Prostate cancer

Overview

Prostate cancer is a growth of cells that starts in the prostate. The prostate is a small gland that helps make semen. It's found just below the bladder. The prostate is part of the male reproductive system.

Prostate cancer is one of the most common types of cancer. Prostate cancer is usually found early, and it often grows slowly. Most people with prostate cancer are cured.

People diagnosed with early prostate cancer often have many treatment options to consider. It can feel overwhelming to learn about all the options and make a choice. Treatments may include surgery, radiation therapy or carefully watching the prostate cancer to see if it grows.

If the cancer grows beyond the prostate or if it spreads, there are still many treatment options. Prostate cancer that spreads can be more difficult to cure. But even when a cure isn't possible, treatments can slow the growth of the cancer and help you live longer.

Symptoms

Prostate cancer may not cause symptoms at first. Most prostate cancers are found at an early stage. This means that the cancer is only in the prostate. An early-stage prostate cancer often doesn't cause symptoms.

When they happen, early-stage prostate cancer signs and symptoms can include:

• Blood in the urine, which might make the urine look pink, red or cola-colored.
• Blood in the semen.
• Needing to urinate more often.
• Trouble getting started when trying to urinate.
• Waking up to urinate more often at night.

If the prostate cancer spreads, other symptoms can happen. Prostate cancer that spreads to other parts of the body is called metastatic prostate cancer. It also might be called stage 4 prostate cancer or advanced prostate cancer.

Signs and symptoms of advanced prostate cancer can include:

• Accidental leaking of urine.
• Back pain.
• Bone pain.
• Difficulty getting an erection, called erectile dysfunction.
• Feeling very tired.
• Losing weight without trying.
• Weakness in the arms or legs.

When to see a doctor

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

Causes

It's often not clear what causes prostate cancer. Healthcare professionals have found some things that raise the risk of this cancer. These include older age, obesity and a family history of prostate cancer. The exact cause of prostate cancer often isn't known.

Prostate cancer starts when cells in the prostate develop changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA tells the cells to grow and multiply at a set rate. The DNA also tells the cells to die at a set time.

In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.

Risk factors

Factors that can increase the risk of prostate cancer include:

• Older age. The risk of prostate cancer goes up with age. It's most common after age 50.
• Race and ethnicity. In the United States, Black people have a greater risk of prostate cancer than do people of other races and ethnicities. Healthcare professionals aren't exactly sure why. In Black people, prostate cancer also is more likely to grow quickly or be advanced when detected.
• Family history of prostate cancer. If a blood relative, such as a parent or sibling, has been diagnosed with prostate cancer, your risk may be increased. The risk also may be increased if other close relatives have had prostate cancer. This includes your grandparents and your parents' siblings.
• Family history of DNA changes. Some DNA changes that increase the risk of cancer are passed from parents to children. The DNA changes called BRCA1 and BRCA2 can cause a higher risk of prostate cancer. These DNA changes are best known for increasing the risk of breast cancer and ovarian cancer.
• Obesity. People who have obesity may have a higher risk of prostate cancer compared with people considered to have a healthy weight. Studies of this issue have had mixed results. In people with obesity, prostate cancer is more likely to grow quickly and more likely to come back after treatment.
• Smoking tobacco. Some research shows a link between smoking and prostate cancer. But not all studies agree. People with prostate cancer who smoke may have a higher risk of the cancer coming back. People who smoke also have a higher risk of the cancer spreading beyond the prostate.

Complications

Complications of prostate cancer and its treatments include:

• Cancer that spreads. Prostate cancer can spread to other parts of the body, such as the bones or other organs. When prostate cancer spreads, it's called metastatic prostate cancer.
• Incontinence. Prostate cancer and its treatment can cause leaking of urine, also called urinary incontinence.
• Erectile dysfunction. Difficulty getting an erection is called erectile dysfunction. It can be caused by prostate cancer or its treatment.

Prevention

There is no sure way to prevent prostate cancer. You can help reduce your risk of prostate cancer if you:

• Choose a healthy diet. Eat a variety of fruits, vegetables and whole grains. Limit the amount of animal fats you eat. Fruits and vegetables contain many vitamins and nutrients that can do good for your health.

  Foods that have been linked to a lower risk of prostate cancer include tomatoes, broccoli, cauliflower and soy. No studies have proved that these foods can prevent cancer. If you already enjoy eating these foods, there may be some added benefit in including them in your diet.

• Exercise most days of the week. It's not clear whether exercise can prevent prostate cancer. It may help you maintain a healthy weight. Exercise also may improve your overall health and your mood. Try to exercise most days of the week. If you're new to exercise, talk about it with a healthcare professional. Start slow and work your way up to more exercise time each day.
• Maintain a healthy weight. If your current weight is healthy, work to maintain it. Choose a healthy diet and exercise most days of the week. If you need to lose weight, add more exercise and eat fewer calories. Ask your healthcare professional for help creating a plan for healthy weight loss.
• Don't smoke. If you don't smoke, don't start. If you smoke, talk with a healthcare professional about what might help you quit. Medicines, nicotine replacement products and counseling can help.

• Medicines to lower the risk of prostate cancer. If you have a high risk of prostate cancer, you and your healthcare professional may consider medicines to lower the risk. These medicines include finasteride (Propecia, Proscar) and dutasteride (Avodart). They are most often used to treat prostate gland enlargement.

  Ask your healthcare professional to talk about the benefits and risks of these medicines with you. When prostate cancer happens in people taking these medicines, it tends to grow faster. Your healthcare professional can help explain your risk and whether these medicines are right for you.