Understanding prostate cancer
Did you know prostate cancer is the second most common cancer among men in America? It affects about 1 in 9 men.1 So, using an everyday example, you could think about it like this: during a baseball game, any 1 of the 9 in the field might be diagnosed with prostate cancer. Most often, that won't happen until they’re quite a bit older — it’s most commonly diagnosed in men who are in their 60s.1
The prostate is a small, walnut-shaped gland in the male reproductive system that makes fluid to support sperm. And, just like you grow with age, your prostate can grow with you. So, an enlarged prostate is often normal and called benign prostatic hyperplasia. It’s not time to worry until the cells in the prostate gland grow out of control and turn into cancer. If that happens, the first step is determining which type of prostate cancer is there.2
What are the types of prostate cancer?
Many cases of prostate cancer grow slowly and stay in the prostate. Sometimes men live without ever knowing they have it. Other times it may be more aggressive and may spread to the organs, lymph system or bones. The most common type (almost all cases) is called an adenocarcinoma.3 These cancerous tumors start in the gland cells that make fluid. (And actually, an adenocarcinoma can happen in any organ with cells that produce mucus, like the breast, lung and colon).4
Other kinds of prostate cancers exist, but are considered more rare. They include: small cell carcinomas, neuroendocrine tumors, transitional cell carcinomas and sarcomas.5
Early detection is really important. If you believe you are at average risk (meaning you don’t have any of the risk factors listed below), you might want to consider asking your doctor about getting routine screenings for prostate cancer once you turn 50.
How does the exam work? Your doctor may perform a digital rectal exam (DRE) during your yearly physical. He or she places a gloved finger in your rectum to feel for any irregularities in prostate size and shape. Don’t worry — it’s often a quick test.
The second test is called the prostate-specific antigen (PSA) blood test. This can be ordered with other lab work you may likely have done during your physical, so there may not be any extra work for you to do — but be sure to consult your doctor to confirm. PSA is a protein found in the prostate and the level of that protein may help indicate if there’s cancer. The higher the number, the more likely there may be cancer.6
If you’re close to 50 years old, have a conversation with your doctor about when you should start getting your prostate cancer screenings.
Usually, most early prostate cancers don’t cause symptoms and may be found through screening. Advanced cancers might cause symptoms, like:7,8
- Frequent, urgent or painful urination
- Loss of bladder or bowel control
- Blood in urine or semen
- Trouble getting an erection
- Painful ejaculation
- Pain in the rectum
- Hip, back or chest pain if cancer has spread to the bones
Keep in mind, many things in this list may also likely be caused by something else, like that benign prostatic hyperplasia we mentioned. Nonetheless, if you believe you may have any of these symptoms, see your doctor right away.
The majority of risk factors for getting prostate cancer may be beyond your control, but it’s good to be aware of them. Things like:10, 11
- Older age: Your risk may increase as you get older, with diagnosis most common after 50.
- Race: Black men have a greater risk of prostate cancer — it’s also more likely to be aggressive.
- Family history: If you have a relative who has been diagnosed or you have the gene associated with a greater chance for getting breast cancer, you may be at higher risk.
- Diet: Eating lots of dairy may increase your risk because of its natural growth hormone, called the insulin-like growth factor.
- Obesity: Being obese may put you at risk for aggressive prostate cancer and increase the chance of it coming back after treatment. Here are tips on how physical activity may help.
The cancer’s type, stage and grade may determine which treatment option is best. Have a conversation with your doctor and care team, ask questions and consider doing your own research to weigh pros and cons before coming up to bat on your treatment journey. Here’s a list of possible prostate cancer treatments, with the first three being most common:11 Again, talk to your doctor about these possible treatment options:
- Active surveillance: It’s possible you may simply keep a close eye on your prostate cancer with regular PSA tests, DREs and prostate biopsies — and only treating if the tumor grows or causes symptoms.
- Surgery: To fight aggressive cancers, removing the prostate may be the best option.
- Radiation: Radiation may be used to kill the cancer cells.
- Cryotherapy: Have you ever had a wart frozen off? Similar idea here.
- Chemotherapy: Chemo medicines may be used to shrink or kill the cancer.
- Biological therapy: Also known as immunotherapy, this approach works a little like a vaccine — but for prostate cancer. It may help your body recognize and fight off cancer cells.12
- High-intensity focused ultrasound: This uses ultrasound waves to help kill the cancer.
- Hormone therapy: This helps blocks the cancer from getting hormones needed to grow.
Who should I see if I'm concerned about prostate cancer?
Think you may have symptoms of prostate cancer? Schedule a visit with your primary provider (the doctor or provider you might see for your yearly physical). If they feel something suspicious during that exam or sees a high PSA level on your latest test, you may get some diagnostics done (like an ultrasound, MRI or biopsy) to learn more. If it turns out you have prostate cancer, your doctor may refer you to a urologist or oncologist to discuss treatment options. 13