Understanding Prostate Cancer
- Ed Matthews, a 58-year-old father and investment banker from the U.K., initially though his frequent nighttime urination was from drinking too much fluid before bed, but a routine PSA test and follow-up exams revealed early-stage prostate cancer.
- After undergoing robotic surgery, he is now cancer-free and sharing his story to raise awareness about the importance of regular checkups and early detection.
- Prostate cancer screening may often involve a digital rectal exam and prostate-specific antigen test. This test measures the level of PSA in the blood, and higher levels can indicate cancer. Most cancer diagnoses are caught with screening.
- The prostate cancer treatment plan is based on whether the cancer is considered low, intermediate, or high risk. The risk level is assessed after your doctor evaluates test results.
- Prostate cancer treatment may include surgery, radiation, and/or hormonal therapy. Each treatment method comes with potential side effects such as sexual dysfunction and urinary incontinence.
- Surgery is not needed for all men diagnosed with prostate cancer. In some cases, active surveillance is a preferred treatment option for older men or those with a low risk of the disease spreading.
It’s important to note that frequent urination doesn’t necessarily mean one has prostate cancer. It could indicate other types of health issues, like Benign Prostatic Hyperplasia (BPH), when the prostate gland is enlarged. An overactive bladder, medications, kidney conditions, a Urinary Tract Infection (UTI), or bladder issues can also cause a constant need to urinate.
Read MoreNow 58, he’s sharing his story in hopes of spreading awareness for the disease, which he was diagnosed with after a routine doctor’s appointment in April 2025, a checkup which followed nearly a year of frequent nighttime urination.
Matthews, who considered himself “fit and healthy” prior to his shocking diagnosis, said a routine Prostate-Specific Antigen (PSA) test result of 4.2.
The PSA test ultimately lead his doctor to recommend a consultation with a urologist as a precaution.
RELATED: What Happens if My PSA Test is Elevated?
After an MRI scan and a biopsy, he was diagnosed three weeks later, a time when he admits to having minimal knowledge of the disease.
Two months later he had his prostate removed through robotic surgery. Robotic prostate surgery, also called robot-assisted radical prostatectomy, uses small instruments controlled by a surgeon from a robotic console. Despite the name, there’s no autonomous robot — it’s your surgeon’s hands at work, just with more dexterity and control.
It’s important to note that not everyone with prostate cancer needs surgery. For those who do, typically men with localized disease, robotic surgery is often preferred over traditional open surgery.
You might be eligible if:
- Your cancer is confined to the prostate (stages I and II)
- You are healthy enough to undergo surgery (e.g., you don’t have severe heart failure or recent stroke)
- You want a definitive treatment with curative intent
Expert Resources On Prostate Cancer
- There’s No One Definitive Symptom for Prostate Cancer, But There Are Clues
- Don’t Believe the Hype: Do Your Own Research on Prostate Cancer Treatment
- ‘Early Detection Can Be the Key’: National Guard Vet & Prostate Cancer Survivor Urges Others to Get Screened
- Myth-Busting — Prostate Cancer Screening: Understanding PSA, Digital Exams & Family Risk
- The PSA Blood Test and a Rectal Exam are Vital for Prostate Cancer Screening
- Could A Urine Test Be The Future of Prostate Cancer Screening? Leading Experts Weigh In
Grateful to have beaten prostate cancer after surgery, Matthews, who is set to run the London Marathon, told SWNS, “It makes you reappraise everything – friends, family, relationships, work.
“It’s like a total reset. You kind of figure out what’s important in life.”
Matthews has also created a Just Giving page to raise money for Prostate Cancer UK’s TCS London Marathon 2026 Team, said on his crowdfunding page, “Last July, I underwent 3.5 hours of robotic surgery to remove my prostate. The best news followed: the cancer was contained. It hadn’t spread. My PSA is now negligible.
“For now, I am cancer free — words I will never take for granted. I know how lucky I am. I caught this early because I have access to annual health checks through work. Many men aren’t as fortunate.”
There’s No One Definitive Symptom for Prostate Cancer, But There Are Clues
He continued, “In 2015, I ran the New York Marathon and swore I’d never do another. But this diagnosis gave me a new purpose.
“I’m running for the men who won’t get the early call I did. I’m running so more families get good news. If my story persuades even one man to get checked, it will have been worth it.”
What Are the Current Prostate Cancer Screening Guidelines?
The Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) both recommend that men at average risk between the ages of 55 and 69 years talk with their doctor about the pros and cons of prostate cancer screening.
The American Cancer Society recommends that men at age 50 who are at average risk should begin screening. Men who are at high risk of prostate cancer should begin screening at age 45. Men with a close relative diagnosed with prostate cancer should consider annual screening at 40.
For men 70 years and older, the USPSTF and the CDC say potential benefits do not outweigh the expected harms and recommend that men 70 and older should not be routinely screened for prostate cancer.
How Is Prostate Cancer Staged?
The National Comprehensive Cancer Network (NCCN) guidelines divides prostate cancer into one of six risk categories based on how aggressive the cancer looks under the microscope and the chance of it coming back after treatment. These risk categories help guide treatment for the different subtypes of prostate cancers.
The main risk categories for prostate cancer are:
- Very-Low-Risk (VLR) and Low-Risk (LR)
- Favorable- (FIR) and Unfavorable-Intermediate-Risk (UFIR)
- High-Risk (HR) and Very-High-Risk (VHR)
Very-Low-Risk and Low-Risk Prostate Cancers
Prostate cancers classified as VLR or LR represent the least aggressive forms of cancer. This categorization will be diagnosed depending on number of factors, including:
- Your doctor can’t feel the cancer on a physical exam, or it occupies one-half or less of one side of the prostate
- Your PSA is less than 10
- Your total Gleason score is 6
If your cancer is categorized as VLR or LR, your doctor may recommend active surveillance, another name for “watch-and- wait.”
What is Active Surveillance?
Why consider active surveillance? The most common and effective treatments for prostate cancer are radiation therapy and surgery.
Despite their effectiveness, these treatments are associated with side effects. Specifically, radiation can cause erectile dysfunction, urinary frequency and urgency, and changes in bowel habits. Surgery also causes erectile dysfunction but also can cause urinary incontinence and urinary leakage.
Given that these side effects can significantly impact the quality of life it is important to only treat prostate cancer when it is necessary to avoid these potential complications.
How Is Prostate Cancer Surgery Performed?
The goal of prostate cancer surgery is to remove the prostate gland and surrounding tissues (such as seminal vesicles) to eliminate cancer. This procedure is called a radical prostatectomy.
It can be performed using two primary approaches:
- Open radical prostatectomy, where the surgeon makes one large incision to access the prostate
- Minimally invasive (robot-assisted laparoscopic) prostatectomy, where small incisions and robotic instruments are used for the same purpose
Regardless of the technique, the surgery also involves cutting and rejoining the urethra and bladder neck. In some cases, nearby lymph nodes are removed for cancer staging. Nerve-sparing techniques may be used if possible, to preserve erectile function.
What Is A Robotic Prostatectomy?
A robotic-assisted laparoscopic prostatectomy (RALP) is a minimally invasive procedure that uses a robotic surgical system, such as the da Vinci® Surgical System. The surgeon operates from a console, controlling robotic arms that hold surgical instruments and a high-definition 3D camera.
Tiny incisions (usually 5-6) are made in the lower abdomen to insert the instruments. The robotic system translates the surgeon’s hand movements into precise actions inside the patient’s body. The camera provides magnified views that help in identifying nerves and structures crucial to continence (bladder and bowel control) and sexual function.
This technique has become the most common method for prostate removal in the United States and other parts of the world, primarily due to its precision and potentially quicker recovery times.
Who is a Candidate for Active Surveillance?
Not all men with prostate cancer are potential candidates for active surveillance. Active surveillance is only recommended for men with low-risk prostate cancer who are capable and willing to follow a very close and active follow-up schedule. Low-risk prostate cancer is slow growing and is biologically less aggressive compared with higher-risk prostate cancer.
“With low-risk prostate cancer, your risk of cancer getting out of the prostate and spreading to other parts of the body is really, really low,” Dr. Stephen Freedland, a urologist at Cedars-Sinai Medical Center, previously told SurvivorNet when discussing the topic.
RELATED: People With Low-Risk Prostate Cancer Can Rely on Monitoring the Disease
Men who have low-risk cancer can choose this approach and avoid the potential complications that come with treatment with surgery and radiation. Because the risk of the cancer spreading outside of the prostate is extremely low in men with low-risk disease, this approach is an effective option for men.
Active surveillance includes a PSA test, rectal exam and high-quality imaging tests, which can identify minuscule yet important changes.
When Is Active Surveillance Not Enough?
If you have been diagnosed with moderate-risk cancer, it can be a slippery slope. Something about the cancer isn’t low grade enough to be considered low risk, and many men choose to begin active treatment at this point. Active treatment involves removing the entire prostate, radiation or cryotherapy.
Bottom line, active surveillance is only a great option for men with low-risk prostate cancer who can follow a very active follow-up protocol. Active surveillance allows about 50 percent of men to avoid over-treatment and side effects.
The protocol is designed to identify early signs of cancer growth or an increase in aggressiveness and these factors will indicate treatment is necessary.
Questions for Your Doctor
If you have experienced symptoms associated with prostate cancer or have a screening coming up, here are some questions you may ask your doctor:
- If I have elevated PSA levels, what could be causing that besides cancer?
- How long will it take to learn if my PSA levels warrant further testing?
- What are the treatment options that are best suited for me based on my risk level?
- What financial resources exist to help me with the costs associated with treatment?
- How long will my potential treatment prevent me from working or continuing normal activities?
Contributing: SurvivorNet Staff
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