If you have been diagnosed with prostate cancer, are currently having tests, or have a forthcoming GP appointment to discuss your concerns, there is a great deal of information to take in. It’s not unusual to think of questions after your appointment that you didn’t think to ask at the time. Or, you may feel unsure about what certain terms mean.
Asking your doctors questions about prostate cancer is important. It can make you feel more informed about your diagnosis, more confident discussing your treatment options and more in control of what happens next.
In this guide, we’ll suggest some questions you may want to ask throughout the prostate cancer diagnosis process, including testing, results and treatment options. You do not need to ask all of them. Choose the ones that feel most relevant to you.
At Proton International London, we treat many prostate cancer patients with proton beam therapy at our private clinic. If you would like to understand whether this advanced form of radiotherapy could be suitable for you, please speak to our team.
Don’t be afraid to ask your doctor questions about your prostate health and diagnosis
When it comes to your health, you should feel free to ask as many questions as you wish. No question is too small if it helps you feel more informed: your healthcare professional wants you to understand your diagnosis and feel involved in decisions about your care.
Before each appointment, write down any questions you have along with your symptoms, and take them to your appointment. It can also help to bring a partner, family member or friend to take notes and be a second pair of ears.
If you are awaiting an appointment, you may wish to read our guide to what to expect during the prostate cancer diagnosis process, which talks about the various testing stages in more detail.
1. Questions to ask your GP about prostate cancer testing
Diagnosing prostate cancer involves several steps, from discussing your symptoms and medical history to having tests that help your doctors understand what is happening.
A GP usually carries out initial tests, which can include a PSA test or a digital rectal exam. These cannot confirm cancer on their own, but can help your GP decide whether you need a referral for further investigations.
When should I ask my GP about prostate cancer testing?
There is no universal prostate cancer screening programme in the UK. However, you can speak to your GP about testing if you have symptoms, are concerned about your risk or simply want to understand your options, particularly if you are over 50.
Early prostate cancer diagnosis is important as it may give you more treatment options and improve the chances of successful treatment.
Questions to ask your doctor:
- What is my risk factor?
- If I’m at high risk, should I consider testing even if I have no symptoms?
- Could my symptoms be caused by something other than cancer?
PSA tests
A PSA test is a simple blood test that measures the amount of prostate-specific antigen in your blood. A raised level can indicate prostate cancer, but also other conditions, such as an enlarged prostate or a urinary infection.
Questions you may want to ask include:
- Is there anything I should avoid beforehand?
- Could anything else have affected my result?
- Will I need another PSA test?
- What is the next step if the result is high?
- When will I get the results, and who should I contact if I haven’t heard?
Digital rectal exams
During a digital rectal examination (DRE), your doctor uses a gloved, lubricated finger to feel the prostate through the wall of the back passage, checking its size and whether there are any lumps or hard areas.
Questions you may want to ask include:
- Did you notice anything unusual about the size or shape of my prostate?
- How do the results of this examination fit with my PSA (prostate-specific antigen) blood test?
- Do I need any further tests, such as an MRI scan, or a referral to a urologist?
- If you did notice something unusual, what could it mean other than cancer?
2. Questions to ask your specialists during additional testing
Based on the findings of your initial tests, your doctor may recommend further tests to confirm or rule out prostate cancer. That may include imaging scans and, if required, a biopsy.
General questions you may want to ask before further testing include:
- What will each test tell us, and how will the results affect my options?
- What does each test involve, and is there anything I need to do to prepare?
- How long will it take to get the results, and who will explain them to me?
MRI scans
An MRI scan gives your specialist a detailed view of your prostate, helping them identify areas that may need further investigation and decide whether you need a biopsy. Being referred for a scan does not mean you have cancer.
Questions you may want to ask include:
- What are you looking for, and what can the scan tell us?
- What will the scan involve, and how should I prepare?
- I’m uncomfortable in enclosed spaces. What could help me manage the scan?
Prostate biopsies
A prostate biopsy involves taking small samples of tissue with a needle. It’s understandable to feel nervous, so asking what to expect can help you feel more prepared.
Questions you may want to ask include:
- How does the procedure work?
- What anaesthetic will I have?
- Can I go straight home afterwards?
- What side effects should I expect, and when should I seek help?
3. Questions to ask about your results
You will be invited to an appointment to discuss the findings of your tests. This can naturally be daunting, so prepare some questions beforehand so you don’t forget them.
The Gleason Score and Grade Group
If your biopsy confirms prostate cancer, ask your doctor about the grade. This is often given as both a Gleason score and a Grade Group ranging from 1 to 5. These help your specialist assess how quickly the cancer is likely to grow and how likely it is to spread.
Questions you may want to ask include:
- What does my grade mean for me, in plain terms?
- Which risk group am I in, and how was this decided?
- Is there any sign that the cancer has spread beyond the prostate?
- Can I have a copy of my results?
Further testing following a diagnosis
If you receive a prostate cancer diagnosis, you may be invited for further tests to show whether the cancer has spread to other parts of the body. They may include scans such as a CT scan, bone scan or PET-CT scan.
Questions you may want to ask your doctors include:
- How could the results affect my treatment options?
- When will I get my results?
- Who can I contact if I’m worried while waiting?
4. Questions to ask about prostate cancer treatment
Treating prostate cancer varies depending on its stage and grade, your PSA level, your general health and what matters most to you.
A multidisciplinary team (MDT) of specialists will usually discuss your case and recommend the options most suitable for you, such as surgery, radiotherapy, and hormone therapy. They will explain which options are suitable and answer questions about the benefits and possible side effects.
Questions you may want to ask include:
- Which treatment options are suitable for me, and why?
- What are the possible benefits and risks of each option?
- How might each treatment affect my urinary, bowel and sexual function?
- How long does each treatment take, and how much time will I need to spend in hospital or attending appointments?
- How soon do I need to make a decision?
- What happens if the cancer comes back after treatment?
Is active surveillance the right option for me?
Active surveillance is often advised for low-risk prostate cancer cases, where the cancer is growing slowly. It involves monitoring prostate cancer closely with regular tests, rather than treating it straight away. It allows treatment and its possible side effects to be avoided or delayed unless there are signs that the cancer is changing.
Questions you may want to ask include:
- Based on my results, is active surveillance a suitable option for me?
- How often will I need PSA tests, MRI scans or further biopsies?
- What changes in my results would mean we should consider treatment?
- If I start on active surveillance, can I change my mind and have treatment later?
- Who do I contact if I notice new symptoms between appointments?
Hormone therapy
Hormone therapy lowers the level of testosterone in the body, or blocks its effects on prostate cancer cells. It’s sometimes used alongside radiotherapy, and is also used to treat cancer that has spread or come back.
If hormone therapy has been mentioned, you may want to ask:
- Why are you recommending hormone therapy for me?
- Will it be given on its own, or alongside another treatment such as radiotherapy?
- How is it given, and how long will I need it for?
- What side effects might I experience, and how can they be managed?
- Are there things I can do to look after my bone health and general wellbeing during treatment?
Radiotherapy
Radiation therapy options for prostate cancer include external beam radiotherapy, which is delivered from outside the body, and brachytherapy, which delivers radiation from a source placed inside the prostate.
Questions you may want to ask include:
- Which type of radiotherapy would you recommend for me, and why?
- Is brachytherapy an option, either alone or alongside external beam radiotherapy?
- What does treatment involve, and how many hospital visits would I need?
- What are the side effects? How could it affect my bladder, bowel or sex life?
Should I ask about proton beam therapy?
Note: Proton beam therapy for prostate cancer is only available privately in the UK.
If radiotherapy is presented as an option, you may wish to consider proton beam therapy, a precise form of external beam radiotherapy that uses protons rather than X-rays. The protons can be controlled so that they release most of their energy at the prostate, which helps limit the radiation dose to nearby healthy tissue, such as the bladder and rectum.
For some men, this may help reduce the risk of certain side effects. Proton beam therapy is not suitable for everyone, and whether it is right for you depends on your diagnosis and your specialist team’s recommendation.
Questions you may want to ask include:
- Is proton beam therapy a suitable option for me?
- How does it compare with the other radiotherapy options available to me?
- How many treatment sessions would I need?
- What side effects might I experience?
- Would my health insurance cover proton beam therapy?
Surgery
Surgery to remove the prostate is called a radical prostatectomy. If this is an option for you, asking about the benefits, risks and support available can help you feel more prepared.
Questions you may want to ask include:
- What will the operation involve?
- How long will I need to stay in hospital, and what help might I need at home?
- How could surgery affect my bladder control, sex life or fertility?
- What support is available to help me manage side effects?
- Might I need further treatment after surgery?
5. Questions about looking after yourself during treatment
Lifestyle changes
Looking after your general health can help you cope with treatment and its side effects. Your medical team can advise you on changes that are safe and suitable for you.
Questions you may want to ask include:
- Diet and nutrition: Should I make any changes to what I eat during or after treatment? Can you refer me to a dietitian?
- Physical activity: What type and amount of exercise is safe for me at the moment?
- Bladder and bowel health: Would pelvic floor exercises help me, and when should I start them?
- Managing side effects: Can changes to my diet or activity levels help with tiredness, weight gain or bone health?
- Smoking and alcohol: Would cutting down or stopping help my treatment or recovery, and what support is available?
Alternative medicine
Some men consider supplements, special diets or complementary therapies alongside their treatment. However, some supplements and herbal products can interact with cancer treatment or affect test results, including PSA levels.
Your medical team will always want to know what you are taking so they can advise you safely. It is important not to stop or delay recommended treatment without first talking to your doctor.
Questions you may want to ask include:
- Could this supplement or therapy interact with my treatment?
- Could it affect my PSA level or other test results?
- Is there any evidence that it is safe for someone in my situation?
- Can you recommend any reliable sources of information?
6. Questions about advanced prostate cancer
Your results may indicate that the cancer is contained within the prostate and has not spread outside it, known as localised prostate cancer. They may indicate the cancer has spread into surrounding tissue or nearby pelvic lymph nodes, known as locally advanced prostate cancer.
If you are advised that your cancer is advanced, or that you have metastatic prostate cancer, it means it has spread further away, most commonly to the bones or distant lymph nodes.
Finding out your cancer has advanced is difficult to hear. You do not have to ask every question or understand everything at once. Your team can talk things through again, explain what happens next and help you find emotional or practical support for you and your family.
Find support groups for prostate cancer patients in the UK at Prostate Cancer UK.
You may want to ask:
- Where has the cancer spread to?
- What treatment options are available to me, and how might each one affect my daily life?
- What are the aims of my treatment?
- Are there any clinical trials I could take part in?
- What support is available to help me manage symptoms such as pain or tiredness?
- Is there a specialist nurse I can speak to, and what support is available for my family?
How to approach getting a second opinion
You can ask for a second opinion at any stage of your care. Doctors are used to these requests, and asking for one will not affect the care you receive. A second opinion can help you feel more confident about your diagnosis or treatment plan, or give you the chance to hear about other options.
Some practical steps may help:
- Speak to your current doctor: Let them know you would like a second opinion. They can refer you, or share your records with another specialist.
- Gather your medical records: This includes your PSA results, scan reports, biopsy results and any letters about your diagnosis.
- Consider a specialist in a different treatment: For example, a urologist can advise on surgery, and a clinical oncologist can advise on radiotherapy.
- Prepare your questions: Think about what you would like the second opinion to help you with.
You can find out more about seeking a private second opinion with a consultant at Proton International London.
Discover more about proton beam therapy for prostate cancer
Proton International London is the UK’s only private proton beam therapy centre, located within the private patient unit at University College Hospital London. Our consultant clinical oncologists specialise in prostate cancer. They can talk you through whether proton beam therapy is suitable for you and how it compares with your other options. In some cases, treatment can be completed in five sessions.
You can read more about proton beam therapy for prostate cancer or make an enquiry to speak with our team.
