Prostate Cancer

Overview

Prostate cancer is the most common cancer in American men after skin cancer. Prostate cancer will develop in about one in seven men at some point in his life. Fortunately, outcomes for men with prostate cancer have improved substantially in recent decades, largely because of screening that allows early detection. Still, learning you have prostate cancer is overwhelming, and researching the disease and its treatment options may feel daunting. This content contains valuable information and resources to empower you to be in control of your treatment.

About the prostate

To understand prostate cancer, you need to know some basic information about the prostate. The prostate is a gland that is present only in males. It is located below the bladder and in front of the rectum. Its size changes with age, but in adults it is often about the size of a walnut (see Figure 1). The prostate makes seminal fluid, the liquid that protects and nourishes sperm cells. The urethra, which is the tube that carries urine and semen through the penis, goes through the middle of the prostate. Men can live without the prostate gland, but it is important for reproduction.

Prostate cancer occurs when normal cells within the prostate gland mutate and grow out of control, usually forming a tumor of abnormal cells. Most prostate cancers grow slowly and stay in the prostate. Many of these cancers can be watched carefully (active surveillance) or effectively removed or destroyed with treatment. However, some prostate cancers are aggressive. Malignant (cancerous) tumors can spread to other body parts if they are not found and treated early enough. When cancer spreads, it is likely to travel to nearby lymph nodes and then to bones and other organs. Prostate cancer that spreads is referred to as advanced prostate cancer.

Figure 1

Risk factors

Risk factors are traits that make you more likely to get a certain disease. Prostate cancer can affect any man, but doctors agree on some risk factors:

  • Age: Prostate cancer is much more common in men older than 50 years. About 60 percent of prostate cancer cases occur in men older than 65 years.
  • Family history: Prostate cancer is more than twice as likely to develop in men who have a father or brother with the disease.
  • Race: Prostate cancer occurs more often in African-American men and Caribbean men of African descent than in men of any other race. Prostate cancer is more likely to develop in non-Hispanic Caucasian men than Hispanic or Asian-American men.
 

Talk to your family about their risk

One risk factor is family history. Prostate cancer is twice as likely to develop in a man whose father or brother has prostate cancer. This risk increases if the cancer was diagnosed when the family member was younger than 55 years or if three or more family members had prostate cancer. Talk to your father, brothers and sons about their increased risk of prostate cancer. Encourage them to talk to their doctors about their risk and screening options.

Prostate cancer survivor Mike Mulcahy says, “I educated my kids on genetic predispositions, and my son has been humbled by it.” (To read his story, click here.) By educating them about their risk, you can help protect your family.

 

Your health care team

As you decide on your unique treatment plan, you will work with several medical specialists. It is important to have a medical team you trust. Several types of doctors will be part of your treatment team:

  • A urologist is a surgeon who diagnoses and treats diseases of the male reproductive organs and the urinary system. The urologist often makes the initial diagnosis of cancer.
  • A urologic oncologist is a specialist who treats cancer of the male reproductive organs and the urinary system.
  • A radiation oncologist is a physician who treats cancer with radiation therapy.
  • A medical oncologist is a physician who treats cancer with medicines, such as chemotherapy and hormone therapy, rather than surgery.

Your treatment team might include other specialists, including nurses, nurse practitioners, physician assistants and nutritionists. You may also work with a pathologist, a doctor who examines tissues and lab results to diagnose disease. Ask the doctor who diagnoses the cancer for referrals to the other kinds of doctors. That way, you can get opinions from experts in all fields related to your prostate cancer diagnosis. Having a medical team experienced in different methods of treating prostate cancer empowers you as a patient because it lets you explore options and decide which is best for you.

As you begin treatment, tell your doctors about any symptoms or side effects you have so they can help you manage them. After you begin treatment, you will have regular follow-up appointments with your doctors to monitor your response to treatment and evaluate your symptoms. It may help to keep a journal of any new symptoms you notice so that you remember to mention them to your medical team. A journal also helps you keep track of when symptoms start, get better or get worse.

Many men with prostate cancer worry that the disease and its treatment will affect their ability to have sex or control the flow of urine. If you experience erectile dysfunction or urinary or bowel incontinence, do not be embarrassed to tell your doctors. They have heard it before, and the sooner they know, the sooner they can help you.

Questions to ask your medical team

  • Is my cancer curable?
  • Has the cancer spread beyond my prostate?
  • What is the clinical stage of my cancer? What is its Gleason score?
  • Do you recommend any further tests?
  • Should I talk to any other kinds of doctors before deciding on a treatment plan?
  • How long will treatment last?
  • What follow-up treatment will I need?

Additional Resources

 

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