Anne E. Lizardi-Calvaresi, DNP, CRNP, RNFA
Urology Care Foundation Prostate Education Council Member and Prostate Health Committee Chair, Thomas Jefferson University
Prostate cancer is cancer that presents in the prostate — a small, walnut-shaped gland in men that sits below the bladder and in front of the rectum.
Prostate cancer often grows slowly and if it stays within the prostate gland, it may need minimal or no treatment. However, while some types of prostate cancer grow slowly, other types can grow faster, spread quickly, and require more immediate treatment.
Prostate cancer detected early — when it’s still confined within the prostate gland — is known as early-stage or localized prostate cancer, and is more likely to be treated successfully.
It’s not clear what causes prostate cancer, but doctors know this particular cancer begins when cells in the prostate become abnormal. These abnormal cells then grow and divide faster than a man’s normal cells do and a cancerous tumor is formed.
Factors that can increase the risk of prostate cancer include:
- Age: A man’s risk of prostate cancer increases as they age.
- Race: For reasons not yet known, Black men have a greater chance of being diagnosed with prostate cancer. In Black men, prostate cancer is also more likely to be aggressive or grow outside of the prostate (known as advanced prostate cancer).
- Family history: If other men in your family have had prostate cancer, your risk may be higher. Also, if there is a history of the BRCA1 or BRCA2 genes in your family, which increase the risk of breast cancer, or if there is a very strong history of breast cancer in your family, your risk of prostate cancer may be higher.
Detecting and diagnosing
Organizations like the American Urological Association and Urology Care Foundation recognize the choice to be screened for prostate cancer is a personal one and should be taken seriously. It begins with a conversation with your doctor about your risk for the disease, including your personal and family history. Then, a talk about the benefits and risks of testing.
Generally, prostate cancer screening is recommended for men with no symptoms who are between the ages of 55 and 69. Some men who are at higher risk for prostate cancer should talk to their doctor about the proper time to get screened.
Prostate cancer often causes no signs or symptoms in its early stages, which is why screening for this disease is so important for catching it early. Prostate cancer is often detected by testing for prostate-specific antigen (PSA) levels in a man’s blood and performing a quick, five-second digital rectal exam (DRE). If the results of either of these tests come back irregular, a prostate biopsy is often done to confirm if a man has prostate cancer.
If a diagnosis of prostate cancer is confirmed, your treatment will depend on:
- The stage and grade of the cancer
- Your age and health
- Possible treatment side effects, including long-term effects and treatment goals
- Results from other diagnostic tests that help your doctor know if the cancer has a chance of spreading or returning after treatment
Early-stage treatment options
There are several treatment options for prostate cancer. Below are three common ones for early-stage prostate cancer explained in a bit more detail.
- Active surveillance: During active surveillance, prostate cancer is carefully monitored for signs of progression through regular PSA screening, prostate exams, imaging, and sometimes repeat biopsies. If symptoms develop or if tests indicate the cancer is becoming more aggressive, active treatment like surgery or radiation may be warranted.
- Surgery: Surgery is a common choice to remove prostate cancer if it is not thought to have spread outside the prostate gland. The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the urologist removes the entire prostate gland and some of the tissue around it, including the seminal vesicles.
- Radiation therapy: Radiation therapy uses high-energy rays to kill or slow the growth of cancer cells. Radiation can be used as the primary treatment for prostate cancer (in place of surgery).
For information about prostate cancer and other treatment options, visit UrologyHealth.org.