Metastatic Prostate Cancer: Step-by-Step Guide
Finding your footing after a metastatic diagnosis is overwhelming, but there is a clear path to follow in the UK. This guide explains the key tests, treatments, and decisions that shape careâand how to make the most of each step.
If youâre comparing options for metastatic prostate cancer treatment UK, use the framework below to prepare for appointments and plan next steps. When in doubt, bring a trusted friend or family member to consultations and take notes.
Tests That Shape Your Plan
After a confirmed metastatic diagnosis, your team will order imaging to map where the cancer has spread. You may encounter MRI, CT, bone scans, and increasingly PSMA PET-CT, which detects very small deposits of disease. These scans help doctors decide whether to focus on systemic therapy, targeted treatments, or symptom-led care first.
Ask about tumour and germline testing, especially if prostate or breast/ovarian cancers run in your family. Results can open doors to targeted drugs and clinical trials. If testing is not mentioned, request it explicitly using the phrase genetic testing BRCA prostate UK so your notes capture the request. Bring a concise list of all medicines and supplements, and ask for written information on likely side effects and monitoring schedules.
Starting Systemic Therapy
Most patients begin with hormone therapy (androgen deprivation) to lower testosterone, often combined with a modern anti-androgen such as abiraterone, enzalutamide, or apalutamide. Some men benefit from adding docetaxel chemotherapy early, particularly if thereâs a high disease burden. Your team will weigh fitness, symptoms, and personal preferences to select a first-line plan and explain how success will be tracked (PSA, scans, and symptom changes).
If your tumour shows homologous recombination repair (HRR) alterations, your clinician may discuss the combination olaparib abiraterone UK in appropriate settings. Keep a side-effect diary from day oneâenergy, mood, sleep, pain, and bowel habitsâso adjustments can happen quickly. Before you leave clinic, confirm who to contact for urgent issues, where blood tests will happen, and the timing of your first reassessment.
Questions to ask at this stage
- Whatâs the goal of treatment right nowâcontrol, symptom relief, or both?
- Which tests will show itâs working, and when will we check?
- What are my alternatives if this plan isnât tolerated?
- Can I be referred for a supportive care review (fatigue, nutrition, mood)?
Considering PSMA radioligand therapy UK and Advanced Options
If your scan shows strong PSMA uptake and your prior treatments are no longer working, your team may discuss PSMA-targeted radioligand therapy. This treatment delivers radiation directly to PSMA-expressing cancer cells and is given in cycles with blood tests and imaging to monitor response. It can reduce pain and lower PSA for many suitable patients, and eligibility depends on scan findings, kidney/bone marrow function, and prior therapies.
Trials can expand your choices at many stages of care. When youâre ready to explore them, ask explicitly about NHS prostate cancer clinical trials and request a referral to a trials unit if appropriate. Keep a simple comparison sheetâtreatment purpose, visit schedule, main risks, and any travel/time commitmentsâso the decision is based on both medical fit and personal practicality. If private options are on the table, ensure your NHS notes are shared promptly to avoid repeating tests.
Step 4: Managing Symptoms, Appointments, and Daily Life
Bone health and pain control are central to living well with metastatic disease. Ask whether youâre a candidate for radiotherapy for bone metastases UK to target painful spots, and discuss bone-strengthening medicines such as bisphosphonates or denosumab if recommended. Donât wait on painâeffective regimens may include long-acting and breakthrough medications alongside bowel care and sleep strategies.
Organise your care so you stay in control:
- Use a one-page treatment summary with current drugs, doses, allergies, and key contacts.
- Block out scan and blood-test weeks in your calendar to reduce clashes with work or family plans.
- Consider âsecond opinion oncology UKâ if you want confirmation of the plan or access to specialised services.
- Connect with support groups (e.g., hospital-based programmes, Prostate Cancer UK, Macmillan) for practical advice on work, benefits, and caregiving.
Nutrition, activity, and mental health matter. Gentle strength and mobility work can help counter fatigue and muscle loss; a registered dietitian can personalise advice around weight changes, appetite, and treatment interactions. If low mood or anxiety persists, ask your GP or CNS about counselling or community servicesâemotional health is part of treatment, not a luxury.
Putting It All Together
Metastatic care is a sequence of decisions rather than a single choice. Start with a strong diagnostic foundation, keep communication lines open, and revisit goals as life evolves. Whether youâre exploring metastatic prostate cancer treatment UK, looking at PSMA radioligand therapy UK, or considering genetic testing BRCA prostate UK, the right plan is the one that fits your biology and your priorities. Speak with your oncology team today about NHS prostate cancer clinical trials and whether olaparib abiraterone UK or other targeted options belong in your pathway.