Prostate cancer, or prostatic cancer, is a cancer that forms in tissues of the prostate. Prostate cancer usually occurs in older men.
The prostate is a gland about the size of a walnut, which wraps around the first part of the urethra—the tube that carries urine out of the bladder. It is located in front of the rectum and just below the bladder.
In prostate cancer, cells abnormally form, which often forms a mass of tissue called a growth or tumor. Prostate growths can be benign (meaning it is not cancer) or malignant (cancer).
Benign prostatic hyperplasia (BPH) is a non-cancerous growth of prostate cells. The prostate grows larger, which can squeeze the urethra that can partially or totally block the flow of urine. To learn more about BPH, please visit our Benign Prostatic Hyperplasia page.
Cancer cells in prostate cancer can spread by breaking away from the prostate tumor. These cancer cells that break away can travel through the blood or lymph vessels and can cause cancer in other parts of the body. The spread of cancer is called metastasis.
Treatment of prostate cancer is much more effective when the disease is found early and has not spread to other parts of the body.
Risks for Prostate Cancer
Until now, no one knows exactly what causes prostate cancer. However, research has shown that men with certain risk factors are more likely than others to develop cancer of the prostate. Your chance of getting prostate cancer may be increased if you have the following risk factors:
- Age over 65. The chance of developing prostate cancer increases as you get older. According to the National Cancer Institute, most men with prostate cancer in the United States are over 65.
- Family history. Your risk is higher if your father or brother has had prostate cancer.
- Race. According to the National Institute on Aging, prostate cancer is most common among African-American men.
- Certain changes in the prostate. Men with cells called high-grade prostatic intraepithelial neoplasia (PIN) may increase the risk of prostate cancer. When viewed under a microscope, these prostate cells look abnormal.
- Certain changes in genes. Researchers have found specific regions on certain chromosomes that are linked to the risk of prostate cancer. According to the National Cancer Institute, a man who has a genetic change in one or more of these regions, the risk of prostate cancer may be increased. Other studies have shown that men with changes in certain genes, such as BRCA1 and BRCA2 have an increased risk of developing prostate cancer.
Having a risk factor, however, does not mean that a man will develop prostate cancer. Also, most men who have risk factors never develop the condition.
Symptoms of Prostate Cancer
Early prostate cancer often does not cause symptoms. As the cancer grows, you may have trouble urinating. You may need to urinate often, especially at night or have a hard time starting or stopping the flow of urine.
Other signs and symptoms of prostate cancer include
- Painful or burning sensation during urination
- Blood in the urine (hematuria) or semen
- Painful ejaculation
- Pain in the back, hips or pelvis, or upper thighs
Often, these symptoms are not due to cancer. Other health problems, such as BPH or an infection may cause these symptoms. If you have any of these symptoms, you should inform your doctor so that problems can be diagnosed and treated.
Diagnosing Prostate Cancer
To find out if your symptoms are caused by prostate cancer, your doctor will ask about your personal and family medical history. Your doctor will perform a physical exam. In the exam, your doctor will insert a lubricated, gloved finger into your rectum to feel your prostate and check for hard or lumpy areas. This exam is called a digital rectal exam.
Your doctor may also perform blood test for prostate-specific antigen (PSA) level. The prostate makes PSA. PSA levels may be high in men who have an enlarged prostate or prostate cancer.
The digital rectal exam and PSA test can detect a problem in the prostate. However, these tests can’t show whether the problem is cancer or a less serious condition. Your doctor may recommend an ultrasound exam, which takes computer pictures of your prostate.
To confirm the diagnosis, your doctor will likely recommend a biopsy of your prostate. Your doctor will get samples of prostate tissues to look for cancer cells. Performing a biopsy is the only sure way to diagnose prostate cancer.
Treating Prostate Cancer
Treatment of prostate cancer depends on whether cancer is in part or the entire prostate or if it has spread to other parts of the body. It also depends on your age and overall health. The treatment that’s best for one man may not be best for another. Talk with your doctor about the best treatment choice for you.
For cancer that has not spread from the prostate to other parts of the body, your doctor may suggest:
- Watchful waiting, which is also called “active surveillance.” If the cancer is growing slowly and not causing problems, you may decide not to treat it right away. Instead, your doctor will check regularly for changes in your condition. Older men with other health problems often choose this option.
- Surgery. The most common type of surgery removes the whole prostate and some nearby tissue. As with any surgery, there are risks. Talk to your doctor about keeping your sexual function.
- Radiation therapy. This treatment uses high-energy x-rays to kill cancer cells and shrink tumors. Talk with your doctor about possible side effects.
- Hormone therapy. Men who have radiation therapy may also be treated with hormone blockers. This is done if it seems likely that the cancer will come back. Hormone therapy is also used for prostate cancer that has spread beyond the prostate.