Basic Information About Prostate Cancer
Cancer is a disease in which cells in the body grow out of control. When cancer starts in the prostate, it is called prostate cancer.
Many men with prostate cancer—especially those with tumors that have not spread beyond the prostate—die of other causes without ever having any symptoms from the cancer.
Except for skin cancer, prostate cancer is the most common cancer in American men. It is the second most common cause of death from cancer among white, African American, American Indian/Alaska Native, and Hispanic men, and the fourth most common cause of death from cancer among Asian/Pacific Islander men.
Data source: U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2010 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2013. Available at: http://www.cdc.gov/uscs.
What Is Prostate Cancer?
Cancer is a disease in which cells in the body grow out of control. When cancer starts in the prostate, it is called prostate cancer. Except for skin cancer, prostate cancer is the most common cancer in American men.
What Is the Prostate?
The prostate is a part of the male reproductive system, which includes the penis, prostate, and testicles. The prostate is located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). It produces fluid that makes up a part of semen.
As a man ages, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow. This is called benign prostatic hyperplasia, and it is not the same as prostate cancer. Men may also have other prostate changes that are not cancer.
This diagram shows the location of the prostate, in front of the rectum and just below the bladder.
What Are the Risk Factors?
Research has found risk factors that increase your chances of getting prostate cancer. These risk factors include—
- Age: The older a man is, the greater his risk for getting prostate cancer.
- Family history: Certain genes (the functional and physical units of heredity passed from parent to offspring) that you inherited from your parents may affect your prostate cancer risk. Currently, no single gene is sure to raise or lower your risk of getting prostate cancer. However, a man with a father, brother, or son who has had prostate cancer is two to three times more likely to develop the disease himself.
- Race: Prostate cancer is more common in some racial and ethnic groups than in others, but medical experts do not know why.
Researchers are trying to determine the causes of prostate cancer and whether it can be prevented. They do not yet agree on the factors that can influence a man's risk of developing the disease, either positively or negatively.
The Selenium and Vitamin E Cancer Prevention Trial (SELECT) studied whether taking vitamin E and selenium (a mineral) prevent prostate cancer. The selenium and vitamin E were taken separately or together by healthy men 55 years of age and older (50 years of age and older for African-American men). The study showed that selenium and vitamin E did not decrease the risk of prostate cancer.
Some drugs lower the risk of getting prostate cancer, but whether they can help lower the risk of dying from prostate cancer is still unclear. For more information, see How Is Benign Prostatic Hyperplasia (BPH) Treated?
Regular use of multivitamins has not been proven to increase or decrease the risk of early or localized prostate cancer. Talk to your doctor about multivitamin use.
What Are the Symptoms?
Different people have different symptoms for prostate cancer. Some men do not have symptoms at all.
Some symptoms of prostate cancer are—
- Difficulty starting urination.
- Weak or interrupted flow of urine.
- Frequent urination, especially at night.
- Difficulty emptying the bladder completely.
- Pain or burning during urination.
- Blood in the urine or semen.
- Pain in the back, hips, or pelvis that doesn't go away.
- Painful ejaculation.
If you have any symptoms that worry you, be sure to see your doctor right away. Keep in mind that these symptoms may be caused by conditions other than prostate cancer.
What Screening Tests Are There?
Cancer screening means looking for cancer before it causes symptoms. However, most prostate cancers grow slowly or not at all.
Two tests are commonly used to screen for prostate cancer—
- Digital rectal exam (DRE): A doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
- Prostate specific antigen (PSA) test: Measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.
As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others. PSA levels also can be affected by—
- Certain medical procedures.
- Certain medications.
- An enlarged prostate.
- A prostate infection.
Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results.
How Is Prostate Cancer Diagnosed?
If your prostate specific antigen (PSA) test or digital rectal exam (DRE) is abnormal, doctors may do more tests to find or diagnose prostate cancer.
- Transrectal ultrasound: A probe the size of a finger is inserted into the rectum, and high-energy sound waves (ultrasound) are bounced off the prostate to create a picture of the prostate called a sonogram. This test may be used during a biopsy.
- Biopsy: A small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.
- Gleason score: This score is determined when the biopsy is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2–10. The lower the score, the less likely it is that the cancer will spread. For more information, visit the National Cancer Institute's (NCI) Prostate Cancer.
For more information about diagnosis, visit NCI's Prostate Cancer Detection and Diagnosis.
Staging
If prostate cancer is diagnosed, other tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. This process is called staging. Whether the cancer is only in the prostate, or has spread outside the prostate, determines your stage of prostate cancer. The stage of prostate cancer tells doctors what kind of treatment you need.
How Is Prostate Cancer Treated?
Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you. Some common treatments are—
- Active surveillance. Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms.
- Surgery. A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the surrounding tissue.
- Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer. There are two types of radiation therapy—
- External radiation therapy. A machine outside the body directs radiation at the cancer cells.
- Internal radiation therapy (brachytherapy). Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells.
- Hormone therapy. Blocks cancer cells from getting the hormones they need to grow.
Other therapies used in the treatment of prostate cancer that are still under investigation include—
- Cryotherapy. Placing a special probe inside or near the prostate cancer to freeze and kill the cancer cells.
- Chemotherapy. Using special drugs to shrink or kill the cancer. The drugs can be pills you take or medicines given through your veins, or, sometimes, both.
- Biological therapy. Works with your body's immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments.
- High-intensity focused ultrasound. This therapy directs high-energy sound waves (ultrasound) at the cancer to kill cancer cells.
For more information, visit the National Cancer Institute's (NCI's) Prostate Cancer Treatment Option Overview. This site can also help you find a doctor or treatment facility that works in cancer care. Visit Facing Forward: Life After Cancer Treatment
for more information about treatment and links that can help with treatment choices.
Clinical Trials
Clinical trials use new treatment options to see if they are safe and effective. If you have cancer, you may want to take part. Visit the sites listed below for more information.
Complementary and Alternative Medicine
Complementary and alternative medicine are medicines and health practices that are not standard cancer treatments. Complementary medicine is used in addition to standard treatments, and alternative medicine is used instead of standard treatments. Meditation, yoga, and supplements like vitamins and herbs are some examples.
Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor before you start any kind of complementary or alternative medicine.
Which Treatment Is Right for Me?
Choosing the treatment that is right for you may be hard. Talk to your cancer doctor about the treatment options available for your type and stage of cancer. Your doctor can explain the risks and benefits of each treatment and their side effects.
Sometimes people get an opinion from more than one cancer doctor. This is called a "second opinion." Getting a second opinion may help you choose the treatment that is right for you.