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Prostate Cancer

Definition

Prostate cancer is the abnormal growth of cells in a man's prostate gland. The prostate gland is part of the reproductive system of men. It is a doughnut-shaped gland located between the base of the penis and the bladder. It surrounds the urethra, which is the tube through which urine and semen pass. The prostate makes the fluid that nourishes and carries sperm.

Prostate cancer has become the most commonly diagnosed cancer among men in the US. It usually grows slowly. Men who have it often die from other causes before the cancer kills them. Still, prostate cancer is one of the most common causes of cancer death in American men. The prostate cancer death rate is especially high among African American men.

Getting Diagnosed / Treatment

Prostate cancer is treated in the U-M Comprehensive Cancer Center's Multidisciplinary Urologic Oncology Clinic. Research into prostate cancer is underway within our Urologic Oncology Program. [Note: for information about metastatic prostate cancer view this page.]

How does it occur?

The exact cause of prostate cancer is not known. Studies have found or suggested the following risk factors for prostate cancer:

Age: Age is the main risk factor for prostate cancer. Prostate cancer is rarely seem in men younger than 45. The chance of getting it goes up sharply as a man gets older. Most men diagnosed with prostate cancer are older than 65.
Heredity: A man's risk is higher if his father or brother had prostate cancer.
Race: Prostate cancer is more common in African American men than in white men, including Hispanic white men. It is less common in Asian and American Indian men.
Diet: Studies suggest that men who eat a diet high in animal fat or meat may be at increased risk for prostate cancer, whereas men who eat a diet rich in fruits and vegetables may have a lower risk.

What are the symptoms?

Prostate cancer often has no symptoms, especially in the early stages. Symptoms that may occur are:

weak flow of urine
urine flow that starts and stops
trouble starting or stopping the flow of urine
frequent and urgent need to urinate, especially at night
not being able to urinate
blood in the urine or semen
pain or burning during urination
trouble having an erection, or pain when semen comes out of the penis (ejaculation)
frequent pain in the lower back, hips, or upper thighs.

Most often these symptoms are due to BPH, an infection, or another health problem. BPH (benign prostatic hypertrophy) is a growth of the prostate that is not caused by cancer. BPH normally occurs as men get older. If you have any of the symptoms listed above, you should see your health care provider so that problems can be diagnosed and treated as early as possible.

How is it diagnosed?

Because prostate cancer often causes no symptoms, it is often found as part of a routine rectal exam or during an exam for some other problem.

A blood test called the prostate-specific antigen (PSA) test may be done to check for prostate cancer. However, like many cancer screening tools, it is not perfect and can give misleading results. If the PSA is normal, there may still be cancer in the prostate. If it is a bit high, it may not be from cancer. For this reason, health care providers do not agree about when or if PSA tests should be done. Use of the PSA test as a routine test is controversial. Many studies have been done, but they do not yet show that it is practical or cost effective to do it on all men at their checkups. Because the test often gives misleading results, an abnormal result can cause undue anxiety, expense, and unnecessary medical procedures. Likewise, a normal result may give unwarranted reassurance.

Read more about the PSA test in our Prostate Cancer Detection section.

If you have a symptom or a test that suggests cancer, other tests that may be ordered are:

Transrectal ultrasound to look at the prostate. A probe that gives off sound waves is inserted into the rectum to produce an image of the prostate on a video screen.
Cystoscopy. The health care provider uses a thin, lighted tube to look into the urethra and bladder.
Transrectal biopsy. The health care provider inserts a needle through the rectum into the prostate. A piece of the prostate tissue is removed to look for cancer cells. It is the only sure way to diagnose prostate cancer.

If a biopsy shows cancer cells, your health care provider may do other tests, such as a bone scan, CT scan, and MRI to see if the cancer has spread and help decide how to treat it.

How is it treated?

Treatment depends on how large the tumor is, whether it has spread to other parts of your body, and your overall health. Some of the treatments, and their side effects, are:

Surgery to remove the prostate. Surgery may cause short-term problems, such as discomfort and loss of control of the flow of urine (incontinence). Most men are able to control their bladder again after a few weeks. Surgery may also cause erectile dysfunction (an inability to have or keep an erection, also called impotence). Nerve-sparing surgery may help so that the impotence does not last. But in some cases, men become permanently impotent. Also, when your prostate is removed, you will no longer produce semen. You will have dry orgasms. If you wish to father children, you may consider sperm banking or a sperm retrieval procedure.
Radiation therapy. This treatment uses high-energy rays to kill cancer cells. It may also lead to long-term problems such as diarrhea, erectile dysfunction, and poor control of urine. The radiation may be given externally (radiation beamed at your body from a machine). This may cause the urethra, rectum, and anus to become inflamed. Or the radiation may be given internally, which means the radiation comes from radioactive seeds implanted into the prostate. This may cause erectile dysfunction a nd loss of bladder control.
Hormone therapy. Drugs or surgery may be used to keep prostate cancer cells from getting the male hormones (testosterone) that they need to grow. The testicles produce the most of the testosterone in your body. Treatment can include drugs that prevent the testicles from making testosterone, drugs that block the action of male hormones, drugs that prevent the adrenal gland from making testosterone, or surgery to remove the testicles. Side effects of treatment depend on the drug used and may include erectile dysfunction, hot flashes, loss of sexual desire, weaker bones, breast tenderness or growth, nausea, and diarrhea.

Watchful waiting, which means not having treatment, may be chosen if:

The risks and possible side effects of treatment outweigh the possible benefits.
You are an older adult.
You have other serious health problems.
You are diagnosed with early-stage prostate cancer that seems to be growing slowly.

How can I prevent prostate cancer?

Because the cause of prostate cancer is not known, health care providers do not know how to prevent it. However, researchers are actively studying possible methods of prevention, such as diet, supplements, and drugs.

Continue reading about prostate cancer

Related Prostate cancer information
In-depth articles pertaining to the states of prostate cancer, diagnosis and treatment

last updated 3/2006

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Developed by McKesson Health Solutions LLC.
Published by McKesson Health Solutions LLC.
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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