Prostate cancer develops in the prostate, a small walnut size gland located below the bladder and in front of the rectum in men. This tiny gland secretes fluid that mixes with semen, keeping sperm healthy for conception and pregnancy.
Prostate cancer is a serious disease.
Fortunately, most people with prostate cancer get diagnosed before it spreads beyond their prostate gland. Treatment at this stage often eliminates the cancer.
If you’re diagnosed with prostate cancer, it’s most likely an adenocarcinoma. Adenocarcinomas start in the cells of glands — like your prostate — that secrete fluid. Rarely, prostate cancer forms from other types of cells.
Less common types of prostate cancers include:
Incidence of prostate cancer:
Prostate cancer is common, second only to skin cancer as the most common cancer affecting men. For every 100 people with prostates, 13 will develop prostate cancer at some point in their lives. Most will live normal lives and eventually die from causes unrelated to prostate cancer. Some won’t need treatment. For a broader understanding of prostate-related issues, visit our Prostate Conditions page.
Symptoms and causes:
Most prostate cancers grow slowly inside the prostate gland. Early-stage prostate cancer rarely causes symptoms.
These issues may occur as the disease progresses:
However, not all growths in your prostate are cancer.
Other conditions that cause symptoms similar to prostate cancer include:
The most common risk factors include:
Some studies have identified other prostate cancer risk factors, but the evidence is mixed.
Other potential risk factors include:
Screenings can help catch prostate cancer early. If you’re average risk, you’ll probably have your first screening test at age 50. You may need earlier screenings if you’re in a high-risk group – start screening at 45.
Screening tests can show whether you have signs of prostate cancer that require more testing.
Diagnostic procedures for prostate cancer:
When a high PSA is detected, the next two steps will be MRI of the prostate with possible biopsy when the MRI demonstrates a possible lesion.
Grade and staging of prostate cancer. Urologists use the Gleason score and cancer staging to determine how serious the cancer is and the types of treatments you need.
Gleason score:
The Gleason score allows your provider to rate how abnormal your cancer is. The more abnormal cells you have, the higher your Gleason score. The Gleason score allows your provider to determine the grade of your cancer, or its potential to be aggressive. Gleason 6 and less responds very well to treatment, Gleason 7 intermediate and Gleason 8 and higher have the more aggressive growth pattern.
Staging prostate cancer:
Cancer staging allows your provider to determine how advanced your cancer is, or how much it’s spread. Cancer may be in your prostate gland only (local), invading nearby structures (regional) or spread to other organs (metastasized). Prostate cancer most commonly spreads to your bones and lymph nodes.
Your treatment depends on multiple factors, including your overall condition, if the cancer’s spread and how fast it’s spreading. Depending on your treatments, you may work with various healthcare providers, including urologists, radiation oncologists and medical oncologists. Most prostate cancer diagnosed in the early stages can be cured with treatment.
Surveillance:
Your healthcare provider may monitor your condition instead of providing treatment if your cancer grows slowly and doesn’t spread.
Active surveillance:
You get screenings, scans and biopsies every one to three years to monitor cancer growth. Active surveillance works best if the cancer grows slowly, is only in your prostate and isn’t causing symptoms. If your condition worsens, your provider can start treatment.
Watchful waiting:
Watchful waiting is similar to active surveillance, but it’s more commonly used for people who are frailer with cancer that likely won’t go away with treatment. Also, testing is much less frequent. Instead of eliminating the tumour, treatments usually focus on managing symptoms.
Surgery:
A radical prostatectomy removes a diseased prostate gland. It can often successfully eliminate prostate cancers that haven’t spread. Your provider can recommend the best removal method if they believe you’d benefit from this surgery.
Robotic radical prostatectomy: Robotic radical prostatectomy allows your provider to perform surgery through several tiny incisions. Instead of operating directly, they operate a robot system via a console for more precision and improved outcomes.
Radiation therapy:
You may receive radiation therapy as a standalone treatment for prostate cancer or in combination with other treatments. Radiation can also provide symptom relief.
Systemic therapies:
Your provider may recommend systemic therapies if cancer has spread outside your prostate gland. Systemic therapies send substances throughout your body to destroy cancer cells or prevent their growth.
Side effects of prostate cancer treatment:
Your survival is excellent if prostate cancer is detected early. Almost everyone diagnosed with cancer that hasn’t spread outside of their prostate has a normal life expectancy.
Prostate cancer survival rates aren’t as good when the cancer’s metastasized, or spread outside of your prostate. Thirty-two percent of people with metastatic prostate cancer are alive five years later.
