Prostate cancer is one of the most common cancers affecting men — and understandably, a diagnosis (or even the worry of one) causes real anxiety. But as a urologist and robotic surgeon, I want to open with a genuinely reassuring truth: prostate cancer is often slow-growing, and when detected early, it is one of the most treatable and curable cancers there is. The challenge is that it usually causes no symptoms in its early stages — which is exactly why awareness and timely screening are so important. In this guide, I’ll explain the symptoms, the PSA test, and the modern treatment options available today.

What is prostate cancer?

The prostate is a small gland below the bladder that surrounds the urethra and helps produce semen. Prostate cancer develops when cells in the gland begin to grow uncontrollably. Importantly, not all prostate cancers behave the same way — many grow so slowly that they may never cause harm, while others are more aggressive and need prompt treatment. A key part of my job is distinguishing between the two, so that each man receives exactly the care he needs — no more, no less.

Symptoms of prostate cancer

In its early stages, prostate cancer usually has no symptoms at all. When symptoms do appear — often as the cancer grows — they resemble those of an enlarged prostate and may include:

• A weak or interrupted urine stream
• Frequent urination, especially at night
• Difficulty starting or stopping urination
• Pain or burning while urinating
• Blood in the urine or semen
• Erectile difficulties
• Pain in the lower back, hips, or pelvis (if the cancer has spread to the bones)

Because early cancer is silent, waiting for symptoms is not a reliable strategy — which brings us to screening.

Prostate cancer vs an enlarged prostate (BPH)

This is a common source of confusion. An enlarged prostate (BPH) is a benign, non-cancerous condition that is extremely common with age, and it causes very similar urinary symptoms. So having these symptoms does not mean you have cancer — most often it’s BPH. However, because the symptoms overlap, the only way to be sure is a proper evaluation, including a PSA test and examination.

Who is at risk?

The main risk factors are age (risk rises significantly after 50), a family history of prostate cancer, ethnicity, and factors such as obesity and diet. If your father or brother had prostate cancer, your own risk is higher, and earlier screening is wise.

The PSA test and screening

The PSA (Prostate-Specific Antigen) blood test, along with a digital rectal examination (DRE), is the main screening tool. I generally recommend that men consider screening from around age 50 — or from 45 if they have a family history or other risk factors. One important point I always explain: a raised PSA does not automatically mean cancer. PSA can also be elevated by an enlarged prostate, a urine infection, recent ejaculation, or even long-distance cycling. That’s why an elevated result is interpreted carefully and followed by further tests rather than causing panic.

How is prostate cancer diagnosed?

If screening raises concern, I use a step-by-step approach: repeating the PSA, an MRI of the prostate (which helps target any suspicious area), and, if needed, a prostate biopsy to confirm the diagnosis. The biopsy also gives us the Gleason score (grade), which tells us how aggressive the cancer is — crucial information for planning treatment. Further staging scans determine whether it has spread.

Treatment options

Treatment is always tailored to the stage, grade, your age, and your overall health:

• Active surveillance — for low-risk, slow-growing cancers, we may simply monitor closely with PSA, MRI, and biopsies, avoiding unnecessary treatment and its side effects.
• Surgery (radical prostatectomy) — removing the prostate, which can cure localised cancer.
• Radiation therapy — external beam radiation or brachytherapy (implanted seeds), equally effective for localised disease.
• Hormone therapy — reduces testosterone (which fuels prostate cancer), used for advanced or locally advanced disease.
• Systemic treatments — for cancer that has spread.

Robotic radical prostatectomy: precision treatment

For men who need surgery, this is where modern technology makes a real difference. Robotic-assisted radical prostatectomy allows me to remove the prostate through a few tiny incisions with exceptional precision. The magnified, 3D view and fine robotic control enable careful nerve-sparing — which is important for preserving urinary continence and erectile function — along with less blood loss, less pain, and a faster recovery than open surgery. For the right patient, it offers an excellent balance of cancer cure and quality of life.

The good news: early detection saves lives

I’ll end where I began — with hope. When prostate cancer is caught early and is still confined to the prostate, the outlook is excellent, with very high cure rates. The men who face the toughest battles are usually those diagnosed late. So please, if you’re over 50 (or over 45 with a family history), talk to a urologist about a simple PSA test — and never ignore persistent urinary symptoms.

Expert prostate cancer care at Dr. Ashish Gupta’s clinic

With over 15 years of experience and specialised training in robotic uro-oncology, I provide accurate diagnosis, honest guidance, and advanced treatment for prostate cancer — from active surveillance to robotic surgery. I consult at Holy Spirit and Sanjeevani Mamta Hospitals in Andheri East and All Cure Hospital, Jogeshwari, with cashless facilities available.