Prostate Cancer

What is prostate cancer?

Prostate cancer is a disease in which cancer forms in the tissues of the prostate, a male gland just below the bladder and in front of the rectum. Prostate cancer is rare in men younger than 50 years of age, and the chance of developing prostate cancer increases as men get older. In the United States, a man has a one in five chance of being diagnosed with prostate cancer in his lifetime.

Risk factors

Risk factors for prostate cancer may include:

• Being an older male
• Family history of prostate cancer
• Being African-American
• Hormones: The prostate needs male hormones, such as testosterone, to function properly. Testosterone helps men develop and maintain male sex characteristics. DHT, a derivative of testosterone, is important for normal prostate growth but can also cause the prostate to enlarge, which may play a part in the development of prostate cancer.
• Regular vitamin E intake
• Not consuming enough folic acid (folate)
• A diet high in fat or dairy

Signs and symptoms

Symptoms may not appear during the early stages of prostate cancer, and most symptoms of prostate cancer vary from person to person. Having these symptoms does not mean you have prostate cancer.

Common prostate cancer signs and symptoms may include:

• Weak or interrupted ("stop-and-go") urine flow
• Sudden or frequent urge to urinate
• Trouble urinating or starting the flow of urine
• Trouble emptying the bladder completely
• Trouble holding back urination
• Pain or burning urination
• Blood in the urine or semen
• Pain in the back, hips, or pelvis that doesn't go away
• Shortness of breath, feeling very tired, an accelerated heartbeat, dizziness, or pale skin caused by anemia
• Difficulty having an erection

Some of the symptoms listed above may occur with a condition called benign prostatic hyperplasia (BPH). BPH occurs when the prostate enlarges and interferes with urine flow or sexual function. BPH is not cancer, but surgery may be needed to correct it. The symptoms of BPH or other problems in the prostate mimic the symptoms of prostate cancer.

Diagnosis

• Digital rectal exam (DRE)
• A prostate-specific antigen (PSA) test that measures the level of PSA in the blood
• Rectal ultrasound
• Biopsy

Learn details about how we diagnose prostate cancer.

Treatment

Treatment plans depend largely on the health and future reproductive wishes of the patient. Other factors, such as the expected side effects of treatment and previous treatment for prostate cancer, may alter the available treatment options.

Treatments for prostate cancer may include:

• Surgery
  
  • Open prostatectomy (often with nerve-sparing techniques)
  • Minimally-invasive laparoscopic robotic surgery
   
• Image-guided radiation therapy (IGRT)
• Brachytherapy
• Active surveillance
• Hormone therapy
• Immunotherapy

Learn details about how we treat prostate cancer.

Prognosis

Most men diagnosed with prostate cancer survive the disease. However, the chance of recovery (prognosis) depends on:

• Patient's age
• The stage of the disease
• Level of PSA in the blood
• Gleason score, a test that evaluates prostate cancer on a cellular level to determine how aggressive the disease is
• Whether the disease is newly diagnosed or recurrent; recurrent cases are more difficult to treat

Read our Insight blog for information and inspiration about prostate cancer treatment at Dana-Farber.