Cancer types · Common solid tumours
Prostate Cancer
Prostate cancer ranges from slow-growing disease that may be monitored to advanced cancer that needs active treatment. Grade (Gleason score or grade group), PSA and imaging help describe the disease.
In advanced prostate cancer, testing for alterations in DNA-repair genes, such as BRCA2, has become more important, and some of these findings are inherited.
Clinical and molecular questions that often arise
- What do the grade group, PSA trend and imaging show about the extent of disease?
- Has tumour or germline testing for homologous-recombination repair (HRR) genes been done in advanced disease?
- Could an inherited variant be relevant to relatives, including female relatives?
- For rising PSA after treatment, what new information would help the next discussion?
Information that may be part of an individual assessment
- PSA testing and trends over time.
- Biopsy with grade group.
- MRI and other imaging, which may include PSMA-PET where available.
- Tumour and germline testing in advanced disease where indicated.
Which investigations are appropriate is decided by the treating team for each person.
Molecular profiling and biomarker interpretation
Depending on the setting, molecular and biomarker questions in prostate cancer may involve:
- BRCA2, BRCA1, ATM, CDK12, PALB2 and other HRR genes
- MSI-high or MMR-deficient status (uncommon)
- PSA kinetics
Biomarkers, panels and available tests vary by subtype, disease setting, assay and guideline version. A detected alteration is not automatically actionable.
How KPCIRC pathways may apply
POAS
POAS may help interpret a tumour or plasma report in advanced prostate cancer, separating HRR findings with prostate-specific evidence from findings of uncertain significance, and flagging where germline confirmation is relevant.
Molecular Tumour Board
MTB discussion may help when imaging and PSA trends disagree, when molecular results raise therapeutic questions, or when the disease course changes.
Second opinion and progression review
A second opinion may be considered when choosing between monitoring and active treatment, or when a proposed plan needs clarification. Progression review can organise PSA, imaging and treatment history.
Hereditary risk and screening
Inherited variants in genes such as BRCA2, BRCA1 and HOXB13, and Lynch-syndrome genes, may increase prostate-cancer risk and can matter to both male and female relatives. PSA-based screening involves weighing potential benefits against harms such as overdiagnosis; a risk assessment can help structure that conversation.
How to access the relevant pathway
Patients and families
- Talk to your treating oncologist about whether an additional review may help.
- Request a consultation and tell us which question you want answered.
- Share records only when asked, through the secure route.
Referring doctors
- Define the clinical question and the pathway: POAS, MTB, second opinion or progression review.
- Start a case enquiry without patient identifiers.
- Scope, fees and timing are confirmed before any review proceeds.
Questions and limitations
Is a high PSA the same as cancer?
No. PSA can rise for other reasons. It is one piece of information that a clinician interprets with examination, imaging and, where needed, biopsy.
Why would a man’s genetic result matter to his daughters?
Some genes linked to prostate cancer, such as BRCA2, are also linked to breast and ovarian cancer risk. Genetic counselling explains what a result may mean for the family.
Does this page apply to my situation?
This page is educational. It explains common questions but cannot account for individual circumstances. Your treating clinician is best placed to interpret your reports and plan your care.
Educational content reviewed against the KPCIRC service scope. It is not a diagnosis, a treatment recommendation or a statement that a specialist or service is available for this cancer type.