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Prostate cancer starts in the prostate, a gland below the bladder and in front of the rectum. The prostate contains several types of cells. But nearly all prostate cancers develop from glandular cells. These cells make fluid that becomes part of semen. In some men, prostate cancer is slow growing and not likely to cause serious problems. In others, the disease is very aggressive. If it’s found early, prostate cancer is highly treatable, and most men survive. Many physicians used to think of prostate cancer in older men as just a normal part of aging. The disease was largely ignored, except when it struck younger men. Now, there are newer, better treatments for prostate cancer. Many men who have or had prostate cancer at any age are leading full, active lives.
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Understanding the Prostate
The prostate is normally about the size of a walnut. It makes and stores seminal fluid — a milky liquid that protects and nourishes sperm. Your prostate surrounds part of your urethra, the tube that carries urine and semen out of your body.
Many men get a condition called benign prostatic hyperplasia (BPH), or an enlarged prostate. Usually, BPH happens in the part of the prostate that surrounds the urethra (transition zone). For this reason, it may slow or block the flow of urine. BPH is not cancer, and it does not lead to or increase the chance of prostate cancer.
Most prostate cancer happens in the part of the prostate near the rectum (peripheral zone). This is why a digital rectal exam is a useful screening test — and why prostate cancer doesn’t usually affect urine flow as much as BPH does. Even so, the prostate is close to the urethra and several other important structures. So, prostate cancer and its treatment can affect urinary, bowel and sexual function.
Researchers at Fred Hutch Cancer Center are studying the best ways to prevent, screen for, diagnose and treat prostate cancer. We’re at the forefront of learning how prostate tumors form and grow so we can develop new therapies for men with all stages and grades of the disease. With prostate cancer, more treatment isn’t always better. Men with early-stage, lower-risk cancer can often delay or completely avoid invasive treatments, going instead with active surveillance or watchful waiting. This is one of our many areas of research.
Fred Hutch and UW Medicine collaborate on the Institute for Prostate Cancer Research, where a team of more than 40 scientists and providers is studying prostate cancer from many angles. We’re also part of the Pacific Northwest Prostate Cancer Specialized Program of Research Excellence (SPORE).
The exact cause of prostate cancer is not known. But generally speaking, it happens because of changes (mutations) in cell DNA.
- DNA is the chemical that makes up your genes
- Genes control when your cells grow, divide into new cells and die
- DNA mutations can cause prostate cells to grow abnormally and lead to cancer if:
- They turn on genes that help cells grow and divide (oncogenes)
- They turn off genes that slow cell division or make cells die when they should (tumor-suppressor genes)
In the United States, prostate cancer is the most common cancer in men after skin cancer and the second leading cause of cancer death, behind lung cancer. Each year about 299,000 men are diagnosed with prostate cancer in the United States.
The incidence of prostate cancer has risen in recent decades. One reason may be that more men are living longer due to a decline in deaths from heart disease. So, more men are reaching ages when the risk of prostate cancer is highest.
Ask your primary care provider to help you understand the best prostate cancer screening plan for you.
- Are any prostate cancer screening tests recommended for me?
- Do I have more than one screening option? If so, which type of screening should I have?
- How often should I take the test?
- At what age should I stop having it?
- What is the purpose of the test? What will the results tell us?
When physicians and scientists talk about cancer survival rates, they typically mean the percentage of people expected to survive their cancer for at least five years after being diagnosed. (The rate doesn’t include the risk of dying during that time for some other reason.) Overall, the relative five-year survival rate for prostate cancer in the United States is 97.9%, according to the National Cancer Institute.
This rate comes from looking at a large, diverse group of people. The chance of surviving cancer at least five years can vary greatly from one person to another. It depends on many factors, like how far the cancer has spread. Your Fred Hutch care team can explain how statistics like survival rates might apply to you.
Learn about prostate cancer survival rates.
Prostate cancer starts when cells in the prostate grow out of control. Normally, cells in the body grow and multiply to form new cells as the body needs them. When cells get old or damaged, they die and are replaced. Sometimes, this normal process breaks down. Abnormal or damaged cells grow and multiply when they shouldn’t, forming tumors. Some tumors are cancer, and others are benign (noncancerous).
Prostate cancer spreads by growing into, or invading, nearby tissues, such as lymph nodes, the bladder or the rectum. If the cancer cells invade nearby lymph nodes or blood vessels, they can travel through the lymph or blood to distant parts in the body, like the bones. This is known as metastatic prostate cancer. In some cases, prostate cancer has already spread (metastasized) by the time a man learns he has the disease.