Urological cancers
Cancer types
Prostate cancer
Prostate, kidney, bladder (including kidney pelvis and ureter), testicular and penile cancers.
Prostate, kidney, bladder (including kidney pelvis and ureter), testicular and penile cancers.
This map explains prostate cancer step by step: what it is, the types, the tests, the stages, the treatment and its side effects.
Tap any topic on the map to read about it. Topics with an arrow open more topics.
Almost all prostate cancers are adenocarcinoma. What matters most is the grade. Tap a topic on the map.
| Grade group | Gleason score | What it means |
|---|---|---|
| 1 | 6 (3+3) | Very slow growing |
| 2 | 7 (3+4) | Slow growing |
| 3 | 7 (4+3) | Moderately fast |
| 4 | 8 | Fast growing |
| 5 | 9 or 10 | Fastest growing |
Why this matters: the grade, PSA and stage together give the risk group, which decides whether treatment is needed and how much.
Small cell or neuroendocrine prostate cancer is rare and fast growing, often with a low PSA. It is treated with chemotherapy rather than hormone treatment.
Tap a test on the map to see why it is done.
Please wait for all the reports. Why we wait
A protein made by the prostate. A raised level can mean cancer, but also infection or enlargement. Used for diagnosis and to follow treatment.
Shows suspicious areas in the prostate and guides the biopsy. Also shows whether the cancer has grown outside the prostate.
Small samples taken with a needle (through the skin behind the scrotum or through the back passage). Gives the Gleason score.
Checks for spread to lymph nodes and bones in intermediate and high-risk cancer. PSMA PET-CT is more sensitive than a bone scan and CT.
In high-risk or metastatic cancer, or with a strong family history: a test for inherited mutations (such as BRCA2). It can open options like PARP inhibitors, and helps the family. Hereditary cancers
Before starting chemotherapy, immunotherapy or targeted therapy, these tests check that you are fit for treatment, and give a starting point to compare with later.
| Test | Why it is done |
|---|---|
| CBC (complete blood count) | Haemoglobin, white cells and platelets. Treatment can lower them. |
| RFT (kidney function) | Many medicines are cleared by the kidneys; the dose may need to change. |
| LFT (liver function) | Many medicines are processed by the liver. |
| Viral markers: HBsAg, anti-HCV, HIV | Hepatitis B can flare up during treatment. If positive, a tablet is given to prevent this. |
| Blood sugar (and HbA1c if diabetic) | Steroids given with chemotherapy can raise blood sugar. |
| ECG and 2D Echo | Check the heart rhythm and pumping before treatment, as some medicines affect the heart. |
Before immunotherapy, also:
| Test | Why it is done |
|---|---|
| Serum TSH (thyroid) | Immunotherapy can affect the thyroid gland. |
| Serum cortisol (morning sample) | Immunotherapy can affect the adrenal and pituitary glands. |
Sometimes needed, depending on your treatment:
Your doctor will choose the tests that apply to you. Some of them are repeated during treatment.
For prostate cancer, doctors use risk groups and whether it has spread. Tap yours on the map.
Grade group 1, PSA below 10, small cancer limited to the prostate. Usually no treatment needed immediately.
Grade group 2 or 3, or PSA 10 to 20. Limited to the prostate. Curable.
Grade group 4 or 5, PSA above 20, or grown outside the prostate or to nearby lymph nodes. Still curable in many.
Spread to bones, distant lymph nodes or other organs. Not curable, but treatment controls it for many years. Called hormone-sensitive at first, and castration-resistant when hormone treatment stops working.
Tap your risk group on the map.
Side effects: surgery · radiotherapy · hormone treatment
Side effects: radiotherapy · hormone treatment · abiraterone
Tap the situation on the map.
Side effects: hormone treatment · newer hormone tablets · chemotherapy
Side effects: chemotherapy · newer hormone tablets
Tap a treatment on the map.
New back pain with weakness or numbness in the legs, or loss of bladder or bowel control can mean pressure on the spinal cord: go to the emergency department immediately. Also: inability to pass urine, fever, or bone pain that suddenly gets much worse.
This information is general. Your own treatment plan may be different. Please discuss it with your doctor.
Written and medically reviewed by Dr Prathyusha Eaga, MD, DM (Medical Oncology). Last reviewed: 12 October 2026. Based on NCCN and ESMO guidelines.
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