Prostate Cancer: What to Know

The prostate is a small gland that makes fluid for semen. It's below the bladder in males, and in front of the rectum. Prostate cancer happens when abnormal cells grow in the prostate gland.

What are the causes?

The exact cause of prostate cancer is not known.

What increases the risk?

You are more likely to get prostate cancer if:

• You're 65 years of age or older.
• Someone in your family has prostate, breast, or ovarian cancer.
• You have certain genes passed from your parents, like ATM, BRCA1, or BRCA2.
• You have Lynch syndrome.
• You are African American or from Africa.

Scientists are still learning why some males get prostate cancer more often than others.

What are the signs or symptoms?

Symptoms of prostate cancer include:

• Problems with peeing, such as:
  • A weak stream or needing to go more often, especially at night.
  • Trouble starting or stopping your pee.
  • Trouble emptying the bladder all the way.
• Blood in your pee or semen.
• Pain in your lower back, belly, or hips that won't go away.
• Trouble getting an erection.
• Weakness or numbness in the legs or feet.

How is this diagnosed?

Prostate cancer can be diagnosed with:

• A digital rectal exam. The health care provider puts a gloved finger into your butt to feel the prostate gland.
• A blood test called a prostate-specific antigen (PSA) test.
• A biopsy. A sample of tissue is taken from the prostate and checked under a microscope.
• An imaging test called transrectal ultrasound.

After finding cancer, providers do more tests, like a bone scan, CT scan, or MRI, to see if it has spread. This is called staging the cancer.

Stages of prostate cancer

Prostate cancer is put into stages to see how far it has grown:

• Stage 1 (I). The cancer is only in the prostate.
• Stage 2 (II). The cancer is bigger but still inside the prostate.
• Stage 3 (III). The cancer has grown outside the prostate to nearby areas.
• Stage 4 (IV). The cancer has spread to other parts of the body, such as the lymph nodes, bones, bladder, rectum, liver, or lungs.

Prostate cancer grading

Prostate cancer is also graded according to how the cancer cells look under a microscope. This is called the Gleason score. The score can be from 6 to 10. A higher score means the cancer is more likely to spread.

• Gleason 6 or lower: The cells look almost normal.
• Gleason 7: The cells look somewhat normal.
• Gleason 8, 9, or 10: The cells look very different from normal.

How is this treated?

Treatment depends on how far the cancer has grown, your age, your choices, and your health. Talk with your provider about what's best for you. Common treatments include:

• Watchful waiting. This is used for early prostate cancer. You'll be tested from time to time to make sure that the cancer isn't growing.
• Medicines such as:
  • Chemotherapy. This uses medicines to kill cancer cells or stop them from growing. It can also kill normal cells.
  • Hormone treatment. This treatment stops or blocks testosterone, a male hormone that helps cancer grow.
  • Targeted therapy. This treatment uses medicines to kill cancer cells without hurting normal cells.
• Surgery to remove the prostate gland. This can be done in different ways, such as:
  • Open surgery. A big cut is made to remove the prostate gland.
  • Laparoscopic. Small cuts are made to remove the prostate gland and lymph nodes.
  • Robotic. Small cuts are made to remove the prostate gland and lymph nodes with the help of robotic arms.
• Cryoablation. This uses freezing cold to kill cancer cells.
• Radiation. This uses special rays to destroy cancer cells. Types include:
  • External beam radiation from outside the body.
  • Brachytherapy. Radioactive needles, seeds, wires, or tubes are put in the prostate gland.
• Immunotherapy. This treatment boosts, directs, or restores your body's defenses (immune system) to fight cancer.

Follow these instructions at home:

Lifestyle

• Get plenty of sleep.
• Eat a healthy diet. To do this:
  • Eat foods that are high in fiber. These include beans, whole grains, and fresh fruits and vegetables.
  • Limit foods that are high in fat and sugar. These include fried or sweet foods.
• Do not smoke, vape, or use nicotine or tobacco.
• Treatment for prostate cancer may affect your sex life. If you have a partner, continue to show love and care. This may include touching, holding, and hugging your partner.
• Join a support group to meet others with prostate cancer. A support group may help you manage stress.

General instructions

• Take your medicines only as told.
• If you have to go to the hospital, let your cancer specialist (oncologist) know.
• Keep all follow-up visits. Your provider will check if your treatment is working and catch any problems early.

Where to find more information

To learn more, go to these websites:

• American Cancer Society at cancer.org. Then:
  1. Click "search" in the home page.
  2. Type "prostate cancer" in the search field.
  3. Find the results you need.
• National Cancer Institute at cancer.gov. Then:
  1. Click "search" and type "prostate cancer."
  2. Find the links you need.

Contact a health care provider if:

• You have new or more trouble peeing.
• You have new or more blood in your pee.
• You have new or more pain in your hips, back, or chest.
• You have chills or a fever.

Get help right away if:

• You have new weakness or numbness in your legs.
• You cannot control peeing or pooping.