About 1 in 8 men develop this disease at some point. Most survive, but not by ignoring symptoms.
The prostate gland—a small but ultimately crucial part of a man's anatomy—has a number of responsibilities. The first step toward taking a proactive role in your prostate health is to understand this gland and the exact roles it plays.
Armed with the facts about prostate cancer, you'll know how to recognize the signs and symptoms that may indicate you have a budding problem or an already existing complication.
Cancer is a disease that occurs when cells whose DNA has mutated divide and multiply uncontrollably. When cancer starts in the prostate, it is considered prostate cancer.
Prostate cancer is often slow-growing and confined to the prostate. In cases like these, the disease may not result in serious harm. When prostate cancer hasn't spread beyond the gland itself and is slow to grow, minimal treatment—or potentially no treatment at all (known as active surveillance)—may be necessary. In other instances, prostate cancer can be aggressive and spread quickly.
Aggressive prostate cancer may require swift and more extensive treatment. As is the case with a lot of other diseases, early detection and treatment of prostate cancer leads to higher chances of successful treatment outcomes.
Before we dive deeper into prostate cancer, let's take a look at the prostate gland itself.
Located near the bladder and in front of the rectum, the prostate is a walnut-sized gland responsible for producing fluid that helps nourish and transport sperm cells from the body and out of the urethra during ejaculation.
The fluid from the prostate, along with sperm cells and secretions from other glands, make up what is known as semen.
A relatively small organ, the prostate gland weighs about 1 ounce, which is roughly the same weight as five U.S. quarters. It's composed of five lobes: one in the front and one in the back (the anterior and posterior), two lateral lobes (one on each side) and a median lobe in the middle.
The prostate gland is made up of connective and glandular tissues, with a coat of stretchy connective tissue known as prostatic fascia enveloping it.
As the prostate is located inside the body, it can't be touched directly. Doctors can feel the prostate through the rectum walls, which is what occurs during a digital rectal exam (DRE).
The prostate produces fluid for semen that is full of enzymes, zinc and citric acid, which nourish sperm cells. Semen is the whitish-gray fluid released by the penis during ejaculation.
In addition to helping sperm cells survive and thrive in the nutrient-rich fluid it produces, the prostate gland also aids in the mechanics of ejaculation. When a man orgasms, his prostate muscles contract. This muscle contraction helps propel semen into, through and out of the penis.
The prostate can also act as a source of sexual pleasure when stimulated.
Men over age 50 might want to include prostate cancer screenings as part of their annual wellness checkups. If you have risk factors that make it more likely you will develop prostate cancer, then alert your primary care doctor.
There are two tests to screen for prostate cancer. The first is a digital rectal exam (DRE), which looks at the physical structure of your prostate and determines if the size, shape or texture is abnormal.
The second is a blood analysis test called a prostate-specific antigen (PSA) test. A small amount of PSA in your blood is normal. However, if the analysis finds high amounts, you may have prostate enlargement, inflammation, infection or cancer.
Further testing from a urologist for a diagnosis include:
If the biopsy confirms you have prostate cancer, your urologist will next determine how aggressive the cancer is and whether it has spread beyond the prostate. The cancer is graded based on how much cancer cells look like healthy cells. Cancer cells similar to healthy cells indicate a less aggressive cancer, whereas highly mutated cancer cells indicate a more aggressive cancer.
Your urologist may use a variety of techniques to identify how aggressive your prostate cancer is. One common technique is the Gleason Score that grades prostate biopsy cells on a scale of 1 (normal cells) to 5 (highly abnormal cells).
The two most predominant kinds of cells in your prostate are then graded using the Gleason scale. Adding the two numbers together results in your Gleason Score, with 10 (5+5) being the highest. Your score is then assigned to a Grade Group:
Second only to skin cancer, prostate cancer is the most common cancer among men in the United States. Statistics show that 13 in 100 men in the U.S. will develop the disease at some point in their lifetime. Most will survive. The five-year relative survival rate is 99 percent for the localized and regional stages.
The American Cancer Society (ACS) estimates there will be about 288,300 new prostate cancer cases in 2023, and about 34,700 people will die from the disease during the year. The ACS reported a sharp decline in prostate cancer diagnoses from 2007 to 2014, which coincided with fewer men getting screened because of changes in screening recommendations. However, the incidence rate of prostate cancer has actually gone up 3 percent per year since 2014.
Older men and non-Hispanic Black men are at the highest risk for prostate cancer, with about 6 in 10 cases diagnosed in men ages 65 and older. The average age of diagnosis is 66, while the disease is considered rare in men younger than 40.
The prostate gland has been with humankind as long as the homo sapiens species has existed, but the word "prostate" first appeared in medical literature during the Renaissance era, between 1450 and 1650. It was once considered a mysterious "glandulous body," but medical experts have come to understand more about this organ and the important role it plays in a man's health.
Now, much attention is given to the prostate gland and how to take care of it, because it is commonly affected by conditions such as prostate cancer, prostatitis, and benign prostatic hyperplasia (BPH).
Specific causes of prostate cancer remain unknown. What medical experts do know is that prostate cancer happens when the DNA of prostate cells mutates and causes them to grow and divide rapidly. These cells continue to live and accumulate while healthy cells die. This can lead to the formation of a tumor and/or metastasization, which occurs when cancerous cells spread to other parts of the body.
Risk factors for prostate cancer include the following:
Medical science knows of several gene mutations that can be passed between generations and have been linked to prostate cancer. This type of cancer is known as hereditary cancer and believed to be a factor in about 10 percent of prostate cancers, according to the ACS.
Some gene mutations that have been linked to hereditary prostate cancer include the following:
Prostate cancer can be asymptomatic, especially in the early stages, which is why screenings are so important and can be potentially lifesaving. As the disease progresses, it can cause a wide array of symptoms.
Common symptoms include:
If you experience any of these signs and symptoms, talk to your doctor. Other persistent or worrying symptoms, even if they are not on the list, should lead you to set up a doctor's appointment. Detecting and treating prostate cancer and other prostate-related problems early is essential for increased chances of successful treatment and expedited symptom relief.
Prostate cancer screening and diagnosis involve a number of tests. Most standard prostate screening tests include the DRE and the prostate-specific antigen (PSA) test.
During a digital rectal exam, a doctor inserts a gloved, lubricated finger into the rectum to physically examine the prostate. If the doctor notices the gland is of abnormal size, shape or texture, they may recommend further testing.
The PSA test consists of blood withdrawal from the arm. PSA is a protein produced by both normal and malignant cells of the prostate gland. The sample is sent to a lab and tested for PSA. Higher-than-normal PSA levels can indicate prostate cancer (but not always), infection, inflammation and enlargement.
If initial prostate cancer screening reveals any abnormalities, a doctor may recommend further diagnostic tests, such as the following:
If you do have prostate cancer, additional testing may be done to determine whether it's aggressive and if it has spread.
Prostate cancer treatment is largely dependent on the stage of the cancer, how aggressive it is, whether it's causing symptoms or affecting your overall health, personal preference, and the balance of the potential benefits versus side effects of treatment.
Individuals with low-grade prostate cancer may not need treatment initially, or maybe ever. In some cases, all that is needed to address prostate cancer is active surveillance. During active surveillance, regular labwork, rectal exams and prostate biopsies may be used to monitor the cancer.
If tests find that prostate cancer is progressing, treatment may become necessary.
Active surveillance is typically reserved for individuals whose cancer is slow-growing, causes minimal or no symptoms and remains confined to a small part of the prostate, according to Mayo Clinic. It may also be used for people with other serious health conditions and those who are of advanced age.
When treatment is necessary for prostate cancer, treatment options include the following:
Unfortunately, there's no surefire way to prevent prostate cancer. However, there are a number of measures you can take to manage your risk level.
The following lifestyle factors can reduce your risk for prostate cancer:
There is some disagreement among medical organizations with regard to if, when and how often healthy men with no symptoms should undergo prostate cancer screening. Even so, most medical organizations recommend men in their 50s talk to their doctors about what screening regimen is right for them.
Men at greater risk for prostate cancer due to their race, family history and other factors may want to talk to their doctor about prostate cancer screenings as early as age 40.
The advancement of medical research relies, in part, on clinical trials, which are often used to research cures, treatments and means for the prevention of prostate cancer and other diseases. Before participating in a clinical trial, make sure to do lots of research, talk to your doctor and consider what's right for you. A list of active and recruiting clinical trials can be found at clinicaltrials. gov.
Fortunately, since most prostate cancer is discovered in the early stages, the five-year relative survival rate is high: more than 99 percent in the localized and regional stages. The American Cancer Society reports that 1 in 41 men die of the disease. All in all, most men with prostate cancer do not die because of the disease.
While prostate cancer can be fatal—the five-year relative survival rate is 32 percent at the distant stage, when cancer has spread—most men with prostate cancer do not die from the disease. This is likely due to medical advancements that have led to increases in early detection and successful treatment.
Most cases of prostate cancer are asymptomatic. Some common signs and symptoms of prostate cancer include trouble with urination, unintentional weight loss, bone pain, rectal pain or pressure, and persistent pain in the pelvis, back or hips. Prostate cancer symptoms can also overlap with symptoms caused by other, often less serious, prostate gland conditions. If you experience any abnormal, concerning or persistent symptoms, consult your doctor right away.
