2 Indications and current treatments
2.1 Prostate cancer is usually diagnosed after a blood test in primary care has shown elevated prostate-specific antigen (PSA) levels. A raised PSA is not diagnostic of prostate cancer and a prostate biopsy is required to confirm the diagnosis and further tests are required to stage the extent of the disease. A NICE guideline describes recommendations for the diagnosis and management of prostate cancer.
2.2 Most prostate cancers are either localised or locally advanced at diagnosis. Localised prostate cancer does not usually cause any symptoms, but some men might have some urinary problems or erectile dysfunction. Current treatments for localised disease include active surveillance, radical prostatectomy, external beam radiotherapy and brachytherapy. Hormone therapy (androgen deprivation or anti-androgens) is usually the primary treatment for metastatic prostate cancer, but is increasingly being used for locally advanced, non-metastatic disease.