The different types of prostate cancer start in different cells. Doctors analyze your prostate tissue in a lab to see what kinds of cells have cancer in them. Your own doctor uses this information along with the stage and the grade to help decide how to treat you.
The Most Common Prostate Cancer: Adenocarcinoma
These cancers start in the gland cells of the prostate. Gland cells make prostate fluid. This fluid combines with sperm to make semen. When you get cancer in these cells, you could have one of two types:
Acinar adenocarcinoma. Most people get this type. It develops in the gland cells that line the prostate gland.
Ductal adenocarcinoma. This kind starts in the cells that line the ducts (or tubes) of the prostate gland. It’s usually more aggressive than the other type. That means it grows and spreads more quickly.
Other Rare Forms of Prostate Cancer
Up to 5% of prostate cancers are not adenocarcinomas. They may be one of the following:
Small-cell carcinoma. This kind of cancer is most common in the lungs. Small-cell carcinomas make up about 1% of prostate cancers. It develops in small round cells in the prostate and can spread very quickly. Usually it has already spread to other parts of the body, such as the bones, by the time doctors diagnose it.
Squamous cell carcinoma. This is more often a skin cancer. Fewer than 1% -- maybe as few as half of a percent -- of men with prostate cancer have this type. It starts in flat cells that cover the prostate. Like small-cell carcinoma, it’s also a faster, more aggressive form.
Transitional cell (or urothelial) cancer. This cancer grows in the urethra. That’s the tube that carries urine outside the body. It’s unclear how often it starts in the prostate and spreads here. Most often, it starts in the bladder before it spreads.
Neuroendocrine tumors. These tumors can pop up in neuroendocrine cells anywhere in the body. Those are cells that make hormones to help the function of the organ they occupy, such as the lungs, stomach, and pancreas. About half of all neuroendocrine tumors start in the digestive system. Rarely, tumors grow inside neuroendocrine cells of the prostate.
Soft tissue sarcoma. This starts in supportive tissues. That can include muscle, nerves, fat, and blood vessels. In the prostate, these cancers are extremely rare. They account for less than 0.1% of cases. That’s fewer than 1 in 1,000 men with prostate cancer.
Knowing Your Type
When you get a complete prostate cancer diagnosis, your doctor will likely give you the following information:
- The type of prostate cancer you have
- The Gleason score, a number from 2 to 10 that estimates how fast (or aggressive) the cancer is
- The stage, a number from I to IV based on whether the cancer has spread past the prostate and how far
This information helps your doctor make recommendations on the best treatment plan for you.