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Prostate Cancer’s Diagnosis and Treatments


Prostate cancer develops when a tumor forms within the prostate — the gland located underneath the bladder, surrounding the urethra (the tube that carries urine out of the body). This organ is a part of the male reproductive system and helps create the fluid found in semen.

Prostate cancer is the most common type of cancer found in men, other than skin cancer. About one out of eight men will be diagnosed with this condition at some point in their lives. This means that more than 268,000 Americans and 1.4 million people worldwide are diagnosed with prostate cancer each year.

Fortunately, prostate cancer doesn’t usually grow or spread quickly and is easy to treat. People diagnosed with prostate cancer typically have a good outlook.

What causes prostate cancer?

Prostate tumors are caused by gene changes that make cells in the prostate start growing too quickly.

If you have certain risk factors, your chances of being diagnosed with prostate cancer are higher. The main risk factors include:

  • Age — The older you get, the higher your risk of this condition.
  • Race — Black men get prostate cancer at higher rates than men of other races and ethnicities.
  • Family history — You may be at risk for prostate cancer if you have a parent, child, or sibling with the disease.

You may also be more likely to develop prostate cancer if you are tall, obese, don’t get a lot of physical activity, have high testosterone levels, or have high blood pressure.

Prostate cancer symptoms

You may not notice any changes if you have prostate cancer. Alternatively, you may experience symptoms like:

  • Needing to urinate often, especially at night
  • A stopping and starting stream of urine
  • Needing to urinate immediately
  • Feeling like you haven’t completely emptied your bladder after urinating
  • Pain while urinating or during ejaculation
  • Blood in the urine or semen
  • Ongoing back or hip pain
  • Tiredness, dizziness, paleness, or shortness of breath, which may be caused by anemia

Tell your doctor if you think you may have any signs of prostate cancer. These symptoms can also be caused by many other conditions.

Screening and diagnosis of prostate cancer

Your doctor may suggest regular prostate cancer screening to detect any tumors early. This may involve:

  • A prostate-specific antigen (PSA) test — A blood test that measures a protein called PSA. Your PSA levels may rise due to prostate cancer, other prostate disorders, or other medical conditions or medications.
  • A digital rectal exam (DRE) — A test in which your doctor inserts a gloved finger into your rectum to feel the shape and size of your prostate.

Experts recommend that men between the ages of 55 and 69 ask their doctor whether prostate cancer screening is a good idea. Screening can help catch cancer early, but can sometimes lead to false positives, unnecessary testing, or unneeded treatments. Ask your doctor to walk you through the risks and benefits.

If there is a chance you may have prostate cancer, your doctor may recommend a biopsy, in which they use a needle to remove a piece of the prostate and examine it under a microscope.

Types and stages of prostate cancer

During the process of diagnosis, your doctor will determine your prostate cancer type and stage.

Adenocarcinoma is the most common type of prostate cancer. This type grows slowly. Other types of prostate cancer, such as small cell carcinoma, neuroendocrine tumors, and sarcomas, grow more aggressively but are rare.

Your prostate cancer stage describes how far in the body cancer cells have spread. Stage 1 (often written as stage I) prostate cancer has not spread at all, while stage 4 (stage IV) has spread to other organs.

Prostate cancer treatments

The treatments that your doctor recommends depend on things like your overall health, type of prostate cancer, cancer stage, and personal preferences. Treatment options include:

  • Watchful waiting — Also called active surveillance, this approach involves not using any treatments. You will need regular follow-up visits to look for changes. If your cancer gets worse, you may need to begin treatment.
  • Surgery — Your doctor may suggest surgery to remove the prostate and nearby tissues such as lymph nodes. This may be an option for men with early-stage cancer who are in good health.
  • Radiation therapy — You may undergo external radiation therapy, in which a large machine delivers high-energy X-rays to your tumor. You may also have the option of internal radiation therapy (a radioactive substance is implanted near your tumor) or radiopharmaceutical therapy (you take a radioactive drug).
  • Hormone therapy — This treatment involves taking medications that help block hormones like testosterone that can feed prostate cancer cells.
  • Other cancer-fighting medications — Drugs like chemotherapy, targeted therapy, and immunotherapy work in different ways to destroy cancer cells.
  • Cryotherapy — In this treatment, doctors use extreme cold to kill cancer cells.

You may also want to use other types of treatments to treat prostate cancer symptoms. These may include pain medication, steroids, or bisphosphonates (medications that help strengthen the bones if prostate cancer has spread there). Additionally, you may be able to try out newer treatment options by participating in a clinical trial.

Survival rates

Prostate cancer treatments usually work well. Overall, about 97% of people with prostate cancer survive their condition for five years or more.

About 87% of prostate cancers are caught early — the cancer cells are located only within the prostate, or have only spread to nearby lymph nodes. In these cases, 100% of people live at least five years after being diagnosed (not counting deaths due to unrelated causes).

However, if prostate cancer has already metastasized (spread to distant locations) when it is diagnosed, it is linked to a worse outcome. About one-third of people with metastatic prostate cancer survive their cancer for five years or more.

Key takeaways

Middle-aged or older men should be talking to their doctors about their prostate health at regular check-ups.

Let your doctor know if you ever experience changes in urination, and ask whether your physician recommends screening.

If you do have prostate cancer, you have a good chance of having a positive outcome, as this type of tumor is typically not aggressive or fast-growing.

References

Cancer Stat Facts: Prostate Cancer. National Cancer Institute. https://seer.cancer.gov/statfacts/html/prost.html

How Is Prostate Cancer Treated? Centers for Disease Control and Prevention. Reviewed August 23, 2021. https://www.cdc.gov/cancer/prostate/basic_info/treatment.htm

Prostate Cancer. MedlinePlus. Updated March 4, 2022. https://medlineplus.gov/prostatecancer.html

Prostate Cancer. StatPearls. Updated July 3, 2022. https://www.ncbi.nlm.nih.gov/books/NBK470550/

Prostate Cancer: Introduction. American Society of Clinical Oncology. September 2021. https://www.cancer.net/cancer-types/prostate-cancer/introduction

Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019. Frontiers in Public Health. February 16, 2022. https://www.frontiersin.org/articles/10.3389/fpubh.2022.811044/full

Prostate Cancer Statistics. Centers for Disease Control and Prevention. Reviewed June 6, 2022. https://www.cdc.gov/cancer/prostate/statistics/index.htm

Prostate Cancer Treatment (PDQ)-Patient Version. National Cancer Institute. November 12, 2021. https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq

What Are the Benefits and Harms of Screening? Centers for Disease Control and Prevention. Reviewed August 23, 2021. https://www.cdc.gov/cancer/prostate/basic_info/benefits-harms.htm

What Are the Symptoms of Prostate Cancer? Centers for Disease Control and Prevention. Reviewed August 23, 2021. https://www.cdc.gov/cancer/prostate/basic_info/symptoms.htm

What Is Screening for Prostate Cancer? Centers for Disease Control and Prevention. Reviewed August 23, 2021. https://www.cdc.gov/cancer/prostate/basic_info/screening.htm

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