Prostate Cancer Guide: Symptoms, Causes, and Treatments

What is prostate cancer?

Prostate cancer is a type of cancer that starts inside the prostate. 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.

Prostate cancer is the second most common cause of cancer in males. But the good news is that prostate cancer also has one of the highest survival rates of any type of cancer.

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What causes prostate cancer?

Prostate cancer occurs when cells in the prostate divide uncontrollably. Normally, 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 exposures in the environment. 

Researchers are still working to discover all the reasons why normal prostate cells turn into cancer cells. Right now, research shows that people are more likely to develop prostate cancer if they: 

• Are over 65 years old

• Have a family history of prostate cancer

• Have certain genetic mutations like BRCA1 or BRCA2

• Smoke tobacco

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What are the symptoms of prostate cancer?

Prostate cancer usually grows slowly. So it can take a really long time before people experience any 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

Most people find out they have prostate cancer before they develop symptoms. Many cases of prostate cancer are discovered during screenings and not because people have symptoms.

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Screening for prostate cancer

Screening for prostate cancer may help identify prostate cancer early when it’s easier to treat. There’s no perfect screening test for prostate cancer. And not all experts agree on who should receive prostate cancer screening.

Right now, two tests are used to screen for prostate cancer: a prostate-specific antigen (PSA) test and a digital rectal exam (DRE). 

Prostate-specific antigen test 

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 may be a sign of prostate cancer.

Digital rectal exam

A DRE is when a healthcare professional places a lubricated, gloved finger in your rectum and feels the prostate to make sure it’s a normal size and shape.

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How is prostate cancer diagnosed?

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

During a prostate biopsy, a needle passes through the rectum or perineum (between your scrotum and anus) and into the prostate 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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What are the treatments for prostate cancer?

Your treatment options can include one or more of the following:

• Active surveillance

• Surgery

• Radiation therapy

• Hormone therapy

• Other systemic therapies

There are several healthcare professionals 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 healthcare professional who uses radiation to treat cancer. 

• Medical oncologist: This is a healthcare professional who focuses on cancer treatment, chemotherapy, and hormone therapy. 

What is active surveillance?

Some people are candidates for active surveillance, which means they don’t start treatment right away. Instead, the medical team will follow your cancer closely. They’ll repeat PSA testing, DREs, and prostate MRIs a few times a year and prostate biopsies every few years. If the cancer starts to progress, then you may need to start other types of prostate cancer treatment.

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Living with prostate cancer

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 nutritious diet and keeping up with your daily activities can also improve your response to cancer treatment.