Prostate Cancer: Symptoms, Tests and When MRI May Be Needed

You may have noticed a change in the way you urinate. Perhaps a blood test has shown a raised PSA level, or prostate cancer has affected someone in your family.

It is natural to want a clear answer.

However, prostate cancer cannot be diagnosed from one symptom, blood result or scan. Urinary changes are common and are often caused by non-cancerous conditions. Early prostate cancer can also develop without causing noticeable symptoms.

Understanding what each prostate cancer test can and cannot show can help you take the most appropriate next step.

This guide explains prostate cancer symptoms, who may have a higher risk, how PSA testing works and when an MRI for prostate cancer may be recommended.

The prostate is a small gland located below the bladder. It surrounds part of the urethra, the tube that carries urine out of the body, and produces fluid that forms part of semen.

Prostate cancer develops when cells within the prostate begin growing in an uncontrolled way.

Some prostate cancers grow slowly and may not require immediate treatment. Others can grow more quickly or spread beyond the prostate.

Doctors therefore consider more than whether cancer cells are present. They may also need to understand the cancer’s location, grade and stage before discussing monitoring or treatment.

One of the most important things to understand about prostate cancer symptoms is that early disease often causes no symptoms.

The NHS explains that prostate cancer commonly begins in the outer part of the gland. This means it may not initially press against the urethra or affect urination.

When urinary symptoms do occur, they may include:

• Difficulty starting to urinate
• A weaker urine flow
• Needing to urinate more frequently
• Getting up several times during the night
• A sudden need to urinate
• Feeling that the bladder has not emptied fully
• Straining or taking longer to urinate
• Dribbling after urination

These symptoms do not automatically mean you have prostate cancer.

An enlarged prostate, prostatitis, a urinary infection and other bladder or prostate conditions can cause similar changes. However, new, persistent or worsening symptoms should still be discussed with a GP.

Prostate cancer that has grown beyond the prostate may sometimes cause:

• Blood in the urine or semen
• Problems getting or maintaining an erection
• Persistent pain in the back, hips or pelvis
• Unexplained weight loss
• Unusual tiredness

These symptoms can have several explanations. They should be medically assessed rather than interpreted on their own.

Ask for an urgent GP appointment or contact NHS 111 if you see blood in your urine, have pain when urinating or cannot urinate at all.

Anyone with a prostate can develop prostate cancer, but some factors increase the likelihood.

According to current NHS prostate cancer guidance, these include:

Increasing age

The risk increases with age, and prostate cancer mainly affects people over 50.

Ethnicity

Black men, including men from Black African and African Caribbean backgrounds, have a higher risk of developing prostate cancer.

Family history

Your risk may be higher if your father, brother or another close relative has had prostate cancer, particularly if they were diagnosed at a younger age.

A close family history of breast, ovarian or pancreatic cancer may also be relevant because some of these cancers can involve the same inherited gene variants.

Inherited gene variants

Changes in certain genes, particularly BRCA2, can increase prostate cancer risk.

Having one or more risk factors does not mean you will develop cancer. It means that a conversation about your individual risk and the possible benefits and limitations of testing may be useful.

Screening means testing people who do not have symptoms.

Following its March 2026 review, the UK National Screening Committee continues not to recommend population-wide prostate cancer screening.

However, it now recommends targeted PSA screening every two years for a specific higher-risk group:

• Men aged 45 to 61
• Who have a pathogenic BRCA2 gene variant
• And have a family history of breast, ovarian, pancreatic or prostate cancer

The way this group is identified and invited will continue to be evaluated. Availability may also vary across the UK.

Testing because you have symptoms or a personal risk concern is different from screening. Men and anyone with a prostate can ask a GP about PSA testing. The decision should consider individual risk, symptoms and the potential benefits and limitations of the test.

There is no single test that can independently diagnose or exclude prostate cancer in every situation.

Test or assessment	What it may help show	Main limitation
Medical and family history	Symptoms and personal risk factors	Cannot diagnose cancer
Urine test	Infection or another urinary cause	Does not test directly for cancer
PSA blood test	Changes affecting prostate health	A raised result does not automatically mean cancer
Digital rectal examination	Prostate size or an unusual texture	The whole prostate cannot be felt
Prostate MRI	Suspicious areas within and around the prostate	Cannot confirm cancer by itself
Prostate biopsy	Whether cancer cells are present	It is invasive and is not required in every case

The results are considered together rather than interpreted separately.

Bruxism, the habit of grinding or clenching the teeth, is one of the most frequent drivers of TMJ dysfunction. It often occurs at night without the person being aware of it. Over time, the repeated overloading of the jaw muscles and joint causes muscle fatigue, inflammation, and in some cases, displacement of the cartilaginous disc.The blood test most commonly associated with prostate cancer is the prostate-specific antigen test, usually called a PSA test.

PSA is a protein produced by prostate cells. It is normal to have some PSA in your blood.

A raised result may be associated with prostate cancer, but it can also be caused by:

• An enlarged prostate
• Prostatitis or inflammation
• A urinary infection
• Recent ejaculation
• Recent anal sex or prostate stimulation
• Vigorous exercise
• Cycling
• Recent prostate procedures

A high PSA does not confirm cancer. Your result must be considered alongside your age, symptoms, prostate size, family history, ethnicity and previous PSA results.

The NHS recommends avoiding ejaculation, anal sex, vigorous exercise and cycling for 48 hours before testing. These activities may temporarily increase PSA.

You can normally eat and drink as usual.

If you have had a urinary infection, the NHS advises waiting four to six weeks after the infection has cleared before having a PSA test.

VitalScan offers private blood tests in Milton Keynes, including a prostate-specific antigen option. If your result requires further investigation, it should be shared with your GP or another appropriate healthcare professional.

A raised PSA does not automatically mean cancer. Your GP or specialist may recommend repeating the test, reviewing other risk factors or arranging prostate imaging.

If you have already been advised to arrange MRI, you can explore VitalScan’s private prostate MRI scan.

People often assume a prostate cancer exam must include a digital rectal examination, or DRE.

During a DRE, a doctor or nurse gently inserts a gloved and lubricated finger into the rectum to feel part of the prostate. This may help identify enlargement, hardness or an unusual area.

However, the whole prostate cannot be examined this way. A prostate can also feel normal when cancer is present.

A DRE is not sufficient as a standalone screening test. It may still be offered when someone has urinary symptoms because it can provide information about an enlarged prostate or another prostate condition.

You do not have to undergo a DRE before requesting a PSA test. Your clinician should explain why the examination is being offered and how it may help.

If your PSA is raised or other findings suggest that the prostate requires closer assessment, you may be referred for an MRI.

The NHS specialist pathway commonly uses MRI to obtain a clearer view of the prostate and help determine whether further tests are needed.

MRI for prostate cancer may be used to:

• Look for suspicious areas
• Assess the size and structure of the prostate
• Examine tissues immediately surrounding it
• Help determine whether a biopsy may be appropriate
• Identify where biopsy samples should be taken
• Support monitoring or treatment planning
• Provide more information after an inconclusive investigation

Prostate imaging commonly uses multiparametric MRI, known as mpMRI. This combines different imaging sequences to examine the prostate in detail.

Some centres may use biparametric MRI, which uses fewer sequences. The correct protocol depends on the clinical question and imaging pathway.

MRI can show an area that looks suspicious, but it cannot confirm prostate cancer.

Only a biopsy can establish whether cancer cells are present because tissue samples must be examined under a microscope.

A prostate MRI can still provide valuable information. It may help some people avoid an unnecessary biopsy when the images and other clinical factors are reassuring. When a biopsy is needed, MRI can help the specialist target the relevant area.

MRI also has limitations:

• Not every prostate cancer is visible
• A suspicious area may turn out not to be cancer
• A reassuring scan does not automatically override a concerning PSA pattern
• A biopsy may still be recommended
• Results require specialist interpretation

The scan should be considered alongside the PSA level, PSA density, symptoms, medical history and individual risk.

A radiologist may give an area seen on prostate MRI a score from 1 to 5. You may hear this described as a PI-RADS or Likert score.

Score	General meaning
1–2	Clinically significant prostate cancer appears unlikely
3	The finding is uncertain
4–5	Clinically significant prostate cancer appears more likely

A higher score does not mean cancer has definitely been found. It means a specialist may recommend a biopsy or another assessment.

Similarly, a lower score does not guarantee that cancer is absent. Your complete risk profile must still be considered.

Prostate Cancer UK provides more information about prostate MRI scores and possible next steps.

Before the examination, you will complete an MRI safety assessment.

Tell the clinical team if you:

• Have a pacemaker or another medical device
• Have metal implants, clips or fragments
• Have had previous surgery
• Have kidney problems
• Have allergies or have reacted to MRI contrast
• Feel anxious in enclosed spaces

During the scan, you will lie on a moving bed while the images are taken. The examination should not be painful, but you will need to remain still and the scanner will make loud tapping and knocking sounds.

You will receive hearing protection and can communicate with the radiographer throughout the examination.

A prostate MRI usually takes around 30 to 40 minutes. Some scans require an injection of contrast to provide additional information, but contrast is not needed in every case.

MRI uses magnetic fields and radio waves rather than ionising radiation.

Read VitalScan’s guide on how to prepare for an MRI scan for more practical advice.

VitalScan provides private prostate MRI scans from its clinic in central Milton Keynes.

The service includes:

• MRI imaging of the prostate
• Clinical review of your booking information
• A full consultant radiologist report
• Access to your digital scan images
• Results within three to five working days
• Pre-scan and post-scan patient support
• Free and accessible parking

The clinic uses a Philips 1.5T BlueSeal MRI scanner with a wide 70 cm opening. The wider scanner design can feel less enclosed for some patients.

Depending on your examination and position, you may also be able to listen to music or watch entertainment during the scan.

You can read more about what to expect at VitalScan before your appointment.

If a healthcare professional has recommended prostate imaging, review the scan details, current price and what is included on the VitalScan prostate MRI page.

If you are uncertain whether prostate MRI is appropriate, contact the VitalScan team before booking.

Not everyone who has a prostate MRI will need a biopsy.

The decision may depend on:

• Your MRI score
• PSA level and changes over time
• PSA density
• Age and general health
• Family history and ethnicity
• Symptoms
• Previous MRI or biopsy findings

If a suspicious area is identified, the MRI can help the specialist decide where to take tissue samples.

A biopsy can confirm whether cancer cells are present and provide information about how they may behave. Cancer Research UK explains more about the prostate cancer testing and biopsy pathway.

If a biopsy confirms prostate cancer, further assessment may be needed to understand its stage and grade.

The stage describes where the cancer is and whether it has spread. The grade provides information about how the cells look and may behave.

MRI, CT, PET or bone scans may form part of staging. Your specialist team will use these results alongside the PSA level and biopsy findings to discuss monitoring or prostate cancer treatment.

Some slow-growing cancers are monitored rather than treated immediately. Other cases may require surgery, radiotherapy, hormone therapy or another specialist treatment.

Arrange a GP appointment if:

• You have persistent or changing urinary symptoms
• You are concerned about your personal risk
• A close relative has had prostate cancer
• You have a relevant inherited gene variant
• You have received a raised or changing PSA result
• You have persistent, unexplained back, hip or pelvic pain
• You notice blood in your semen

Ask for an urgent GP appointment or contact NHS 111 if you have blood in your urine, pain when urinating or cannot urinate at all.

A private scan should not delay urgent medical assessment or an NHS suspected-cancer referral.

A change in your urinary symptoms or PSA result does not automatically mean prostate cancer. It does mean that an appropriate assessment may help you understand what should happen next.

A prostate MRI can provide detailed images, identify areas that may require further investigation and help specialists decide whether a biopsy should be considered. However, MRI cannot independently confirm or completely exclude cancer.

If a clinician has recommended prostate MRI, you can arrange your scan at VitalScan’s private clinic in central Milton Keynes. Your images will be reviewed by a consultant radiologist, with the report and digital images usually available within three to five working days.

If a healthcare professional has recommended a prostate MRI, VitalScan offers private appointments at its central Milton Keynes clinic. Your scan will be reviewed by a consultant radiologist, with your report and digital images usually available within three to five working days.

Book your private prostate MRI today.

Not sure whether a prostate MRI is the right examination for you? Contact the VitalScan team and we will help you understand the available options before you book.

VitalScan’s diagnostic imaging services support clinical decision-making. They do not replace assessment, diagnosis or treatment from your GP, urologist or cancer specialist.