Prostate cancer is a common cancer that develops in a man’s prostate gland. It’s estimated that 1 out of every 9 men will receive a prostate cancer diagnosis during their lifetime.

What is the prostate gland?

The prostate is part of the male reproductive system. During ejaculation, the gland makes fluid that mixes with semen to keep sperm healthy for conception.

This small gland sits in front of the rectum (the last part of the intestines) and below the bladder (which stores urine). The urethra, or tube that carries urine and semen through the penis, runs through the middle of the gland.

In younger men, the prostate is about the size and shape of a walnut. The gland often gets bigger as you age. This is known as an enlarged prostate.

How common is prostate cancer?

This year, nearly 200,000 American men will find out they have prostate cancer. It’s one of the most common cancers affecting males, second only to skin cancer. While there are many successful prostate cancer treatments, more than 33,000 men die from the disease every year.

What causes prostate cancer?

Almost all — 99% — of prostate cancers are adenocarcinomas. This cancer forms in glands that secrete mucus or fluids. Doctors aren’t exactly sure why some cells in the prostate become cancerous.

Are you at risk for prostate cancer?

Any man can get prostate cancer, but these factors increase your risk:

• Age: Your chances of developing prostate cancer go up as you get older. Prostate cancer is rare in men younger than 40. But 6 in 10 men older than 65 have the disease. 

• Ethnicity and race: For unknown reasons, Black men and Caribbean men of African ancestry are more likely to get prostate cancer at a young age. This cancer also tends to be more aggressive, which means it may spread (metastasize) to other parts of the body. Asian-American, Hispanic, and Latino men are less likely to get prostate cancer.

• Family history: Having a first-degree relative (father or brother) with prostate cancer doubles your risk of getting the disease. Still, many men with prostate cancer have no family history of the disease. 

• Genetic changes: Some men inherit changes (mutations) in genes linked to prostate cancer. These include mutated breast cancer genes (BRCA1 or BRCA2) and Lynch syndrome (an inherited type of colorectal cancer). 

• Smoking: Smokers may have double the risk of prostate cancer.

What are prostate cancer screenings?

Prostate cancer rarely causes symptoms during the early stage, which is why screenings are so important. If your risk for prostate cancer is low, your doctor may recommend getting annual screenings starting at age 50. You may need to start screenings during your 40s if you have a family history of disease or other high-risk factors.

Screening tests for prostate cancer include:

• digital rectal exam (DRE)

• prostate-specific antigen (PSA) blood test

• imaging scans

Digital rectal exam (DRE)

Your doctor inserts a gloved, lubricated finger into the rectum to feel the prostate gland. You may be bent over or lying on your side on an exam table during this test. Your doctor feels for bumps or hard, thick areas that may indicate the need for additional tests. A DRE can indicate a potential problem. It doesn’t diagnose prostate cancer.

Prostate-specific antigen (PSA) blood test

Your prostate gland makes protein-specific antigen (PSA). High levels of this protein in the blood may indicate cancer. But other noncancerous (benign) prostate conditions also increase PSA, so your doctor may perform another test to confirm or rule out prostate cancer.

PSA blood levels are measured in units called nanograms per milliliter (ng/mL). There isn’t a set number that indicates prostate cancer. In general, the higher the PSA level, the higher your odds of prostate cancer. If your reading is 10 ng/mL or higher, you have a 50% chance of having prostate cancer. Of course, there’s also a 50% chance that a benign condition is elevating PSA levels.

If your PSA levels are in the borderline range of 4 ng/mL and 10 ng/mL, there is a 1 in 4 chance of you having prostate cancer.

Only about 15% of men with PSA levels below 4 ng/mL have prostate cancer.

Imaging scans

Your doctor may order an MRI or a transrectal ultrasound (TRUS) to get detailed images of the prostate. These imaging scans can identify prostate gland abnormalities, such as prostate stones, abscesses, or enlargement. An abnormality may also indicate cancer.

How is prostate cancer diagnosed?

If a digital rectal exam and PSA blood test suggest you might have prostate cancer, your doctor will perform a core needle biopsy. This test is the only definitive way to diagnose the disease.

Your doctor numbs the area before performing the procedure. Using a thin, hollow needle, your doctor will draw out about a dozen small samples (cores) of tissue from the prostate gland. An MRI or TRUS technology may be used to guide the biopsy.

A lab expert called a pathologist examines the biopsy samples for signs of cancer cells. This information helps your doctor diagnose prostate cancer and the cancer stage.

Sources

• Key Statistics for Prostate Cancer. American Cancer Society. January 2020.

• Observation or Active Surveillance for Prostate Cancer. American Cancer Society. August 2019.

• Prostate Cancer Risk Factors. American Cancer Society. June 2020.

• Prostate Cancer Stages and Other Ways to Assess Risk. American Cancer Society. August 2019.

• Radiation Therapy for Prostate Cancer. American Cancer Society. August 2019.

• Screening Tests for Prostate Cancer. American Cancer Society. August 2019.

• Survival Rates for Prostate Cancer. American Cancer Society. January 2020.

• Tests to Diagnose and Stage Prostate Cancer. American Cancer Society. January 2020.

• Treating Prostate Cancer Spread to Bones. American Cancer Society. August 2019.

• What’s New in Prostate Cancer Research. American Cancer Society. August 2019.

• What Is Prostate Cancer? American Cancer Society. August 2019.

• Advanced Prostate Cancer. American Urological Association.

• Adenocarcinoma. Cancer Treatment Centers of America. 

• Metastatic Prostate Cancer. Cancer Treatment Centers of America. November 2020.

• Hypercalcemia. Mayo Clinic. March 2020.

• Gleason Score and Grade Group. Prostate Cancer Foundation.

• Prostate Cancer Metastases. Prostate Cancer Foundation.

• Prostate Cancer Staging. Prostate Cancer Foundation.

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts. This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.