Prostate Cancer

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Caroline Davidge-Pitts, M.B., B.Ch. 
Benjamin Leder, MD
Eric Orwoll, MD

Additional Resources
Prostate Cancer Foundation
Mayo Clinic

What is prostate cancer?

The prostate is the gland that makes seminal fluid, the milky substance that transports sperm during ejaculation (orgasm). Prostate cancer starts in the cells of the prostate but can spread throughout the body. Other than skin cancer, it is the most common cancer in U.S. men. About one of six men will be diagnosed with prostate cancer during his lifetime, but only one man of 33 will die of this disease.

In most men, prostate cancer grows very slowly and stays inside the prostate gland. But, aggressive forms of prostate cancer can spread quickly to other parts of the body, including bone.

Prostate cancer may have no symptoms. If symptoms are present, these may include weight loss, blood in the urine, difficulty urinating, bone pain. Your physician may feel a nodule, or your prostate may be hardened.

When should you begin to screen for prostate cancer? 

Prostate cancer can be discovered by an abnormal prostate exam, or an elevated prostate-specific antigen (PSA) in the blood. Prostate cancer screening is controversial, and recommendations vary.

The decision to pursue screening depends on several factors, including your age, symptoms and risk of prostate cancer. The decision on whether to screen or not, should be discussed with your physician.

Most experts recommend stopping annual prostate exams at about age 70 or when expected life span is less than 10 years.

How is prostate cancer treated?

Treatment options include “watchful waiting” with regular surveillance by your physician.  If treatment is pursued, options include surgery to remove the tumor, implant radiation therapy, and external beam radiation. If the cancer has spread, chemotherapy, androgen deprivation therapy (ADT) or removal of the testes may be needed. The latter of two options reduce the production of testosterone which may help to slow the progression of cancer. PSAs are followed regularly to determine response to therapy. 

Questions to ask your doctor

  • Should I be screened for prostate cancer?
  • What happens if I have an abnormal prostate exam, or an elevated PSA?
  • When should I be referred to a Urologist?
  • What are my treatment options?
  • What are the risks and benefits of each of these treatments?
Edited: May 2018