General Information About Prostate Cancer
Key Points for This Section
- Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate.
- Signs of prostate cancer include a weak flow of urine or frequent urination.
- Tests that examine the prostate and blood are used to detect (find) and diagnose prostate cancer.
- Certain factors affect prognosis (chance of recovery) and treatment options.
The prostate is a gland in the male reproductive system. It lies just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland makes fluid that is part of the semen.
- Weak or interrupted ("stop-and-go") flow of urine.
- Sudden urge to urinate.
- Frequent urination (especially at night).
- Trouble starting the flow of urine.
- Trouble emptying the bladder completely.
- Pain or burning while urinating.
- Blood in the urine or semen.
- A pain in the back, hips, or pelvis that doesn't go away.
- Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by anemia.
Other conditions may cause the same symptoms. As men age, the prostate may get bigger and block the urethra or bladder. This may cause trouble urinating or sexual problems. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be like symptoms of prostate cancer.
The following tests and procedures may be used:
- Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormal areas.
- Prostate-specific antigen (PSA) test : A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH (an enlarged, but noncancerous, prostate).
- Transrectal ultrasound : A procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. Transrectal ultrasound may be used during a biopsy procedure.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will check the tissue sample to see if there are cancer cells and find out the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumor will spread. The lower the number, the less likely the tumor is to spread.
There are two types of biopsy procedures used to diagnose prostate cancer:
- Transrectal biopsy : The removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells.
- Transperineal biopsy : The removal of tissue from the prostate by inserting a thin needle through the skin between the scrotum and rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells.
- The stage of the cancer (level of PSA, Gleason score, grade of the tumor, how much of the prostate is affected by the cancer, and whether the cancer has spread to other places in the body).
- The patient’s age.
- Whether the cancer has just been diagnosed or has recurred (come back).
Treatment options also may depend on the following:
- Whether the patient has other health problems.
- The expected side effects of treatment.
- Past treatment for prostate cancer.
- The wishes of the patient.
Most men diagnosed with prostate cancer do not die of it.