The prostate is a gland in the male reproductive system. About the size of a walnut, it sits below the bladder, in front of the rectum, and surrounds the urethra. It releases prostatic fluid, which contributes to the formation of semen. Prostate cancer forms in tissues of the prostate.
Men who are at normal risk should have an annual prostate exam starting at age 50. Men with higher risk (family history or African American) should start around age 40.
A 2022 study concluded that PSA screenings prevented one death in every 11 to 14 men who were diagnosed with the disease – exceeding previous research results by twofold. Among Black Americans, who are at higher risk of dying from the disease, the survival rate is higher.
Exact causes of prostate cancer are unknown, though genetics, inflammation and environmental factors such as diet and smoking likely play a role. Men older than 65 and/or with an immediate family history of prostate cancer are at greater risk, as are African American men. Obesity also increases the risk of prostate cancer.
Prostate cancer usually causes no symptoms unless it has spread outside the prostate, but some patients may experience:
A urologist performs a detailed history and physical exam, including a variety of tests:
Early detection means more options for treatment and an increased chance of survival:
If test results are abnormal, the urologist may advise:
Click here to learn more about a prostate biopsy in our patient guidebook Prostate Biopsy: What it is and what to expect.
The Gleason score and tumor stage are used together to predict prognosis and help guide therapy.
The Gleason score is a description of the aggressiveness of the cancer cells and is assigned based on the microscopic appearance of the cancer cells. The Gleason score ranges from 2 (least aggressive) to 10 (most aggressive) and is based on prostate cancer cells’ microscopic appearance.
The tumor stage, however, describes how the cancer was detected and the extent of the cancer in the body. The tumor stage will not be indicated on a prostate biopsy report, but will be described by your doctor.
We base our prostate cancer treatment approach on each patient’s situation.
Treatments for local growth (stages I and II) include:
Treatments for metastatic growth (stages III and IV):
Advanced Prostate Cancer Clinic
For men whose cancer has progressed, the Advanced Prostate Cancer Clinic provides additional alternatives and support.