Understanding Prostate Cancer | Understanding Your Prostate | PSA Tests | Symptoms | Diagnosing | Staging | Testing | Risk Factors | Resources
Prostate cancer is the most common cancer after skin cancer in men in the United States.
In some men, it is slow growing and unlikely to cause serious problems. In others, the disease is very aggressive. If it’s detected early, prostate cancer is highly treatable, and most men survive.
Fred Hutchinson Cancer Center offers comprehensive prostate cancer treatment from a team of experts.
Prostate cancer starts in the prostate, a gland located below the bladder and in front of the rectum.
Many physicians used to consider prostate cancer in older men to be just part of the normal aging process, and the disease was largely ignored, except when it struck younger men. Now there are newer, better treatments for prostate cancer, and many men who have or had prostate cancer at any age are leading active, productive lives.
Your prostate 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 develop a noncancerous condition called benign prostatic hyperplasia (BPH), or enlargement of the prostate. If the prostate, which is normally about the size of a walnut, grows too large, it can slow or block the flow of urine.
Most prostate cancer develops in the zone of the prostate near the rectum (peripheral zone), which is why a digital rectal exam is a useful screening test.
Prostate cancer is complex. There are a lot of things to think about before you and your physician choose a treatment plan. First, know that if it’s detected early, prostate cancer is highly treatable, and most men with prostate cancer survive. Our specialists at Fred Hutch are here to help you.
Prostate cancer symptoms typically don’t appear early in the disease. In many men, physicians first detect signs of prostate cancer during a routine check-up.
More advanced prostate cancer symptoms may include:
Many of these symptoms are also seen with noncancerous diseases. They may be similar to BPH symptoms or prostatitis symptoms. (Prostatitis is infection of the prostate.) If you are experiencing any signs and symptoms of prostate cancer, call your doctor.
When it is diagnosed early, prostate cancer is curable. Good prostate cancer screening tests, like the prostate-specific antigen (PSA) test, have resulted in early diagnosis in about 80 percent of men with the disease. According to the American Cancer Society, all of these men survive at least five years.
Whether cancer is suspected based on symptoms or a digital rectal exam or PSA test, the actual diagnosis is made with a prostate biopsy, a procedure in which samples of your prostate are removed and examined under a microscope.
A core needle biopsy, the main method for diagnosing prostate cancer, is typically performed in a physician’s office by a urologist.
Your biopsy samples will be sent to a lab to be examined by a pathologist. Getting results usually takes a few days.
Fred Hutch offers an imaging test called prostate-specific membrane antigen (PSMA) positron emission tomography (PET), which is considered the most sensitive measure of prostate cancer detection. This test may be appropriate in certain situations. We also have an imaging test called Axumin® PET. Before the scan, you get an injection of fluciclovine F 18 (Axumin®), a radioactive agent that tends to collect in areas with cancer activity, which then light up on your scan.
Staging is done as part of the diagnosis process to determine how extensive your cancer is within your prostate and whether it has spread to lymph nodes or other organs.
Prostate cancer is typically staged using the TNM system, which is based on:
Using this information, prostate cancer is then grouped into stages I through IV, with stage I being the least advanced and stage IV being the most advanced.
Stage I: Cancer is confined to your prostate. Gleason score is 6 or below. PSA level is less than 10.
Stage II: The tumor is more advanced but does not extend beyond your prostate.
Stage III: The tumor extends beyond your prostate and may be in a seminal vesicle. Cancer has not spread to lymph nodes.
Stage IV: The tumor has spread to another part of your body, such as your bladder, rectum, lymph nodes or bones.
Many centers, including Fred Hutch, are testing other means of finding cancer spread using new types of positron emission tomography (PET) scans. We offer prostate-specific membrane antigen (PSMA) PET, which is considered the most sensitive measure of prostate cancer detection. We also have an imaging test called Axumin® PET. Sometimes lymph nodes around the prostate may be checked for metastasis in order to design treatment appropriately.
At Fred Hutch and UW Medicine, a long-term effort has identified cells in the bone marrow that originated from prostate cancer, even in the absence of other evidence of spread. With these and other studies being offered to men with advanced prostate cancer, we hope to find ways to identify men at the highest risk of relapse so this knowledge can inform our treatment recommendations.
While the exact cause of prostate cancer is unknown, generally speaking it results from mutations in cell DNA.
Many factors may contribute to prostate cancer risk. The main risk factors are:
Although the reasons are unclear, scientists believe diet is a critical factor in prostate cancer risk. A diet high in red meat, dairy foods and calcium and low in fruits and vegetables may play a part. Vitamin E and folic acid are also thought to increase the risk.
Studies have not shown a clear link between obesity and prostate cancer, but in some studies obese men have had a lower risk of getting a low-grade form of the disease but a higher risk of getting more aggressive prostate cancer. Several studies have found that obese men may be at greater risk of having more advanced prostate cancer and of dying from prostate cancer.
Researchers are studying how nutrition may reduce the risk of prostate cancer. They are also studying whether men can reduce their risk through exercise and by taking certain dietary supplements.
Learn more about the Impact of Diet and Exercise
Scientists have also studied whether having an inflamed or enlarged prostate, having a vasectomy, smoking, being exposed to radiation or having a sexually transmitted virus might increase prostate cancer risk. At this time, there is little evidence that these factors contribute to risk.
Learn more about Prostate Cancer Prevention
Each year about 160,000 men are diagnosed with prostate cancer in the U.S. and about 27,000 die of the disease. Prostate cancer is the third leading cause of cancer death, behind lung cancer and colon cancer, in men in the United States.
The incidence of prostate cancer has nearly doubled over the past 20 years. One possible reason is that, due to a decline in deaths from heart disease, more men are living longer, reaching ages at which the risk of prostate cancer is highest.
There are many resources online for learning about your disease. Health educators at the Fred Hutch Patient and Family Resource Center have compiled a list of trusted sources to help you get started.
Whether you are newly diagnosed, going through treatment or know someone with cancer, our staff are available to tailor personalized resources and answer questions about support options in the community.
Our list of online resources provides accurate health information from reliable and reputable sources, like the National Cancer Institute (NCI), the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN).
American Cancer Society (ACS): Overview of Prostate Cancer
If you have prostate cancer or are a caregiver for someone who does, knowing what to expect can be helpful. Here you can find out all about prostate cancer in adults, including risk factors, symptoms and how they are found and treated.
American Society of Clinical Oncology (ASCO): Guide to Prostate Cancer
This is Cancer.Net's Guide to prostate cancer. Here you can learn more about prostate cancer, treatment, the latest research and clinical trials.
ASCO Answers: Prostate Cancer
ASCO Answers is a collection of oncologist-approved patient education materials developed by ASCO for people with cancer and their caregivers. Here you can find illustrations and information on prostate cancer.
CancerCare: Prostate Cancer General Information and Support
CancerCare provides free, professional support services for people affected by prostate cancer, as well as prostate cancer treatment information and additional resources.
Institute for Prostate Cancer Research (IPCR) Symposium
Each year, the IPCR brings together experts in multiple field to discuss the latest breakthrough in the prevention, detection and treatment of prostate cancer. This event is filled with scientific insights and projections, discussions on technology and patient care, reviews of the latest scientific innovations and landmark research projects changing how scientists view this disease.
National Cancer Institute (NCI): Prostate Cancer-Patient Version
The NCI is the federal government's principal agency for cancer research and training. Here you can find more information about prostate cancer treatment, research and coping with cancer.
National Comprehensive Cancer Network (NCCN) Guidelines for Patients: Advanced State Prostate Cancer
This step-by-step guide to the latest advances in cancer care features questions to ask your physician, patient-friendly illustrations and glossaries of terms and acronyms.
National Comprehensive Cancer Network (NCCN) Guidelines for Patients: Prostate Cancer: Early Stage
This step-by-step guide to the latest advances in cancer care features questions to ask your physician, patient-friendly illustrations and glossaries of terms and acronyms. This guide is for people diagnosed in the early stages of prostate cancer.
Our list includes local and national organizations that are dedicated to improving the quality of life for patients and family members through providing emotional support, education and community.
An informative discussion on current choices in prostate cancer treatment including promising new therapies. From initial diagnosis to active surveillance, join the discussion alongside others living with prostate cancer. If you have questions or would like to talk with someone before you attend, please call 206.297.2500.
Fred Hutch: Why and How to Exercise with Prostate Cancer - Patient Video Series
This video series, featuring experts from Fred Hutch, offers people with prostate cancer helpful information on how to stay healthy, including detailed instructions for exercises you can do at home.
Prostate Cancer Foundation is the world’s leading philanthropic organization dedicated to the research and eradication of prostate cancer.
Us TOO in Seattle is a support group that is open to individuals with prostate cancer, their loved ones, friends and caregivers. Their goal is to provide comprehensive information on prostate cancer, its diagnoses, treatments, side effects, current research and other aspects that may be used to help make informed decisions about the disease.