Prostate Cancer

The prostate sits just below the bladder and in front of the rectum. It surrounds part of the urethra, the tube that empties urine from the bladder.

The majority of prostate cancers are adenocarcinomas. 'Adenocarcinomas' refer to cancers that begin in the gland cells that help make up the lining of many organs, including the prostate.

Despite only impacting males, prostate cancer is the third most common cancer in the United States, with more than 191,000 new cases diagnosed each year. It is also one of the most treatable cancers, with a five-year survival rate of nearly 98%.

This success is due to a number of factors. The disease is often slow-growing; there are effective, established treatments; and most cases are caught before cancer has spread beyond the prostate, making the disease easier to treat.

Symptoms

Prostate cancer often shows no symptoms in the early stages. In more advanced prostate cancer, symptoms may appear. However, they can vary from person to person. Since the prostate is close to the bladder and surrounds the urethra, which empties the bladder, most symptoms involve urination.

Symptoms of prostate cancer may include:

• Inability to urinate or difficulty in starting to urinate
• Trouble emptying the bladder completely
• Weak or interrupted urine flow
• Painful or burning urination
• Difficulty trying to hold back urination
• Frequent or urgent need to urinate
• Blood in the urine or semen
• Difficulty having or maintaining an erection (erectile dysfunction or ED)
• Continual pain in the bones, including in the lower back, pelvis, hips, or thighs. This is typically only experienced by patients whose prostate cancer has spread to their bones (metastatic prostate cancer).

These symptoms do not always mean you have prostate cancer. Sometimes these symptoms may be related to benign prostatic hyperplasia (BPH), a non-cancerous condition in which the prostate increases in size and may cause urination problems. While BPH needs to be treated, it is not prostate cancer. Other non-cancerous conditions could also cause these symptoms, so it is important to discuss them with your doctor.

Risk factors

Anything that increases your chance of getting prostate cancer is a risk factor. These include:

• Age: This is the most important risk factor. More than 90% of cases are in men who are age 55 or older.
• Family history: Risk is higher when other members of your family (especially father, brother, son) have or had prostate cancer. The risk increases if your family member was diagnosed at a younger age. Learn more about family history and cancer.
• Hereditary cancer syndromes: Certain genetic mutations increase a man’s risk of developing prostate cancer. These include Lynch syndrome and mutations of the BRCA1 and BRCA 2 genes. Learn more about hereditary cancer syndromes.
• Race: African American men or men of African descent have nearly double the risk of prostate cancer as white men. It is found less often in Asian American, Hispanic, and American Indian men.
• Diet: A high-fat diet, particularly a diet high in animal fats, may increase risk. Diets high in fruits and vegetables may decrease risk.
• Nationality: Prostate cancer is more prevalent in North America and northwestern Europe than in other parts of the world.
• Some research suggests that inflammation of the prostate (prostatitis) may play a role in prostate cancer. Sexually transmitted diseases are being investigated as possible risk factors as well.

Prevention

Certain actions may help lower your risk of prostate cancer:

• Eat at least five servings of fruits and vegetables daily and eat less red meat. Decrease fat intake.
• Tell your doctor about the supplements you take. Some of these may decrease the PSA level.
• Exercise regularly
• Maintain your ideal weight

Other ways to prevent prostate cancer are being investigated. These include:

• Lycopenes: These substances found in tomatoes, pink grapefruit and watermelon may help prevent damage to cells.
• Proscar® (finasteride) or Avodart® (dutasteride): These medications can reduce the risk of low-grade prostate cancer. If you are at high risk for prostate cancer, talk to your urologist or another provider who is familiar with studies about these drugs.

Some cases of prostate cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.

Why choose MD Anderson for your prostate cancer treatment?

Choosing the right hospital may be the most important decision you make as a prostate cancer patient. At MD Anderson you’ll get care and support from one of the nation’s top-ranked cancer centers.

Here, you can benefit from the expertise at our Multidisciplinary Prostate Clinic. Most newly diagnosed patients with intermediate to high-risk prostate cancer have a choice between surgery or radiation therapy. During your first clinic visit you will have a joint appointment with a radiation oncologist and surgeon who both specialize in prostate cancer. The three of you will review your case and discuss your treatment options. Your doctors may even discuss clinical trials with you, which could offer better outcomes than standard treatments.

If you have a more complex cancer, such as a disease that has recurred or spread, we offer the most advanced therapies. Thanks to our robust research and clinical trial programs, these may include new surgical options or new cancer drugs, such as targeted therapy or immunotherapy.

And at MD Anderson you'll also be surrounded by the strength of one of the nation's largest and most experienced cancer centers. From a dedicated prostate cancer support group to counseling to integrative medicine care, we have all the services needed to treat not just the disease, but the whole person.