Prostate Cancer Diagnosis and Treatment

Prostate cancer is the second most common cancer in American men after skin cancer. But the survival rate 5 years after diagnosis is nearly 100% if your doctor catches it early.

What Is the Prostate?

The prostate is a gland in the male reproductive system. It's just under your bladder in front of the rectum. It makes some of the fluid that’s in semen. Prostate cancer happens when cancer cells in your prostate grow out of control. This usually happens slowly, so it may take several years for signs of the disease to show up.

What Are the Symptoms of Prostate Cancer?

Symptoms of prostate cancer include:

  • Difficulty starting to pee
  • Weak or interrupted pee stream
  • Peeing often, especially at night
  • Difficulty emptying your bladder completely
  • Pain or burning when you pee
  • Blood in your pee or semen
  • Continuing pain in your back, hips, or pelvis
  • Pain with ejaculation

What Are the Causes and Risk Factors for Prostate Cancer?

Doctors aren’t sure what causes prostate cancer. But your risk is higher if:

  • You’re over 50
  • You’re black or African-American
  • Prostate cancer runs in your family

How Is Prostate Cancer Diagnosed?

The two most common screening tests are a digital rectal exam (DRE) and a prostate specific antigen (PSA) test. During a DRE, your doctor puts a gloved, lubricated finger in your rectum to see if your prostate has any bumps or hard spots.

Your prostate makes a protein called prostate specific antigen (PSA). A PSA test shows how much of this protein is in your bloodstream. A little is OK. But if your levels are higher than normal, your prostate might be infected, inflamed, or you could have cancer.

Your doctor may also do these tests:

Ultrasound. This test uses sound waves to make a picture of your prostate.

Biopsy. For this test, doctors take tissue cells from your prostate. They look at them under a microscope to see if there’s cancer.

Magnetic resonance imaging (MRI). This body scan uses a magnet linked to a computer to show detailed images of your prostate.

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How Is Prostate Cancer Treated?

If your doctor finds prostate cancer, they’ll come up with a plan to treat it. Some of these treatment options include:

Active surveillance. This is also called “watchful waiting.” It’s when your doctor regularly does digital rectal exams, prostate specific antigen tests, and biopsies to see if the cancer grows. If it does, you might need:

Surgery. A prostatectomy is when your prostate is taken out. A radical prostatectomy is when your prostate and the tissue around it are taken out.

Radiation therapy. This uses high-energy rays to kill cancer cells. There are two types of radiation therapy.

  • External radiation therapy. A machine outside the body sends radiation to cancer cells.
  • Internal radiation therapy (brachytherapy). One common type of brachytherapy is the placement of tiny radioactive seeds or pellets inside your prostate tissue. They send out low-dose radiation for a long period of time to kill cancer cells. They don’t have to be taken out because the radiation wears off.

Hormone therapy. Prostate cancer cells need testosterone to grow. Your doctor may give you drugs to stop your body from making testosterone or to stop it from reaching the cancer cells. Or you may need surgery to remove your testicles, which make testosterone.

Cryotherapy. Your doctor puts a special tool with very cold gas in your prostate to freeze and kill cancer cells.

Chemotherapy. You take drugs to shrink or kill the cancer. They come in pill form, or you can get them through your veins (intravenous).

Biological therapy (immunotherapy). This treatment works with your body’s immune system to fight cancer or manage side effects from other cancer treatments.

High-intensity focused ultrasound (HIFU). This is when high-energy sound waves are used to kill prostate tissue. It’s not approved to treat actual prostate cancer. Research is ongoing to see how it works.

The right treatment depends on how far along your prostate cancer is, along with other things. Your doctor will help you to make the best decision.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on November 20, 2019

Sources

American Cancer Society: "Prostate Cancer."

CDC: “Prostate Cancer.”

Mayo Clinic: “Prostate Cancer.”

FDA: "FDA approves apalutamide for metastatic castration-sensitive prostate cancer."

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