Why is prostate cancer difficult to detect and diagnose?

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Prostate cancer is the most commonly diagnosed cancer for men in the UK. On average more than 52,000 are diagnosed every year, and around 1 in 8 men will be diagnosed during their lifetime.

Rates of detection and diagnosis are however not as high as other types of cancer. Whilst there are many reasons why this is unfortunately the case, some of the top reasons are;

  • Risk factors: Many men are not aware of what increases the risk of getting prostate cancer.
  • Early signs & symptoms: Early prostate cancer usually doesn’t cause any obvious signs or symptoms – and the symptoms, once they start, are often not noticed (or ignored).
  • Testing: There is no simple test to prove whether or not someone has prostate cancer.

In this article we look at these reasons in more detail and talk about what can be done to improve the chances of detecting prostate cancer.

Risk factors

It is still not known what causes prostate cancer, but a number of things may mean you’re more likely to get it.

You have a higher risk of prostate cancer if you are:

  • older (it mainly affects men over 50)
  • have a family history of prostate cancer
  • of black ethnic origin

One of the most important factors is your family history.

If people in your family have had prostate, breast or ovarian cancer, then it could increase your risk of getting prostate cancer. Specifically, if your father or brother has had it, then research shows you are 2 ½ times more likely to get prostate cancer (compared to someone who has no relatives with it).

Awareness of your individual risk is therefore really important, and Prostate Cancer UK has developed a simple online tool that allows you to quickly check your overall risk.

Most prostate cancers, however, still occur in men without a family history of it. As well as knowing your risk, it’s therefore important men are aware of the early signs and symptoms.

Early signs & symptoms

Prostate cancer usually develops slowly, so there may be no signs or symptoms for many years.

Symptoms also do not usually appear until the prostate is large enough to press against the urethra (the tube that allows urine to pass from the bladder out of the penis).

When this happens, you may notice things like:

  • difficulty starting to urinate or emptying your bladder
  • an increased (or sudden) need to urinate
  • a weak flow
  • a feeling that your bladder has not fully emptied
  • or dribbling urine after you’ve finish urinating

Symptoms like these do not mean you definitely have prostate cancer. It is more likely they are a sign of a very common, non-cancerous, condition called an enlarged prostate (or some other health problem).

The symptoms however shouldn’t be ignored, and you should tell your GP about them. That way they can find out what’s likely causing the symptoms and, if needed, get you the right treatment. Also, if you do have prostate cancer, then it’s best to get diagnosed (and start treatment) as soon possible.


There is no simple test to determine whether you have prostate cancer.

Your GP can however do certain initial tests to find out if you might have a problem with your prostate. These tests include:

  • a urine test
  • a digital rectal examination (where the GP uses their finger to check for any problems inside your rectum)
  • or a prostate-specific antigen (‘PSA’) test

PSA is a protein produced by the prostate. A blood test can measure the level of PSA. For this test, a blood sample is taken and sent to a laboratory for analysis.

It’s normal for all men to have some PSA in their blood, but a high level of PSA could potentially be a sign of cancer.

PSA tests are however not completely reliable and can give a ‘false-positive’ result i.e. they can suggest prostate cancer when no cancer in fact exists. This is because your PSA level could be raised due to other conditions, such as a urine infection.

‘False-negative’ results can also be given because approximately 1 in 7 of those with normal PSA levels may have prostate cancer. This can mean that some cases of prostate cancer might be missed.

The lack of a reliable test is therefore part of the reason why, unlike other types of cancer, there is currently no national screening programme for prostate cancer in the UK.

Despite its flaws, PSA testing still gives a good indication of possible prostate problems. If your PSA level is abnormal, further tests can then also be done at hospital. These tests (such as an MRI, CT or bone scan) can give a better picture of your prostate and surrounding area. This can help indicate what further investigations, or treatment, you might need.


Prostate cancer is not always life-threatening but, when it is, the earlier you catch it the more likely it is to be cured.

Hopefully greater awareness around the risk factors and early symptoms, as well as access to screening tests, mean that detection rates improve – and more people can get the treatment they need as early as possible.

How can we help?

Even though there is no formal screening program, many GPs have been advising men over the age of 50 to have a prostate examination and / or PSA test as a routine examination. Unfortunately we have seen some GPs turn away patients who ask to be tested, even when they meet the age requirement or have had a close relative with prostate or breast cancer (which increases their chances of having it themselves). Most prostate cancers take a long time to develop but unfortunately this is not the case with all, and a delayed diagnosis can have a negative impact on the patient’s prognosis and treatment plan.

If you or a loved one found out you have prostate cancer at a progressed stage and would like to understand if something went wrong with your diagnosis and treatment, and if the cancer should have been diagnosed sooner, an expert from our cancer claims team will be happy to have a free, confidential discussion with you. Call us on 0800 044 8488 or fill in our form here Contact Us – Enable Law so we can give you a call back.

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