What Is Prostate Cancer?
Cancer is a disease in which cells in the body grow out of control. When cancer starts in the prostate, it is called prostate cancer. Not including skin cancer, prostate cancer is the most common cancer in American men.
Many men with prostate cancer—especially those with tumors that have not spread beyond the prostate—die of other causes without ever having any symptoms from cancer.
What Is the Prostate?
The prostate is a part of the male reproductive system, which includes the penis, prostate, seminal vesicles, and testicles. The prostate is located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). It produces fluid that makes up a part of semen.
As a man ages, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow. This is called benign prostatic hyperplasia, and it is not the same as prostate cancer. Men may also have other prostate changes that are not cancer.
Symptoms of Prostate Cancer
Different people have different symptoms for prostate cancer. Most men do not have symptoms at all.
If you have any symptoms that worry you, be sure to see your doctor right away. They may be caused by conditions other than prostate cancer.
If you have any of the following symptoms, be sure to see your doctor right away:
- Difficulty starting urination.
- Weak or interrupted flow of urine.
- Urinating often, especially at night.
- Trouble emptying the bladder completely.
- Pain or burning during urination.
- Blood in the urine or semen.
- Pain in the back, hips, or pelvis that doesn't go away.
- Painful ejaculation.
Keep in mind that these symptoms may be caused by conditions other than prostate cancer.
African-American Men
- Are more likely to get prostate cancer than other men.
- Are more than twice as likely to die from prostate cancer than other men.
- Get prostate cancer at a younger age, tend to have more advanced disease when it is found, and tend to have a more severe type of prostate cancer than other men.
Family History
You may have an increased risk of getting a type of prostate cancer caused by genetic changes that are inherited if—
- You have more than one first-degree relative (father, son, or brother) who had prostate cancer, including relatives in three generations on your mother’s or father’s side of the family.
- You were diagnosed with prostate cancer when you were 55 years old or younger.
- You were diagnosed with prostate cancer, and other members of your family have been diagnosed with breast, ovarian, or pancreatic cancer.
Talk to your doctor about your family’s health history.
What Is Screening for Prostate Cancer?
Some men get a PSA test to screen for prostate cancer. Talk to your doctor, learn what is involved, and decide if a PSA test is right for you.
Cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread.
If you are thinking about being screened, learn about the possible benefits and harms of screening, diagnosis, and treatment, and talk to your doctor about your personal risk factors.
There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.
Prostate Specific Antigen (PSA) Test
A blood test called a prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.
As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.
PSA levels also can be affected by—
- Certain medical procedures.
- Certain medications.
- An enlarged prostate.
- A prostate infection.
Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results. If the PSA test is abnormal, your doctor may recommend a biopsy to find out if you have prostate cancer.
Digital Rectal Examination (DRE)
Digital rectal examination (DRE) is when a health care provider inserts a gloved, lubricated finger into a man’s rectum to feel the prostate for anything abnormal, such as cancer. In 2018, the U.S. Preventive Services Task Force stated that it does not recommend DRE as a screening test because of lack evidence on the benefits.
How Is Prostate Cancer Diagnosed?
A biopsy is a procedure that can be used to diagnose prostate cancer. A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.
Gleason score is determined when the biopsy tissue is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2 to 10. The lower the score, the less likely it is that the cancer will spread.
A biopsy is the main tool for diagnosing prostate cancer, but a doctor can use other tools to help make sure the biopsy is made in the right place. For example, doctors may use a transrectal ultrasound, when a probe the size of a finger is inserted into the rectum and high-energy sound waves (ultrasound) are bounced off the prostate to create a picture of the prostate called a sonogram. Doctors also may use magnetic resonance imaging (MRI) to guide the biopsy.
Staging
If prostate cancer is diagnosed, other tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. This process is called staging. Whether the cancer is only in the prostate, or has spread outside the prostate, determines your stage of prostate cancer. The stage of prostate cancer tells doctors what kind of treatment you need.
Resources
- CDC Prostate Cancer information page - for further information about treatment options and clinical trials.
- Blog post: Simple Answers to a Complicated Question: Should You Get Screened for Prostate Cancer?
- Understanding Prostate Changes: A Health Guide for Men (National Cancer Institute)
- Prostate-Specific Antigen (PSA) Test (National Cancer Institute)
- Prostate Health Education Network
- Talk to Nathan (CDC)