Prostate cancer: find out your risk in 30 seconds - and the Gleason score explained

Prostate cancer is the most common cancer in men in the UK and more than half a million are living with it or after it. It's back in the headlines again after former US president Joe Biden was diagnosed with an aggressive form of the disease that has spread to his bones.

Early detection is key as almost everyone who’s diagnosed at stage one or two (when the cancer is contained within the prostate gland) will survive for five years or more.

Six-time Olympic cycling champion Sir Chris Hoy had no symptoms when he was diagnosed with stage four prostate cancer last year and he is calling on more men to take a simple 30 second test to check their risk - and potentially save their lives.

The Gleason score, grades and stages of prostate cancer

Prostate cancer is normally measured and described in stages or grades.

The stages of prostate cancer

The TNM system is a way of staging prostate cancer. It stands for Tumour, Node, Metastasis. Staging describes the size of the cancer and how far it has grown.

The stage describes how much cancer there is and how far it has spread. It goes from stage one where the cancer has not spread outside the prostate gland to stage four where the cancer has spread to other parts of the body.

The Grade Group or Gleason score

The Gleason score, or Grade Group, refers to how samples of the cancer cells look when compared to normal prostate cells. 

The pathologist grades each sample of prostate cancer cells based on how quickly they are likely to grow or how aggressive the cells look. 

Joe Biden has a Gleason score of 9 (Grade Group 5) which means his cancer is 'high grade' and the cells could spread quickly.

Staging and grading of cancer is important for deciding how to treat the disease and for determining how curable it is.

What's my risk of prostate cancer?

One in eight men will get it: over-50s are most affected and your risk increases with age.

The cause is unknown and symptoms don’t usually appear until the prostate becomes enlarged and affects the tube that carries urine from the penis (urethra) or the cancer has spread outside of the prostate.

Anyone with a prostate could get it, including trans women and non-binary people who were assigned male at birth and some intersex people.

Factors such as family history could put you at a higher risk, particularly if your father or brother had prostate cancer or your mother or sister had breast cancer.

Ethnicity affects your risk too – it’s more common in Black men compared with other ethnic backgrounds (one in four Black men will be diagnosed with prostate cancer in their lifetime). The reason why is not yet known.

Prostate cancer facts

• Prostate cancer is the most common cancer in men in the UK, and now the most common cancer in England.
• Data from the NHS in England revealed in January 2025 shows that 50,751 men were diagnosed with prostate cancer in England in 2022, and 55,033 men in 2023. Prostate Cancer UK also says that prostate cancer cases shot up by a quarter (25%) between 2019 and 2023.
• Across the UK today, one in eight men will get prostate cancer, and if you are Black your risk is double (one in four). There’s estimated to be 510,000 men living with or after prostate cancer in the UK.
• When it comes to prostate cancer, earlier diagnosis saves lives. But right now, more than 21,000 men are diagnosed at stage three and four (later stages) every year.
• Sadly, more then 12,000 men die from prostate cancer every year.

(Source Prostate Cancer UK)

What’s my risk of prostate cancer?

One in eight men will get it: over-50s are most affected and your risk increases with age.

The cause is unknown and symptoms don’t usually appear until the prostate becomes enlarged and affects the tube that carries urine from the penis (urethra) or the cancer has spread outside of the prostate.

Anyone with a prostate could get it, including trans women and non-binary people who were assigned male at birth and some intersex people.

Factors such as family history could put you at a higher risk, particularly if your father or brother had prostate cancer or your mother or sister had breast cancer.

Ethnicity affects your risk too – it’s more common in Black men compared with other ethnic backgrounds (one in four Black men will be diagnosed with prostate cancer in their lifetime). The reason why is not yet known.

Symptoms of prostate cancer

Amy Rylance, head of improving care at Prostate Cancer UK, said: “Prostate cancer often has no symptoms in its early, more treatable stages – so a man could feel fit and well while unknowingly living with the disease."

“That’s why it’s so important to understand your level of risk, which is higher for all men over 50. If you’re Black, or your dad or brother had the disease, the risk is even greater, so we strongly recommend you speak to your GP from the age of 45.

"Some prostate cancers grow slowly and you might not notice symptoms for many years, so it’s important to know if you’re at risk and what you can choose to do about it.”

See your GP if you have any of these common symptoms

Whilst you should not watch and wait for symptoms before discussing your prostate cancer risk with your GP, if you do experience any of the following it is best to contact your GP immediately.

• Needing to urinate more often than usual, especially at night
• Feeling the need to urinate, but having difficulty getting started
• A weak flow
• A sudden need to urinate
• A feeling that your bladder hasn’t emptied
• Blood in your urine or semen 

Nothing to be embarrassed about

Because early stage prostate cancer doesn’t often show any symptoms, it’s important to be aware of your risk.

Awareness of the disease has been increased most recently by Sir Chris Hoy and by celebrities including Stephen Fry, Sir Ian McKellen and Nile Rodgers, talking openly about being diagnosed.

In the week following much-loved TV presenter Bill Turnbull’s death from the disease in August 2022, Prostate Cancer UK saw a 2,500% increase in people using the risk checker, and the charity noticed the “Fry-Turnbull” effect causing a similar spike in referrals.

Then when it was announced in 2024 that King Charles was undergoing a procedure for an enlarged prostate, the NHS said searches soared - with its website receiving 11 times the normal daily visits.

Nothing to be embarrassed about

Because early stage prostate cancer doesn’t often show any symptoms, it’s important to be aware of your risk.

Awareness of the disease has been increased most recently by Sir Chris Hoy and by celebrities including Stephen Fry, Sir Ian McKellen and Nile Rodgers, talking openly about being diagnosed.

In the week following much-loved TV presenter Bill Turnbull’s death from the disease in August 2022, Prostate Cancer UK saw a 2,500% increase in people using the risk checker, and the charity noticed the “Fry-Turnbull” effect causing a similar spike in referrals.

Then when it was announced in 2024 that King Charles was undergoing a procedure for an enlarged prostate, the NHS said searches soared - with its website receiving 11 times the normal daily visits.

How to help prevent prostate cancer

Prostate cancer is not a “lifestyle cancer” (e.g lung cancer is connected with the lifestyle choice of smoking),and no one knows right now how to prevent it.

However Prostate Cancer UK suggests that a healthy diet and regular exercise are important for health, and might help lower your risk of being diagnosed with advanced or aggressive prostate cancer. 

Measures that could help include

• Maintaining a healthy weight
• Staying physically active
• Eating a healthy diet, including at least five portions of fruit and vegetables a day; limiting caffeine and sugary drinks, and minimising your intake of saturated fat, salt and sugar
• Cutting down on red and processed meat: eat no more than 70g a day
• Stopping smoking: smoking is linked to aggressive prostate cancer, but if you quit your risk is lower after ten years.

What can I do to prevent prostate cancer?

Prostate cancer is not a “lifestyle cancer” (e.g lung cancer is connected with the lifestyle choice of smoking),and no one knows right now how to prevent it.

However Prostate Cancer UK suggests that a healthy diet and regular exercise are important for health, and might help lower your risk of being diagnosed with advanced or aggressive prostate cancer. 

Measures that could help include

• Maintaining a healthy weight
• Staying physically active
• Eating a healthy diet, including at least five portions of fruit and vegetables a day; limiting caffeine and sugary drinks, and minimising your intake of saturated fat, salt and sugar
• Cutting down on red and processed meat: eat no more than 70g a day
• Stopping smoking: smoking is linked to aggressive prostate cancer, but if you quit your risk is lower after ten years.