Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-shaped structure that makes up part of a man's reproductive system. It wraps around the urethra, the tube that carries urine out of the body.
Cancer - prostate; Biopsy - prostate; Prostate biopsy; Gleason score
Prostate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40.
People who are at high risk include:
Other people at risk include:
Prostate cancer is less common in people who do not eat meat (vegetarians).
A common problem in almost all men as they grow older is an enlarged prostate. This is called benign prostatic hyperplasia, or BPH. It does not raise your risk of prostate cancer. But, it can increase your prostate-specific antigen (PSA) blood test result.
With early prostate cancer, there are often no symptoms.
The PSA blood test may done to screen men for prostate cancer. Often, PSA level rises before there are any symptoms.
The symptoms listed below can occur with prostate cancer as it grows larger in the prostate. These symptoms can also be caused by other prostate problems:
When the cancer has spread, there may be bone pain or tenderness, most often in the lower back and pelvic bones.
Treatment depends on many things, including your Gleason score and your overall health. Your doctor will discuss your treatment options with you.
If the cancer has not spread outside the prostate gland, common treatments include:
If you are older, your doctor may recommend simply monitoring the cancer with PSA tests and biopsies.
Hormone therapy is mainly used for cancer that has spread beyond the prostate. It helps relieve symptoms and prevents further growth and spread of the cancer. But it does not cure the cancer.
If prostate cancer spreads even after hormone therapy, surgery, or radiation has been tried, treatment may include:
Surgery, radiation therapy, and hormone therapy can affect your sexual performance. Problems with urine control are possible after surgery and radiation therapy. Discuss your concerns with your health care provider.
After treatment for prostate cancer, you will be closely watched to make sure the cancer does not spread. This involves routine checkups, including PSA blood tests (usually every 3 months to 1 year).
You can ease the stress of illness by joining a prostate cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
How well you do depends on whether the cancer has spread outside the prostate gland and how abnormal the cancer cells are (the Gleason score) when you are diagnosed.
A cure is possible if the cancer has not spread. Hormone treatment can improve survival, even if a cure is not possible.
Discuss the advantages and disadvantages of PSA screening with your health care provider.
Talk with your provider about possible ways to lower your risk of prostate cancer. These may include lifestyle measures, such as diet and exercise.
There are no medicines approved by the FDA for preventing prostate cancer.
American Urological Association website. PSA testing for the pretreatment staging and posttreatment management of prostate cancer: 2013 Revision of 2009 Best Practice Statement. www.auanet.org/guidelines/prostate-specific-antigen-(psa)-best-practice-statement. Accessed December 5, 2019.
American Urological Association website. Early detection of prostate cancer (2018): clinical guideline. www.auanet.org/guidelines/prostate-cancer-early-detection-guideline. Accessed August 22, 2019.
National Cancer Institute website. Prostate cancer treatment (PDQ) health professional version. www.cancer.gov/types/prostate/hp/prostate-treatment-pdq. Updated September 20, 2019. Accessed December 5, 2019.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): prostate cancer. Version 4.2019. www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Updated August 19, 2019. Accessed September 4, 2019.
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US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Screening for prostate cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(18):1901-1913. PMID: 29801017 www.ncbi.nlm.nih.gov/pubmed/29801017.