Prostate Cancer

Prostate cancer begins when cells in the prostate gland start to grow uncontrollably. Prostate cancer is one of the most common cancers in men. It attacks the prostate gland, a small, walnut-shaped organ in men that produces seminal fluid used to nourish and transport sperm.

Because the symptoms of prostate cancer often do not appear until the cancer is well advanced and deadly, it is crucial for men to be screened for the disease beginning at age 50. If detected early, the cancer is treatable.

The main types of doctors who treat prostate cancer include …

  • Urologists: These surgeons treat diseases of the urinary system and male reproductive system (including the prostate)
  • Radiation oncologists: These doctors treat cancer with radiation therapy
  • Medical oncologists: These doctors treat cancer with medicines such as chemotherapy or hormone therapy

Prostate cancer is rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About six in 10 cases of prostate cancer are found in men older than 65.


Prostate cancer occurs more often in African-American men and in Caribbean men of African ancestry. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men than in non-Hispanic whites. The reasons for these racial and ethnic differences are not clear.


Prostate cancer is most common in North America, northwestern Europe, Australia, and on Caribbean islands. It is less common in Asia, Africa, Central America, and South America.

Family History:

Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor. Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease.

There is no sure way to prevent prostate cancer, but there are things you can do that might lower your risk.

The effects of body weight, physical activity and diet on prostate cancer risk are not clear, but there are things you can do that might lower your risk, such as …

  • Eating at least 2½ cups of a wide variety of vegetables and fruits each day
  • Being physically active
  • Staying at a healthy weight

Early prostate cancer usually causes no symptoms. More advanced prostate cancers sometimes cause symptoms. Those symptoms include …

  • Problems urinating such as a slow/weak urinary stream, or the need to urinate more often especially at night
  • Blood in the urine and semen
  • Pain in the hips, back or chest
  • Weakness or numbness in the legs or feet or even loss of bladder or bowel control from cancer pressing on the spinal cord

Most of these symptoms are more likely to be caused by something other than prostate cancer. For example, trouble urinating is much more often caused by benign prostatic hyperplasia (BPH), a non-cancerous growth of the prostate. Still, it’s important to tell your healthcare provider if you have any of these symptoms so that the cause can be found and treated, if needed.

Tests are used to screen for different types of cancer. There is no standard or routine screening test for prostate cancer. However, testing may include …

  • Medical history and physical exam.
  • Prostate-specific antigen (PSA) blood test—this test is used mainly to screen for prostate cancer in men without symptoms. It’s also one of the first tests done in men who have symptoms that might be caused by prostate cancer.
  • Cholesterol levels
  • Transrectal ultrasound (TRUS)—In this procedure, a small probe about the width of a finger is lubricated and placed in your rectum. The probe gives off sound waves that enter the prostate and create echoes. The probe picks up the echoes, and a computer turns them into a black and white image of the prostate.The procedure often takes less than 10 minutes and is done in a doctor’s office or outpatient clinic. You will feel some pressure when the probe is inserted, but it usually is not painful. The area may be numbed before the procedure.

If certain symptoms or the results of tests such as a PSA blood test suggest that you might have prostate cancer, your doctor will do a prostate biopsy. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope.

A core needle biopsy is the main method used to diagnose prostate cancer. It is usually done by a urologist—a surgeon who treats cancers of the genital and urinary tract, which includes the prostate gland. Using TRUS to “see” the prostate gland, the doctor quickly inserts a thin, hollow needle through the wall of the rectum and into the prostate. When the needle is pulled out, it removes a small cylinder (core) of prostate tissue. This is repeated several times. Most urologists will take about 12 core samples from different parts of the prostate.

A newer technology called Artemis 3-D is used at Prisma Health to detect prostate cancer. Artemis allows our urologists and radiologists to use a specialized software program to create a three-dimensional image of the prostate. Studies have shown it to be 50% more accurate than a standard random biopsy.

Different types of treatment are available for patients with prostate cancer. Treatment options can include those that have not yet been approved but are being tested in clinical trials.

Seven types of standard (FDA-approved) treatments are used:

  • Watchful waiting or active surveillance
  • Surgery
  • Radiation therapy and radiopharmaceutical therapy
  • Hormone therapy
  • Chemotherapy
  • Biologic therapy
  • Bisphosphonate therapy