Prostate Cancer: Your GoodRx Guide

Definition

The prostate is an organ about the size of a ping-pong ball. It sits below the bladder, and it helps make semen. The prostate is important for fertility, but it isn’t a vital organ — meaning you don’t need it to survive.

Anyone born with a prostate can develop prostate cancer. Prostate cancer is the second most common cause of cancer in people with male sex organs. 

Prostate cancer has one of the highest survival rates of any type of cancer.

The good news is that prostate cancer is one of the most treatable types of cancer. 

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Causes

Prostate cancer occurs when cells in the prostate divide uncontrollably. In good health, this doesn’t happen because the body carefully controls how often a cell divides. But in cancer, some cells have a genetic mistake — a mutation — that lets them bypass the body’s checkpoints. These mutations can come from genes that people inherit or through exposure to certain things in the environment. Scientists are still working to discover all the reasons why normal prostate cells turn into cancer cells.

The risk of developing prostate cancer increases as you get older.

Research shows that several things increase the risk of developing prostate cancer, including:

• Age: Older males are more likely to develop prostate cancer. Among prostate cancer cases, 60% happen over the age of 65.

• Race: It’s not yet clear why, but Black males are almost twice as likely to develop prostate cancer than white males. 

• Genetics: Certain genes increase the risk of developing prostate cancer. You are twice as likely to develop prostate cancer if you have a close family member who also had prostate cancer. You may be at higher risk if there’s a history of breast, ovarian, colon, or pancreatic cancer in your family. 

• Diet: Diets that are higher in saturated fat and meat products are associated with prostate cancer. 

• Smoking: People who smoke are more likely to develop aggressive prostate cancer. 

• Body mass index (BMI): A higher BMI is associated with aggressive prostate cancer because body fat can affect hormones that are linked to prostate cancer.

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Symptoms

Prostate cancer usually grows slowly, so it takes awhile to cause symptoms. Some people experience symptoms like:

• A need to urinate (pee) frequently

• A weak urine stream or a urine stream that starts and stops

• A feeling of being unable to completely empty the bladder 

• Pain or burning with urination or ejaculation

• Blood in urine or semen

But most people with prostate cancer never have any symptoms. This is why screening for prostate cancer is so important. 

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Screening

Screening for prostate cancer lets healthcare providers find prostate cancer early when it is easier to treat. Healthcare providers screen people for prostate cancer with a digital rectal exam (DRE) and a prostate-specific antigen test (PSA). 

Digital rectal exam 

A DRE is a normal part of the physical exam. A healthcare provider places a lubricated, gloved finger in your rectum and feels the prostate to make sure it is a normal size and shape.

Prostate-specific antigen 

A PSA is a blood test. A “normal” PSA is different from person to person — depending on a person’s age and medical history. In general, a high PSA level can be a sign of prostate cancer.

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Diagnosis

The only way to make the diagnosis of prostate cancer is to have a prostate biopsy. 

In the U.S. 1 in 8 males will be diagnosed with prostate cancer.

During a prostate biopsy, a needle passes through the rectum into the prostate in order to get a sample of cells. These cells are examined under a microscope to look for cancer cells. Your healthcare team will use all this information to understand and stage your cancer. Staging is important to determine what treatment is best for you. 

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Treatments

There are several doctors who work together to treat people with prostate cancer, including a:

• Urologist: A urologist is a surgeon with special training in prostate cancer. Your urologist will perform your biopsy and any other surgeries you might need.

• Radiation oncologist: This is a doctor who specializes in using radiation to treat cancer. 

• Medical oncologist: This is a doctor who specializes in cancer treatment, chemotherapy, and hormone therapy. Your medical oncologist is the “team captain” of your medical team. 

Depending on your cancer, your treatment options can include one or more of the following:

• Surgery

• Radiation therapy

• Hormone therapy

Watch and wait

Some people are candidates for active surveillance, which means they don’t start treatment right away. Instead, the medical team will follow them closely and repeat PSA testing and DREs once or twice a year along with prostate biopsies every few years. If the cancer starts to progress, then they would start treatment. 

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Living

Adjusting to a cancer diagnosis can be overwhelming. It’s important to know your feelings are normal and that you’re not alone. Your family, friends, and medical team are available to support you. You can also talk to your medical team about accessing support groups and mental health services. 

Prostate cancer treatment comes with side effects. Your medical team can help you navigate these issues so that you have the best quality of life during and after your treatment. Research shows that people who are able to manage their side effects have better treatment outcomes. Maintaining a healthy diet and keeping up with your daily activities can also improve your response to cancer treatment. 

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