What is prostate cancer?

Prostate cancer is the abnormal growth of cells in the prostate gland. (The prostate is part of the male reproductive system. It is a small organ below the bladder that makes fluid for semen.)

Most cases of prostate cancer occur after age 65. It usually grows slowly and can take years to grow large enough to cause any problems.

In some cases, the cancer grows more quickly. It may spread within the prostate, to nearby lymph nodes and other tissues, and to other parts of the body. But usually prostate cancer is found early, before the cancer has spread outside the prostate.

Prostate cancer usually doesn't cause symptoms in its early stages. Most people don't know they have it until it is found during a regular medical exam.

When there are symptoms of prostate cancer, they often include urinary problems, such as:

• Not being able to urinate at all.
• Having a hard time starting or stopping the flow of urine.
• Having to urinate often, especially at night.
• Feeling pain or burning during urination.

Less common symptoms may include:

• Difficulty having an erection.
• Blood in your urine or semen.
• Deep and frequent pain in your lower back, belly, hip, or pelvis.

Your doctor will ask you about your family history and your medical history. You'll have a physical examination that includes a digital rectal exam, in which the doctor inserts a gloved finger into your rectum to feel your prostate.

Other tests may include:

• Blood tests, such as a prostate-specific antigen (PSA) and a complete blood count (CBC).
• Imaging tests, such as:
  • A transrectal ultrasound.
  • An MRI, a multiparametric MRI (mpMRI), or a positron emission tomography MRI (PET-MRI).
  • A CT scan or a PET-CT scan.
  • A bone scan.
• Prostate biopsy. A biopsy is the only way to confirm whether you have prostate cancer.
• Genetic tests. These include tests to look for inherited gene changes and tests that look for biomarkers.

Treatment for localized prostate cancer is based on many things, including your age and overall health. One important factor is the risk that the cancer will grow. Test results, including the Gleason score from your prostate biopsy, can show if the cancer is likely to grow.

• Low-risk cancer isn't likely to grow right away. Active surveillance may be a good choice. It lets you avoid or delay treatments that can cause serious side effects. If the cancer grows very slowly, you may never need treatment. Radiation therapy or surgery to remove the prostate may also be options.
• Medium-risk cancer is more likely to grow. Active surveillance may be an option for some people who have a medium-risk cancer. Others may need to be treated with radiation therapy or surgery.
• High-risk cancer is most likely to grow and spread. A combination of treatments may be used, such as surgery, radiation therapy, and hormone therapy.

Your doctor will talk with you about your options and then make a treatment plan.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Follow your doctor's instructions to relieve pain. Pain from cancer and surgery can almost always be controlled. Use pain medicine when you first notice pain, before it becomes severe.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep, and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor or a counselor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Jell-O, dry toast, crackers, and cooked cereal are also good choices.
• If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.