Prostate cancer is a disease in which cancer cells grow in the prostate gland. The prostate is a walnut-sized gland in men. It surrounds the urethra, the tube that carries urine out of the body. The prostate makes a fluid that is part of semen.
Copyright © Nucleus Medical Media, Inc.
The sooner prostate cancer is treated, the better the outcome.
Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.
It is not clear exactly what causes these problems in the cells, but it is probably a combination of genetics and environment.
Prostate cancer is more common in men who are aged 55 years and older. It is also more common in black men than white men. Other factors that may increase your chance of prostate cancer include: Family history of prostate cancer, especially father or brotherFamily history of prostate cancer diagnosed at a young ageA high-fat diet
Prostate cancer may cause: A need to urinate frequently, especially at nightDifficulty starting urination or holding back urineNot able to urinateWeak or interrupted urine flowPainful or burning urinationDifficulty having an erectionPainful ejaculationBlood in urine or semenFrequent pain or stiffness in the lower back, hips, or upper thighs
These symptoms may be caused by other conditions, such as
benign prostatic hyperplasia (BPH)
or an infection. If you have any of these symptoms, promptly see your doctor.
Your doctor will ask about symptoms and medical history. A physical exam will also be done.
Tests may include: Digital rectal examBlood testsUrine tests
Imaging tests evaluate the prostate and surrounding structures. These may include: Transrectal ultrasonographyIntravenous pyelogramCystoscopyProstate biopsy
The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, prostate cancer is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.
Cancer treatment varies depending on the stage of prostate cancer. You and your doctor will discuss the best treatment options for you. Treatment may include:
This involves your doctor monitoring the cancer to see if it is growing. Watchful waiting may be appropriate if you: Have early stage prostate cancer that is growing slowlyAre of an advanced ageHave serious health problems (risks of treatment outweigh the benefits)
involves the use of radiation to kill cancer cells and shrink tumors. Examples include:
Conformal radiation therapy—conformal radiation therapy uses 3-dimensional radiation beams that are conformed into the shape of the diseased prostate. This treatment spares nearby tissue the damaging effects of radiation.
Intensity-modulated radiation therapy (IMRT)—IMRT
uses radiation beams of different intensities to deliver higher doses of radiation therapy to the tumor and lower doses to nearby tissues at the same time.
If prostate cancer has spread or has returned after being treated, hormone therapy may be used. The goal of hormone therapy is to lower the levels of male hormones, called androgens. The main androgen is testosterone. Lowering androgen levels can cause prostate cancer to shrink or slow its growth.
Hormone therapy may include: Luteinizing hormone-releasing hormone (LHRH) analogsLuteinizing hormone-releasing hormone (LHRH) antagonistsAnti-androgensEstrogen therapy—rarely used now unless other treatments are not workingAntifungal medicationsAntineoplastic agents
In some case, a type of surgery called orchiectomy may be needed. This involves removing the testicles, which stops androgens from being produced.
Other options may include: Cryosurgery—this involves using an instrument to freeze and destroy prostate cancer cellsChemotherapyImmunotherapy—a drug treatment that builds your immune system so that you can better fight cancer cells
Targeted therapies—focus on the cancer cells, rather than attacking both the cancer cells and the healthy cells
High-intensity focused ultrasound—an endorectal probe (a probe that is inserted into the rectum) is used to destroy cancer cells with ultrasound energy
To help reduce your chance of prostate cancer, take the following steps:
healthful diet. Your diet should be high in
and fish, and low in red meat.
Ask your doctor about taking certain medications. For example, daily
therapy and 5-alpha reductase inhibitors may reduce your risk of prostate cancer.
Angiogenesis inhibitors. National Cancer Institute website. Available at:
http://www.cancer.gov/about-cancer/treatment/types/immunotherapy/angiogenesis-inhibitors-fact-sheet. Updated October 7, 2011. Accessed September 25, 2014.
Biological therapies for cancer. National Cancer Institute website. Available at:
http://www.cancer.gov/about-cancer/treatment/types/immunotherapy/bio-therapies-fact-sheet. Updated June 12, 2013. Accessed September 25, 2014.
Chemotherapy and targeted therapy. Texas Oncology website. Available at:
http://www.texasoncology.com/types-of-cancer/prostate-cancer/targeted-therapy-for-prostate-cancer. Accessed September 25, 2014.
Enzalutamide. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 25, 2014. Accessed September 25, 2014.
Evolution of cancer treatments: targeted therapy. American Cancer Society website. Available at:
http://www.cancer.org/cancer/cancerbasics/thehistoryofcancer/the-history-of-cancer-cancer-treatment-targeted-therapy. Updated June 12, 2014. Accessed September 25, 2014.
FDA approval for sipuleucel-T. National Cancer Institute website. Available at:
http://www.cancer.gov/cancertopics/druginfo/fda-sipuleucel-T. Updated July 3, 2013. Accessed September 25, 2014.
Imatinib. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 1, 2014. Accessed September 25, 2014.
Prostate cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003134-pdf.pdf. Accessed September 25, 2014.
Prostate cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 10, 2014. Accessed September 25, 2014.
Prostate cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 4, 2014. Accessed September 25, 2014.
Prostate cancer staging and imaging. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 1, 2014. Accessed September 25, 2014.
What is provenge immunotherapy? Provenge website. Available at:
http://www.provenge.com/advanced-prostate-cancer-immunotherapy.aspx Accessed July 31, 2012.
2/12/2010 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Smith DP, King MT, Egger S, et al. Quality of life three years after diagnosis of localised prostate cancer: population based cohort study.
2/19/2010 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Mahmud SM, Franco EL, Aprikian AG. Use of non-steroidal anti-inflammatory drugs (NSAIDs) and prostate cancer risk: a meta-analysis.
Int J Cancer.
Last reviewed September 2015 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.