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For information on cancer that has come back or spread to other parts of the body, see the topic Prostate Cancer, Advanced or Metastatic.
Prostate cancer is the abnormal growth of cells in a man's prostate gland. The prostate sits just below the bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. As men age, the prostate usually grows larger.
Prostate cancer is common in men older than 65. It usually grows slowly and can take years to grow large enough to cause any problems. As with other cancers, treatment for prostate cancer works best when the cancer is found early. Often, prostate cancer that has spread responds to treatment. Older men with prostate cancer usually die from other causes.
Experts don't know what causes prostate cancer, but they believe that your age, family history (genetics), and race affect your chances of getting it. What you eat, such as foods high in fats, may also play a part.
Prostate cancer usually doesn't cause symptoms in its early stages. Most men don't know they have it until it is found during a regular medical exam.
When problems are noticed, they are most often problems with urinating. But these same symptoms can also be caused by an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men.
See your doctor for a checkup if:
The most common way to check for prostate cancer is to have a digital rectal exam, in which the doctor puts a gloved, lubricated finger in your rectum to feel your prostate, and a prostate-specific antigen (PSA) blood test. A higher level of PSA may mean that you have prostate cancer. But it could also mean that you have an enlargement or infection of the prostate.
If your PSA is high, or if your doctor finds anything during the rectal exam, he or she may do a prostate biopsy to figure out the cause. A biopsy means that your doctor takes tissue samples from your prostate gland and sends them to a lab for testing.
Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences.
You and your doctor may decide to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or if you have cancer that is low-risk and hasn't spread (early stage), you may be able to wait and watch with active surveillance to see what happens. During active surveillance, you will have regular checkups with your doctor to see if your cancer has changed.
Choosing treatment for prostate cancer can be confusing. Talk with your doctor to choose the treatment that's best for you.
Your age and overall health will make a difference in how treatment may affect your quality of life. Any health problems you have before you are treated, especially urinary, bowel, or sexual function problems, will affect how you recover.
Both surgery and radiation can cause urinary incontinence (leaking urine) or impotence (not being able to have an erection). The level of urinary incontinence and how long it lasts and the quality of the erections a man has after treatment will depend on whether the cancer has spread. These also depend on what treatment is used.
Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer may damage these nerves. Many times a special form of surgery, called nerve-sparing surgery, can preserve the nerves. But if the cancer has spread to the nerves, they may have to be removed during surgery.
These same nerves can also be damaged by the X-rays that are used in radiation therapy.
Medicines and mechanical aids may help men who are impotent because of treatment. Some men recover part or most of their ability to have an erection several months or even years after surgery.
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Health Tools help you make wise health decisions or take action to improve your health.
| Decision Points focus on key medical care decisions that are important to many health problems. | |
| Prostate Cancer Screening: Should I Have a PSA Test? | |
| Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer? | |
| Actionsets are designed to help people take an active role in managing a health condition. | |
| Stress Management: Breathing Exercises for Relaxation | |
The exact cause of prostate cancer isn't known. But experts believe that your age and family history (genetics) may have something to do with your chances of getting the disease. What you eat may add to your chances of getting it.
The prostate usually gets larger as you age. Having an enlarged prostate (benign prostatic hyperplasia, or BPH) is very common among older men and doesn't increase your chances of getting prostate cancer. But an enlarged prostate is sometimes caused by prostate cancer instead of BPH.
Prostate cancer usually doesn't cause symptoms in its early stages. When there are symptoms, they may include:
Symptoms that may show that the cancer has spread, or metastasized, to other parts of the body include:
For more information about prostate cancer that has come back or spread, see the topic Prostate Cancer, Advanced or Metastatic.
Prostate cancer is a common cancer affecting older men. It usually takes years to become large enough to cause any problems. Sometimes, though, it grows quickly.
Almost all prostate cancers are early-stage cancer, when the cancer cells are only in the prostate. When prostate cancer spreads, it goes first to tissue, then to lymph nodes in the pelvis, and then on to the bones, lungs, or other organs. For more information, see the topic Prostate Cancer, Advanced or Metastatic.
About 17 out of 100 men living in the United States will get prostate cancer. Out of these 17 men, 3 will die of prostate cancer. That means that 97 out of 100 men will die from something other than prostate cancer.1
Some things can increase your chances of getting prostate cancer. These things are called risk factors. But many people who get prostate cancer don't have any of these risk factors. And some people who have risk factors don't get this cancer.
Being older than 50 is the main risk factor for prostate cancer.
Your chances of getting the disease are higher if other men in your family have had it.
Call your doctor right away if:
Watch closely for changes in your health, and be sure to contact your doctor if:
The following health professionals can evaluate urinary symptoms:
The following doctors treat prostate cancer:
You may want to get a second opinion from a different specialist before making your treatment decision. For example, if your doctor is a family medicine physician, you may want to talk to a radiation oncologist, a urologist, or a urologic or medical oncologist.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
If you are having problems urinating, your doctor may use tests to see if you have an enlarged prostate (benign prostatic hyperplasia). This condition is the most common cause of urination problems.
Tests include:
If tests point to prostate cancer, your doctor may recommend a prostate biopsy, in which tissue is taken from the prostate and examined under a microscope. A biopsy is the only way to confirm whether you have prostate cancer.
After treatment for prostate cancer, you have regular checkups to check for any signs that the cancer has come back or spread. Tests include:
Screening for prostate cancer involves checking for signs of the disease when there are no symptoms. It may be done with the digital rectal exam and the PSA test. And while it's important to have to have regular health checkups, including a digital rectal exam, experts agree that PSA testing isn't right for all men. Testing could lead you to have cancer treatments that you don't need. Cancer treatments may cause other health problems, such as loss of bladder control and not being able to have an erection.
So talk with your doctor. Ask about your risk for prostate cancer, and discuss the pros and cons of PSA testing.
Choosing treatment for prostate cancer can be confusing. Any treatment can cause serious side effects.
Your treatment decision will depend on:
Treatment may be more successful if prostate cancer is found and treated early. Unlike many other cancers, prostate cancer is usually slow-growing. For most men, this slow growth means they have time to learn all they can before deciding whether to have treatment or which treatment to have.
The main treatments for prostate cancer include:
A diagnosis of prostate cancer usually means that you will be seeing your doctor regularly for years to come. So it's a good idea to build a relationship that is based on full and honest information. Ask your doctor questions about your cancer so that you can make the best decision about treatment. Your doctor also may give you some advice on changes to make in your life to help your treatment succeed.
For more information about specific treatments, see the following topics:
A cancer diagnosis can change your life. You may feel like your world has turned upside down and you have lost all control. Connect with friends, family, or others—it's more important than ever.
If your emotions get in the way of your ability to make decisions about your health, it's important to talk with your doctor. Your cancer treatment center may offer psychological or financial services. And a local chapter of the American Cancer Society can help you find a support group.
If you choose surgery or radiation to treat your prostate cancer, it will be important to have regular checkups. If your cancer comes back, this will help your doctor find it early.
If you decide to do active surveillance instead of having treatment, you will have regular checkups with your doctor to check on your cancer. It is possible that a curable cancer could spread and become incurable during a 6-month period, but this isn't common. If there is no change in your condition, you may continue active surveillance. If the cancer begins to grow or spread, you may consider medicines, surgery, or radiation.
One thing you can do that may lower the risk for prostate cancer is eat more low-fat, high-fiber foods and foods with omega-3 fatty acids, such as:
During any stage of prostate cancer, there are things you can do at home to help manage the side effects of cancer or treatment. Healthy habits such as eating right and getting enough sleep and exercise can help control your symptoms.
Try the following tips to manage:
Hormones are medicines that can affect the growth of prostate cancer cells. Hormone therapy is sometimes used with radiation treatment or surgery to help make sure that all cancer cells are destroyed.
Hormone therapy can't cure prostate cancer. But it will usually shrink the tumor and slow the rate of cancer growth, sometimes for years. Taking a hormone-therapy medicine lowers your level of testosterone and other male hormones. Another way to lower male hormones is by having surgery to remove the testicles, called an orchiectomy.
Chemotherapy is the use of powerful medicines—either injected or taken as pills—to destroy cancer cells. Many men decide to have chemotherapy for treatment of late-stage prostate cancer, but researchers are studying whether chemotherapy should be used before or after surgery to treat early-stage, high-risk prostate cancer.1
Surgery for prostate cancer may be done to:
Radical prostatectomy is an operation to remove the entire prostate and any nearby tissue that may contain cancer. It can be done as open surgery through an incision (cut) in the belly, or as laparoscopic surgery through several very small incisions in the belly. Laparoscopic surgery is done with a tiny camera and special tools to remove the prostate. Sometimes lymph nodes in the area also are removed so that they can be checked for signs of cancer. This is called a lymph node biopsy.
Surgery may completely remove your prostate cancer. But it isn't possible to know for sure before surgery whether the cancer has spread beyond the prostate. When cancer has spread, it can't always be cured with surgery alone.
Active surveillance means that you will be watched closely by your doctor. If you are a younger or active man who is at low risk, this will mean regular checkups. If the cancer starts to grow more quickly, you will need to have other treatment, such as surgery. Your regular checkups may include digital rectal exams, PSA tests, and biopsies.
Active surveillance is a good treatment choice for men who have low-risk cancer that hasn't spread.5 If you have cancer that is more likely to spread, you will need to have other treatment unless you are only expected to live a short time.
Radiation therapy may be used alone or combined with hormone treatment or surgery to treat prostate cancer. Like surgery, it is most effective in treating cancer that hasn't spread outside the prostate. When combined with surgery, radiation is used to destroy any cancer cells that might be left behind and to relieve pain when the cancer has spread.
Radiation treatment for prostate cancer includes:
Radiation treatment may cause erection problems and bladder problems. It sometimes causes diarrhea. The ability to have an erection sometimes returns or at least improves over time. So does the ability to control urination.
Side effects are common. Some men develop long-term problems that may have a big impact on the quality of their lives. Long-term problems that can be caused by radiation treatment include:
Your doctor may talk to you about joining a research study called a clinical trial if one is available in your area. Clinical trials are research studies to look for ways to improve treatments for prostate cancer. Experts are doing studies on:
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:
Mind-body treatments like those mentioned above may help you feel better and cope better with treatment. These treatments also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. Complementary therapies aren't meant to take the place of standard medical treatment. But they may improve your quality of life and help you deal with the stress and side effects of cancer treatment.
| Centers for Disease Control and Prevention (CDC) | |
| 1600 Clifton Road | |
| Atlanta, GA 30333 | |
| Phone: | 1-800-CDC-INFO (1-800-232-4636) |
| TDD: | 1-888-232-6348 |
| Email: | cdcinfo@cdc.gov |
| Web Address: | www.cdc.gov |
|
The Centers for Disease Control and Prevention (CDC) is an agency of the U.S. Department of Health and Human Services. The CDC works with state and local health officials and the public to achieve better health for all people. The CDC creates the expertise, information, and tools that people and communities need to protect their health—by promoting health, preventing disease, injury, and disability, and being prepared for new health threats. |
|
| Man to Man | |
| Phone: | 1-800-227-2345 |
| Web Address: | www.cancer.org/docroot/ESN/content/ESN_3_1X_Man_to_Man_36.asp?sitearea=SHR |
|
The American Cancer Society's Man to Man program provides community-based education and support for men with prostate cancer. Self-help and support groups focus on prostate cancer, treatment, side effects, and coping with the disease and with treatment. Program services and activities depend on the location. Some locations offer groups for men along with their wives or partners. And other locations may offer a group setting called Side by Side for the wives or partners to meet separately. To locate a program in your area, call the American Cancer Society toll-free at the number shown above. |
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| National Cancer Institute (NCI) | |
| 6116 Executive Boulevard | |
| Suite 300 | |
| Bethesda, MD 20892-8322 | |
| Phone: | 1-800-4-CANCER (1-800-422-6237) |
| Web Address: | www.cancer.gov (or https://cissecure.nci.nih.gov/livehelp/welcome.asp# for live help online) |
|
The National Cancer Institute (NCI) is a U.S. government agency that provides up-to-date information about the prevention, detection, and treatment of cancer. NCI also offers supportive care to people who have cancer and to their families. NCI information is also available to doctors, nurses, and other health professionals. NCI provides the latest information about clinical trials. The Cancer Information Service, a service of NCI, has trained staff members available to answer questions and send free publications. Spanish-speaking staff members are also available. |
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| Prostate Cancer Foundation | |
| 1250 Fourth Street | |
| Santa Monica, CA 90401 | |
| Phone: |
1-800-757-CURE (1-800-757-2873) (310) 570-4700 |
| Fax: | (310) 570-4701 |
| Email: | info@pcf.org |
| Web Address: | www.prostatecancerfoundation.org |
|
The Prostate Cancer Foundation is the world's leading organization for funding prostate cancer research. On its Web site, you'll find information on prostate cancer detection, treatment, and support groups. |
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| UrologyHealth.org, American Urological Association | |
| 1000 Corporate Boulevard | |
| Linthicum, MD 21090 | |
| Phone: | 1-800-828-7866 |
| Phone: | (410) 689-3700 |
| Fax: | (410) 689-3998 |
| Email: | auafoundation@auafoundation.org |
| Web Address: | www.urologyhealth.org |
|
UrologyHealth.org is a website written by urologists for patients. Visitors can find specific topics by using the "search" option. The website provides information about adult and pediatric urologic topics, including kidney, bladder, and prostate conditions. You can find a urologist, sign up for a free quarterly newsletter, or click on the Urology Resource Center to find materials about urologic problems. |
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Citations
- Zelefsky MJ, et al. (2008). Cancer of the prostate. In VT DeVita Jr et al., eds., Devita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology, 8th ed., vol. 1, pp. 1392–1452. Philadelphia: Lippincott Williams and Wilkins.
- American Cancer Society (2009). Cancer Facts and Figures 2009. Atlanta: American Cancer Society. Available online: http://www.cancer.org/acs/groups/content/@nho/documents/document/500809webpdf.pdf.
- U.S. Preventive Services Task Force (2008). Screening for Prostate Cancer: Clinical Summary of a U.S. Preventive Services Task Force Recommendation. Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.ahrq.gov/clinic/uspstf08/prostate/prostaters.htm.
- Kantoff PW (2007). Prostate cancer. In DC Dale, DD Federman, eds., ACP Medicine, section 12, chap. 9. New York: WebMD.
- National Comprehensive Cancer Network (2009). Prostate cancer. NCCN Clinical Practice Guidelines in Oncology, version 2.2009. Available online: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site.
- D'Amico AV, et al. (2007). Radiation therapy for prostate cancer. In AJ Wein et al., eds., Campbell-Walsh Urology, 9th ed., vol. 3, pp. 3006–3031. Philadelphia: Saunders Elsevier.
Other Works Consulted
- Ahmed HU, et al. (2007). Will focal therapy become a standard of care for men with localized prostate cancer? Nature Clinical Practice Oncology, 4(11): 632–642.
- Chen RC, et al. (2008). Treatment "mismatch" in early prostate cancer: Do treatment choices take patient quality of life into account? Cancer, 112(1): 61–68.
- D’Amico, et al. (2008). Androgen suppression and radiation vs radiation alone for prostate cancer: A randomized trial. JAMA, 299(3): 289–295.
- Elkord E (2007). Immunology and immunotherapy approaches for prostate cancer. Prostate Cancer Prostatic Disease, 10(3): 224–236.
- Hartke DM, Resnick MI (2007). Radical perineal prostatectomy. In AJ Wein et al., eds., Campbell-Walsh Urology, 9th ed., vol. 3, pp. 2979–2984. Philadelphia: Saunders Elsevier.
- Keating NL, et al. (2010). Diabetes and cardiovascular disease during androgen deprivation therapy: Observational study of veterans with prostate cancer. Journal of the National Cancer Institute, 102(1): 39–46.
- Malcolm JB, et al. (2010). Quality of life after open or robotic prostatectomy, cryoablation or brachytherapy for localized prostate cancer. Journal of Urology, 183(5): 1822–1828.
- National Cancer Institute (2010). Prostate Cancer PDQ: Treatment – Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/prostate/patient.
- National Comprehensive Cancer Network (2009). Prostate cancer. NCCN Clinical Practice Guidelines in Oncology, version 2.2009. Available online: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site.
- Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
- Redman MW, et al. (2008). Finasteride does not increase the risk of high-grade prostate cancer: A bias-adjusted modeling approach. Cancer Prevention Research. Published online May 18, 2008 (doi:10.1158/1940-6207.CAPR-08-0092).
- Su L, Smith JA (2007). Laparoscopic and robotic-assisted laparoscopic radical prostatectomy and pelvic lymphadenectomy. In AJ Wein et al., eds. Campbell-Walsh Urology, 9th ed., vol. 3, pp. 2985–3005. Philadelphia: Saunders Elsevier.
- Tunn U (2007). The current status of intermittent androgen deprivation (IAD) therapy for prostate cancer: Putting IAD under the spotlight. British Journal of Urology International, 99(Suppl 1): 19–24.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Last Revised | April 2, 2012 |
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