareness through private blood tests in London.
What Is Prostate Cancer?
The prostate gland sits just below the bladder and surrounds the upper part of the urethra — the tube that carries urine out of the body. Its primary function is to produce a portion of the fluid that makes up semen. Prostate cancer begins when cells within this gland start to grow in an uncontrolled manner, forming a tumour that may remain confined to the prostate or, over time, extend beyond it.
At the most fundamental level, how prostate cancer starts involves DNA mutations in prostate cells. Every cell in the body contains DNA — the set of instructions that tells cells when to grow, divide, and die. When mutations occur in these instructions, cells can begin dividing more rapidly than normal and can lose the ability to self-destruct when they become damaged. Over time, these abnormal cells accumulate and form a mass of tissue — a tumour.
Not all prostate tumours behave aggressively. Some grow so slowly that they may never cause significant problems during a man's lifetime. Others, however, can progress more rapidly and may eventually spread to other parts of the body. This variability is one of the reasons why understanding the nature of the condition — and being aware of screening options — matters.
What Causes Prostate Cancer?
The exact causes of prostate cancer are not fully understood, but research has identified several risk-based associations that increase the likelihood of developing the condition. It is important to recognise that having one or more risk factors does not guarantee that prostate cancer will develop — these are statistical associations rather than certainties.
Age as a risk factor for prostate cancer: Age is the single most significant risk factor. Prostate cancer is uncommon in men under 50, but the incidence rises sharply from the age of 50 onwards. The majority of cases are identified in men over 65. Age-related cellular changes, combined with a longer period of exposure to potential genetic mutations, contribute to this increased risk.
Prostate cancer family history: Men with a close relative — particularly a father or brother — who has been affected by prostate cancer have an elevated risk compared to the general population. The risk increases further if the relative was under 60 at the time of identification or if more than one family member has been affected.
Genetic risk factors for prostate cancer: Certain inherited gene mutations, including BRCA1 and BRCA2, have been linked to an increased risk of prostate cancer. These mutations affect the body's ability to repair damaged DNA, making it more likely that abnormal cell growth will go unchecked. Ongoing research continues to identify additional genetic markers associated with the condition.
Other factors that may influence risk include:
- Ethnicity — men of Black African and Black Caribbean descent have a statistically higher risk than men of other ethnic backgrounds
- Diet and lifestyle — while the evidence is not conclusive, diets high in processed foods and low in vegetables have been associated with marginally increased risk in some studies
- Obesity — higher body weight has been linked to a greater likelihood of more advanced disease at the time of identification
Early Prostate Cancer Symptoms
One of the challenges with prostate cancer is that early-stage disease often produces no noticeable symptoms at all. When prostate cancer symptoms do appear, they frequently overlap with benign conditions such as prostate enlargement (BPH), which is extremely common in older men. This overlap makes symptom-based identification unreliable without further investigation.
Prostate cancer symptoms that may warrant awareness include:
- Increased frequency of urination — particularly at night (nocturia)
- Difficulty starting or stopping urination — hesitancy or a weak flow
- A feeling of incomplete bladder emptying — the sensation that the bladder has not fully drained
- Blood in urine or semen — though this can have many causes, it should always be noted
- Discomfort in the pelvic area — a dull ache or pressure in the lower pelvis
- Erectile changes — new difficulty achieving or maintaining an erection
It is worth emphasising that many of these symptoms are far more commonly caused by non-cancerous conditions. However, persistent or worsening urinary changes in men over 50 are worth bringing to the attention of appropriate healthcare services for further evaluation. Awareness of symptoms is not about creating alarm — it is about enabling timely and informed action.
Advanced and Metastatic Prostate Cancer
When prostate cancer is not identified at an early stage, it may progress beyond the prostate gland itself. Advanced prostate cancer development refers to the process by which the cancer grows through the outer capsule of the prostate and begins to affect nearby tissues, such as the seminal vesicles or the bladder neck.
Metastatic prostate cancer describes a stage in which cancer cells have spread — or metastasised — to distant parts of the body. The most common sites of metastasis for prostate cancer are the bones (particularly the spine, pelvis, and ribs) and the lymph nodes. When the disease reaches these areas, it may produce additional symptoms such as bone pain, unexplained weight loss, and persistent fatigue.
It is important to understand that metastatic prostate cancer represents the most advanced form of the condition. The progression from localised disease to metastatic spread is not inevitable — many prostate cancers remain confined to the prostate for extended periods, and awareness of screening options can support earlier identification when the condition is still at a more manageable stage.
Understanding Prostate Cancer Stages
Prostate cancer stages describe how far the disease has progressed at the time of identification. Staging provides a framework for understanding the extent of the condition, and it is typically categorised into three broad groups:
| Stage | Where Cancer Is Located | General Description |
|---|---|---|
| Localised | Confined entirely within the prostate gland | The cancer has not spread beyond the prostate capsule. This is the earliest identifiable stage and is often associated with a more favourable outlook. |
| Locally advanced | Extends beyond the prostate into nearby tissues | The cancer has grown through the prostate wall and may involve surrounding structures such as the seminal vesicles, but has not reached distant organs. |
| Metastatic | Has spread to distant areas such as bones or lymph nodes | Cancer cells have travelled beyond the immediate prostate region. The bones, spine, and lymph nodes are the most common sites of secondary spread. |
Gleason score explained: The Gleason score is a grading system used to describe how prostate cancer cells appear under a microscope compared to normal cells. It assigns a score based on the architectural patterns observed in tissue samples — with lower scores indicating cells that more closely resemble normal prostate tissue, and higher scores indicating more abnormal patterns. The Gleason score is an educational concept that helps illustrate the spectrum of prostate cancer behaviour, from slow-growing to more aggressive forms. It is determined through pathological analysis of tissue samples, not through blood testing.
What Is a PSA Test for Prostate Cancer?
A PSA test for prostate cancer is a blood test that measures the level of prostate-specific antigen — a protein produced by both normal and abnormal prostate cells — in the bloodstream. PSA levels can be elevated for a variety of reasons, including benign prostate enlargement, infection, inflammation, and prostate cancer. A raised PSA level does not confirm the presence of cancer, but it can serve as an indicator that further investigation through appropriate healthcare services may be worthwhile.
What a PSA blood test measures:
- Total PSA — the overall level of prostate-specific antigen in the blood
- Baseline establishment — a first PSA result creates a reference point for future comparison
- Trend monitoring — tracking PSA levels over time is often more informative than a single measurement in isolation
Many individuals considering prostate screening are looking to understand what PSA testing involves and whether it is right for them. PSA testing is a laboratory-based blood test — it requires a blood sample to be taken and analysed, with results returned in a clear and understandable format. Walk in Clinic London provides PSA blood testing as a laboratory service, with no consultations, clinical assessments, or diagnostic claims involved.
Who Should Consider Prostate Screening?
There is no universal screening programme for prostate cancer in the UK, which means that the decision to test is often a personal one based on individual awareness and risk factors. The following groups may find particular value in considering PSA testing:
- Men aged 50 and over — the age at which prostate cancer risk begins to rise significantly
- Men aged 45 and over with a family history — those with a father or brother affected by prostate cancer may wish to begin monitoring earlier
- Men of Black African or Black Caribbean descent — who carry a statistically higher risk and may consider earlier screening
- Men with known genetic risk factors — such as BRCA1 or BRCA2 mutations
- Health-conscious individuals — men who want to establish a baseline PSA level for future trend monitoring
Deciding to have a PSA test is a personal choice. For those seeking a comprehensive overview, a prostate cancer risk health screening panel can provide additional context alongside the PSA result, offering a broader set of markers for informed awareness.
What Happens After a PSA Blood Test?
Once your blood sample has been analysed by the laboratory, you will receive a detailed report showing your PSA level alongside the relevant reference range. This report is designed to be clear and easy to interpret, so you can see exactly where your result falls.
Practical steps after receiving your PSA result:
- Understand the reference range — PSA levels are typically measured in nanograms per millilitre (ng/mL), and the reference range may vary by age
- Consider the context — a single PSA result is most meaningful when viewed alongside your age, family history, and any previous PSA readings
- Monitor trends over time — repeating the test at regular intervals allows you to track whether your PSA is stable, rising gradually, or increasing more rapidly
- Seek medical advice if needed — if your PSA level is elevated or rising, seeking appropriate healthcare services for further evaluation is the recommended next step
Walk in Clinic London provides laboratory-based PSA testing and clear reporting. The clinic does not provide consultations, diagnostic interpretation, or clinical recommendations. If your result raises questions, engaging with appropriate healthcare services ensures you receive the specialist input needed to determine next steps.
Benefits of PSA Testing at Walk in Clinic London
Walk in Clinic London offers PSA blood testing as part of its laboratory-based screening services. The process is straightforward, confidential, and designed to provide clear results without unnecessary complexity.
- Laboratory-based PSA testing — blood samples are processed through accredited laboratories for reliable, high-quality results
- Confidential access — your visit, samples, and results are handled with complete privacy
- Clear, patient-friendly reports — results are presented in plain language with reference ranges, so you can understand them without difficulty
- No referral required — attend directly at a time that suits your schedule
- Baseline and trend monitoring — regular testing allows you to establish a personal baseline and track any changes over time
- Central London location — conveniently accessible for men living or working in the capital
Understanding your PSA level is a proactive step towards informed health awareness. Whether you are testing for the first time to establish a baseline, or you are continuing to monitor a known reading, Walk in Clinic London provides the laboratory infrastructure and clear reporting to support your decision. No diagnosis. No consultations. Just reliable data, delivered clearly.
Frequently Asked Questions
What are early prostate cancer symptoms?
Early prostate cancer often produces no symptoms at all. When symptoms do occur, they may include increased urinary frequency (especially at night), difficulty starting or maintaining urine flow, a sensation of incomplete bladder emptying, and occasionally blood in the urine or semen. These symptoms overlap with benign prostate conditions and require further evaluation through appropriate healthcare services.
What causes prostate cancer?
The exact causes of prostate cancer are not fully established, but known risk factors include advancing age, family history of the condition, inherited gene mutations such as BRCA1 and BRCA2, and ethnicity. Environmental and dietary factors may also play a contributing role, though the evidence for these is less definitive.
How does prostate cancer start at a cellular level?
Prostate cancer starts when DNA mutations occur within prostate cells, causing them to grow and divide in an uncontrolled manner. These mutations disrupt the normal instructions that tell cells when to grow and when to die. Over time, the accumulation of abnormal cells forms a tumour within the prostate gland.
What are prostate cancer stages?
Prostate cancer stages describe how far the disease has progressed. Localised cancer is confined within the prostate, locally advanced cancer has grown beyond the prostate into nearby tissues, and metastatic cancer has spread to distant areas such as the bones or lymph nodes. Staging helps frame the extent of the condition at the time of identification.
What does metastatic prostate cancer mean?
Metastatic prostate cancer means that cancer cells have spread from the prostate gland to other parts of the body, most commonly the bones, spine, and lymph nodes. It represents the most advanced stage of the disease and may produce symptoms such as bone pain, fatigue, and weight loss in addition to urinary changes.
What is a PSA test for prostate cancer?
A PSA test is a blood test that measures the level of prostate-specific antigen in the bloodstream. PSA is a protein produced by prostate cells, and elevated levels can be associated with prostate cancer as well as benign conditions such as prostate enlargement. The test provides data for awareness and trend monitoring rather than a definitive diagnosis.
Is family history a risk factor?
Yes. Having a close relative — particularly a father or brother — who has been affected by prostate cancer increases an individual's risk. The risk is further elevated if the relative was under 60 at the time of identification or if multiple family members have been affected. Men with a strong family history may consider earlier PSA monitoring.
How are DNA mutations in prostate cells involved?
DNA mutations in prostate cells are central to how prostate cancer develops. These mutations alter the genetic instructions that control cell growth and death, allowing abnormal cells to proliferate unchecked. Some mutations are inherited, while others occur spontaneously over a person's lifetime due to age and environmental factors.
What is the Gleason score explained simply?
The Gleason score is a grading system that describes how prostate cancer cells look compared to normal cells when viewed under a microscope. Lower scores indicate cells that are closer to normal in appearance and tend to be slower-growing, while higher scores suggest more abnormal patterns associated with potentially faster progression. It is determined from tissue analysis, not blood testing.
At what age should men consider screening?
Men aged 50 and over may wish to consider PSA testing as part of their health awareness routine. Those with a family history of prostate cancer or who are of Black African or Black Caribbean descent may consider testing from the age of 45. Establishing a baseline PSA level allows for meaningful trend monitoring over subsequent years.
Does age increase prostate cancer risk?
Yes. Age is the most significant risk factor for prostate cancer. The condition is uncommon before the age of 50 but becomes increasingly prevalent in older men, with the majority of cases identified in men over 65. Age-related cellular changes contribute to the cumulative risk of DNA mutations within prostate cells.
When should PSA levels be monitored?
PSA levels should be monitored when an individual has decided to engage with prostate screening — typically from the age of 50, or earlier for those with elevated risk factors. Regular monitoring allows trends to be observed over time, which is often more informative than a single result. If a PSA level is elevated or rising, seeking medical advice through appropriate healthcare services is recommended.