Prostate cancer is a disease in which cancer cells grow in the prostate gland. The prostate is a walnut-sized gland in men. It surrounds the urethra, the tube that carries urine out of the body. The prostate makes a fluid that is part of semen.
Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.
It is not clear exactly what causes these problems in the cells, but it is probably a combination of genetics and environment.
Prostate cancer is more common in men who are aged 55 years and older. It is also more common in African Americans than Caucasians. Other factors that may increase your chances of prostate cancer:
Prostate cancer may cause:
These symptoms may be caused by other conditions, such as benign prostatic hyperplasia (BPH) or an infection. If you have any of these symptoms, promptly see your doctor.
A significant number of prostate cancers are found by a prostate-specific antigen test (PSA) screening before symptoms develop.
Your doctor will ask about symptoms and medical history. A physical exam will also be done.
Tests may include:
Imaging tests evaluate the prostate and surrounding structures. These may include:
The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, prostate cancer is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.
Cancer treatment varies depending on the stage of prostate cancer. You and your doctor will discuss the best treatment options for you. Treatment may include:
This involves your doctor monitoring the cancer to see if it is growing. Watchful waiting may be appropriate if you:
Types of surgery that may be needed include:
Since prostate cancer surgery may cause side effects, like erectile dysfunction, urinary incontinence, and fecal incontinence, there may be other surgery techniques that may be a good option for you. Some examples include nerve-sparing surgery, robotic surgery, and laparoscopic surgery.
Radiation therapy involves the use of radiation to kill cancer cells and shrink tumors. Examples include:
If prostate cancer has spread or has returned after being treated, hormone therapy may be used. The goal of hormone therapy is to lower the levels of male hormones called androgens. The main androgen is testosterone. Lowering androgen levels can cause prostate cancer to shrink or slow its growth.
Hormone therapy may include:
In some case, a type of surgery called orchiectomy may be needed. This involves removing the testicles, which stops androgens from being produced.
Other options may include:
To help reduce your chances of prostate cancer:
National Cancer Institute
Urology Care Foundation
Prostate Cancer Canada
Angiogenesis inhibitors. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/angiogenesis-inhibitors-fact-sheet. Updated October 7, 2011. Accessed October 9, 2017.
Biological therapies for cancer. National Cancer Institute website. Available at: http://www.cancer.gov/about-cancer/treatment/types/immunotherapy/bio-therapies-fact-sheet. Updated June 12, 2013. Accessed October 9, 2017.
Chemotherapy & targeted therapy. Texas Oncology website. Available at: https://www.texasoncology.com/types-of-cancer/prostate-cancer/targeted-therapy-for-prostate-cancer. Accessed October 9, 2017.
Enzalutamide. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T904251/Enzalutamide. Updated October 6, 2017. Accessed October 9, 2017.
Evolution of cancer treatments: targeted therapy. American Cancer Society website. Available at: https://www.cancer.org/cancer/cancer-basics/history-of-cancer/cancer-treatment-targeted-therapy.html. Updated June 12, 2014. Accessed October 9, 2017.
FDA approval for sipuleucel-T. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/drugs/fda-sipuleucel-t. Updated July 3, 2013. Accessed October 9, 2017.
Imatinib. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T232821/Imatinib. Updated October 6, 2017. Accessed October 9, 2017.
Prostate cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/prostate-cancer.html. Accessed October 9, 2017.
Prostate cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114483/Prostate-cancer. Updated August 9, 2016. Accessed September 14, 2016.
Prostate cancer screening. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113802/Prostate-cancer-screening. Updated August 23, 2017. Accessed October 9, 2017.
Prostate cancer staging and imaging. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T905769/Prostate-cancer-staging-and-imaging. Updated August 23, 2017. Accessed October 9, 2017.
What is provenge immunotherapy? Provenge website. Available at: http://www.provenge.com/advanced-prostate-cancer-immunotherapy. Accessed October 9, 2017.
2/19/2010 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T902624/Prevention-of-prostate-cancer: Mahmud SM, Franco EL, Aprikian AG. Use of non-steroidal anti-inflammatory drugs (NSAIDs) and prostate cancer risk: a meta-analysis. Int J Cancer. 2010;127(7):1680-1691.
7/17/2017 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905769/Prostate-cancer-staging-and-imaging: Coakley FV, Oto A, Alexancer LF, et al. ACR Appropriateness Criteria for prostate cancer-pretreatment detection, surveillance, and staging. Available at: https://acsearch.acr.org/docs/69371/Narrative. Updated 2016.
Last reviewed September 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP Last Updated: 7/17/2017