About prostate cancer

Prostate cancer is the second most-common cancer among men in the United States, behind skin cancer. The American Cancer Society (ACS) estimates that about 248,530 new cases of prostate cancer will be diagnosed in 2021.

The most common type is adenocarcinoma, a cancer that begins in gland cells, which are cells in the prostate responsible for making fluid for semen. Rare types of prostate cancer include small cell carcinomas, neuroendocrine tumors, transitional cell carcinomas and sarcomas.

While most prostate cancers are slow-growing, some are more aggressive. Approximately one in every 41 men diagnosed will die from the disease, according to the ACS. Black men are reportedly more prone to developing fast-growing prostate cancers that start causing problems earlier and are harder to treat.

Prostate cancer is serious, but even advanced prostate cancer that has spread to other parts of the body often may be managed with treatment, allowing patients to maintain a good quality of life for many years.

The prostate is a walnut-sized gland located below the bladder and in front of the rectum. It surrounds the urethra and produces a substance that contributes to semen, the fluid that carries sperm from the testicles.

Prostate cancer occurs when gene changes, or mutations, cause cells in the prostate to behave abnormally, and they start growing uncontrollably.

Mutations may be passed down from parent to child (inherited mutations) or occur for other reasons over a lifetime (acquired mutations). About 10 percent of prostate cancers are thought to be related to inherited mutations, according to the ACS.

Learn more about prostate cancer risk factors

Prostate cancer is rarely diagnosed in men younger than 40. Still, by age 50, it’s common for men to experience changes in the size and shape of the cells in the prostate. Understanding whether these changes are signs of a tumor and knowing your risk for developing prostate cancer are important steps in protecting your health.

Besides age, other risk factors for prostate cancer include:

• Race: Black men are more likely to develop prostate cancer than men of other races—and are more likely to die from the disease.
• Family history: The risk of developing prostate cancer is higher among people who have an immediate family member, such as a father, brother or son, who had or currently has prostate cancer.
• Inherited genetic changes: Several inherited mutations are associated with a higher risk of prostate cancer. Mutations in the BRCA1 or BRCA2 genes are one example. (BRCA mutations are well-known for their link to breast cancer and ovarian cancer in women.) An inherited condition called Lynch syndrome is also associated with a higher risk of prostate cancer, among other types of cancer.

Almost all prostate cancers—more than 99 percent—are adenocarcinomas.

This type of tumor is found in many common cancers, including breast cancer, lung cancer and colorectal cancer. Prostate adenocarcinomas form in the glands that secrete prostate fluid.

Other prostate cancer types include:

• Transitional cell carcinomas
• Sarcomas
• Small cell carcinomas
• Neuroendocrine tumors

Learn more about prostate cancer types

In the early stages, prostate cancer usually doesn't show symptoms. However, as prostate cancer grows, it may lead to:

• Trouble initiating urination
• Weak, slow or interrupted urine flow
• Frequent need to urinate, particularly at night
• Difficulty emptying the bladder fully
• Incontinence
• Blood in urine or semen
• Back, hip, chest or pelvis pain that doesn't subside
• A burning sensation or pain during urination
• Difficulty getting an erection

Keep in mind that these symptoms may be caused by something other than prostate cancer. Patients who develop new or concerning symptoms should consult with their doctor or urologist.

Learn more about the signs and symptoms of prostate cancer

Because symptoms are often absent in the early stages of prostate cancer, many cases are discovered through routine screening tests.

Getting screened for prostate cancer is an individual decision. It may help to discuss the risks and benefits with a doctor.

Screening for prostate cancer usually involves the following tests:

• Prostate-specific antigen (PSA) test
• Digital rectal exam (DRE)

If either of these suggests the possibility of prostate cancer, doctors typically perform additional tests before making a diagnosis.

The only way to know for sure whether a tumor is cancerous is by examining cells under a microscope, a procedure also known as a prostate biopsy.

Learn about diagnostic procedures for prostate cancer

A diagnosis of prostate cancer usually includes the cancer’s stage, indicating how far it has (or hasn’t) spread within the body. The stage of the cancer plays an integral role in determining the most appropriate course of treatment.

Factors that affect the stage of prostate cancer include:

• How widespread the cancer is within the prostate
• Whether the cancer has spread beyond the prostate and, if so, where
• PSA levels
• Gleason score or grade group, which are used to determine the patient’s prognosis

Learn more about prostate cancer stages

Deciding on prostate cancer treatment is a personal decision made between a patient and his care team. Factors such as preferences, age, health history and the cancer stage all play a role in the decision-making process.

Treatment may involve one or a combination of these options:

• Watchful waiting or active surveillance
• Surgery
• Radiation therapy

Other therapies that are used less commonly, or are not considered standard treatment for prostate cancer, include:

• Cryotherapy
• Chemotherapy
• Biological therapy
• High-intensity focused ultrasound
• Hormone therapy

Learn more about treatments for prostate cancer