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Prostate cancer is the abnormal growth of cells in the prostate gland. (The prostate is part of the male reproductive system. It is a small organ below the bladder that makes fluid for semen.)
Most cases of prostate cancer occur after age 65. It usually grows slowly and can take years to grow large enough to cause any problems.
In some cases, the cancer grows more quickly. It may spread within the prostate, to nearby lymph nodes and other tissues, and to other parts of the body. But usually prostate cancer is found early, before the cancer has spread outside the prostate.
Experts don't know exactly what causes prostate cancer. But they do know that changes in the body's DNA are involved. These include DNA changes that are inherited as well as those that happen as you get older.
Prostate cancer usually doesn't cause symptoms in its early stages. When there are symptoms, they are most often problems with urinating. You may also have deep and frequent pain in your lower back, belly, hip, or pelvis.
Your doctor may check for prostate cancer with a blood test called a prostate-specific antigen (PSA) test. And you will probably have a digital rectal exam. If your PSA level is high, you'll likely have more tests to find the cause. A prostate biopsy is needed to confirm a diagnosis of prostate cancer.
Treatment for prostate cancer is based on the stage of the cancer, your Gleason score, and other things, such as your age and overall health. The main options are active surveillance, radiation therapy, and surgery to remove the prostate. Active surveillance may be recommended for slow-growing cancer that's confined to the prostate.
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The prostate usually gets larger as you age. Having an enlarged prostate doesn't increase your chance of getting prostate cancer. But an enlarged prostate is sometimes caused by prostate cancer.
Some things can increase your chances of getting prostate cancer. These risk factors include:
Getting older is the main risk factor for prostate cancer. Most cases occur after age 65.
Your chances of getting the disease are higher if someone in your family has had it. Your risk also depends on the age at which your relative was diagnosed.
Prostate cancer is more common among African-American people than people of other races.
There are some risk factors for prostate cancer that you can't control, such as getting older or inheriting certain gene changes. But you may be able to help lower your risk for prostate cancer (and some other cancers) by staying at a healthy weight, being active, and not smoking.
Prostate cancer usually doesn't cause symptoms in its early stages. Most people don't know they have it until it is found during a regular medical exam.
When there are symptoms of prostate cancer, they often include urinary problems, such as:
Less common symptoms may include:
Prostate cancer usually grows slowly. It usually takes years to get large enough to cause any problems. But sometimes it grows quickly. When prostate cancer spreads beyond the prostate, it goes first to the lymph nodes in the pelvis, and then on to the bones, lungs, or other organs.
About 12 out of 100 men in the U.S. will be diagnosed with prostate cancer sometime during their lifetime.footnote 1 But most people who are diagnosed with prostate cancer don't die from it.
Prostate cancer begins inside the prostate gland. Usually this cancer grows so slowly that it may never cause a problem during a person's life. But in some cases, it grows more quickly, spreading into nearby tissues, such as the lymph nodes or seminal vesicles, and to other areas of the body.
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Your doctor will ask you about your family history and your medical history. You will have a physical examination that includes a digital rectal exam, in which the doctor inserts a gloved finger into your rectum to feel your prostate.
Tests that may be used to check for prostate cancer include:
The main screening test for prostate cancer is the prostate-specific antigen (PSA) test. It's a blood test that measures how much PSA is in your blood. And you will probably have a digital rectal exam. A high PSA level may mean that you have an enlarged prostate, an infection or, less often, prostate cancer.
The prostate-specific antigen (PSA) test can help find prostate cancer early. But experts recommend that you discuss the benefits and risks of the test with your doctor before you decide whether to have this test. It may not help you live any longer than if you had no screening. And it could lead to harmful treatments that you don't need.
Talk with your doctor about your health, your risk factors for prostate cancer, and the pros and cons of PSA testing.
Treatment for prostate cancer is based on the stage of the cancer, your Gleason score, and other things, such as your age and overall health. The main options are active surveillance, radiation therapy, and surgery to remove the prostate. Hormone therapy is sometimes given along with radiation therapy or surgery. Other treatments may be used, such as chemotherapy and immunotherapy.
Your doctor will talk with you about your options and then make a treatment plan. Some people choose watchful waiting instead of treatment.
Some people use complementary therapies along with traditional medical treatment. These therapies may help you cope with the symptoms and stress of cancer. For example, acupuncture may help reduce hot flashes caused by hormone therapy. Talk with your doctor about any of these options you would like to try.
This may be an option if the cancer is slow-growing and confined to the prostate (localized). With active surveillance, you'll have regular checkups and tests, but you won't have treatment unless the cancer grows.
Treatments such as surgery or radiation can cause serious side effects. Active surveillance lets you avoid or postpone treatment and its side effects. Some people who have very slow-growing localized prostate cancer may never need treatment. Others can delay treatment until tests show that the cancer is growing more quickly.
If you choose this option, it's very important to follow your doctor's schedule of tests and exams. This increases the chance of finding out right away if the cancer starts growing. Then it can be treated in the early stages, when treatment is most successful.
Even if the cancer isn't growing, you can choose to start treatment at any time.
Radiation therapy uses high-dose X-rays to destroy cancer cells and shrink tumors. Radiation for prostate cancer is usually given by a machine outside the body (external radiation). It may also be given by placing substances inside the body (internal radiation, or brachytherapy).
Radiation therapy may be used alone to treat prostate cancer. Or it may be combined with hormone therapy if tests show that the cancer is likely to grow. Radiation is sometimes used after surgery to destroy any remaining cancer cells.
Surgery to remove the prostate is called radical prostatectomy. This is most often done if tests show the cancer hasn't spread outside the prostate (localized cancer). A doctor removes the whole prostate and the seminal vesicles. The doctor also removes any nearby tissue that may contain cancer. This may be done as:
If possible, the doctor will try to save the nerves that are needed for an erection. This can only be done when there is no chance of leaving cancer cells behind.
The doctor may also remove lymph nodes in the pelvic area to check them for cancer. This is called pelvic lymph node dissection.
Prostate cancer needs male sex hormones (androgens) to grow. Hormone therapy lowers the level of androgens in your body. This can slow the growth of prostate cancer and even shrink the tumors. This may also be called androgen deprivation therapy (ADT).
The main androgen is testosterone. It is mostly made by the testicles. Hormone therapy may be done with:
Other treatments may be used, especially if prostate cancer has come back after treatment (recurrent cancer) or has spread to other parts of the body (metastatic cancer). Examples include:
Watchful waiting is a wait-and-see approach to treatment that may be an option for certain people. You would have regular visits with your doctor but fewer tests than with active surveillance. The focus is on treating any symptoms that bother you rather than trying to cure the cancer. This may be a good choice if you are too ill to have (or don't want to have) aggressive treatment, such as surgery.
As with active surveillance, you can change your mind and start treatment at any time.
Palliative care is a type of care for people who have a serious illness. It's different from care to cure your illness, called curative treatment. Palliative care provides an extra layer of support that can improve your quality of life—not just in your body, but also in your mind and spirit. Sometimes palliative care is combined with curative treatment.
The kind of care you get depends on what you need. Your goals guide your care. You can get both palliative care and care to treat your illness. You don't have to choose one or the other.
Palliative care can help you manage symptoms, pain, or side effects from treatment. It may help you and those close to you better understand your illness, talk more openly about your feelings, or decide what treatment you want or don't want. It can also help you communicate better with your doctors, nurses, family, and friends.
It can be hard to live with an illness that cannot be cured. But if your health is getting worse, you may want to make decisions about end-of-life care. Planning for the end of your life does not mean that you are giving up. It is a way to make sure that your wishes are met. Clearly stating your wishes can make it easier for your loved ones. Making plans while you are still able may also ease your mind and make your final days less stressful and more meaningful.
Some people use complementary therapies along with medical treatment. They may help relieve the symptoms and stress of cancer or the side effects of cancer treatment. Therapies that may be helpful include:
Talk with your doctor about any of these options you would like to try. And let your doctor know if you are already using any complementary therapies. They are not meant to take the place of standard medical treatment. But they may help you feel better and cope better with treatment.
Relationships take on new importance when you're faced with cancer. Your family and friends can help support you. You may also want to look beyond those who are close to you.
Remember that the people around you want to support you, and asking for help isn't a sign of weakness.
Your friends and family want to help, but some of them may not know what to do. It may help to make a list. For example, you might ask them to:
Places to turn for support include:
Surveillance, Epidemiology, and End Results Program (2021). Cancer stat facts: Prostate cancer. National Cancer Institute. https://seer.cancer.gov/statfacts/html/prost.html. Accessed January 18, 2022.
Current as of:
September 8, 2021
Author: Healthwise StaffMedical Review: E. Gregory Thompson MD - Internal MedicineKathleen Romito MD - Family MedicineAdam Husney MD - Family MedicineChristopher G. Wood MD, FACS - Urology, OncologyRichard M. Hoffman MD, MPH - Internal Medicine
Current as of: September 8, 2021
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & Christopher G. Wood MD, FACS - Urology, Oncology & Richard M. Hoffman MD, MPH - Internal Medicine
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