Learn more about prostate cancer from Mayo Clinic urologist Mitchell Humphreys, M.D.
Hi. I'm Dr. Humphreys, a urologist at Mayo Clinic. In this video, we'll cover the basics of prostate cancer: What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers about your own health or that of someone you love, we're here to provide you with the best information available. Prostate cancer, unfortunately, is common. It affects one in seven men, making it the second most common cancer among men worldwide. The good news is, is that prostate cancer can be curable, especially when identified and treated early. That is why I and most urologists and medical professionals you talk to encourage men over a certain age to get regular prostate screenings. First, let's talk about what the prostate is and how it functions. The prostate is a small gland that is involved in reproduction and makes some of the essential components in semen. While it is small, it has an important role in reproductive health and can cause voiding or urinary symptoms as men age, as well becoming a source of cancer. Like other kinds of cancer, prostate cancer starts when cells mutate. These small changes in DNA cause the cells to grow faster and live longer than they normally would. As these abnormal cells accumulate, they monopolize resources from normal cells, which can damage surrounding tissue. These cancerous cells can then spread to other parts of the body.
Who gets it?
By definition, prostate cancer only affects bodies with male reproductive organs. But in addition, there are some other risk factors that we can monitor. Age is a big one, as prostate cancer is more prevalent in older men, which is why testing is encouraged as men age. For reasons that are unclear, Black men also have a greater risk compared to other races or ethnicities. Being at a higher weight as another possible risk factor. Genetics can also play a role in prostate cancer. A family history of prostate cancer or certain kinds of breast cancer increases the likelihood of being diagnosed with prostate cancer. Well, it's not a guarantee, there are plenty of steps you can take to reduce your risk. A healthy diet and exercise helps your body's overall well-being and can lower your chances of getting prostate cancer.
What are the symptoms?
A big reason to get regular testing is that prostate cancer usually has no presenting symptoms. And when they do show up, it generally indicates a worse stage of cancer. When symptoms do occur, they can include: trouble urinating or decreased force of stream, blood in the urine or semen, bone pain, unexpected weight loss, and unexplained fevers. If you consistently notice any of these symptoms, you should see your doctor right away. How is it diagnosed? There are a variety of ways to detect prostate cancer in both physical exam and from the blood. For starters, there's the DRE, the digital rectal exam. Just like the name suggests, the doctor inserts their finger and your rectum to feel the prostate to detect any abnormalities. You can also get a blood test to look for prostate-specific antigen, or PSA. It is recommended that you have this as well as the physical exam. And if there are any abnormalities, there are additional tests that can be used. If prostate cancer is detected, the next step is figuring out how fast it grows. Fortunately, prostate cancer often doesn't grow very fast. Prostate cancer is graded by a Gleason score, which measures how abnormal or different from normal cells are. There are also other tests to see if the cancer has spread: bone scan, CT scan, MRI, and even specific PET scans. Your doctor will be able to determine which, if any, is appropriate for you.
How is it treated?
Treatments are most effective when the cancer is caught early. In fact, immediate treatment isn't always necessary. Keeping an eye on the cancer until it grows bigger is sometimes enough. When cancer is localized only to the prostate, surgery to remove the prostate, or a radical prostatectomy, could be your best option. Radiation is another possibility. With external beam radiation, high-energy beams that deliver photons, target and kill the abnormal cells of the prostate from outside your body. Another treatment is chemotherapy, which uses powerful chemicals, destroy the cancer cells. Cryotherapy, which freezes the cancer cells, or heat, can be used to kill the cancer cells with high-intensity focused ultrasound. Consider that prostate cancer uses male hormone or testosterone as an important factor for growth. In some prostate cancers, it may be beneficial to block that hormone with androgen deprivation therapy, or ADT, which can slow the cancer or even put it in remission. It is generally not curative and usually the cancer will find a way to grow even with the lack of testosterone. Sometimes ADT is used in combination to enhance the treatment success of other therapies, such as with radiation. All of these treatments have side effects of various degrees and have different success rates of treating prostate cancer. It's important that you have a candid discussion with your family and your care team and weigh all that information to make the best choice for you. Support groups for cancer survivors can be helpful in dealing with the stress of the diagnosis and treatments.
As we've seen here, research and scientific advancement has provided us with a host of options for this extremely treatable form of cancer. And with early detection, your chances are even better. While it may not be a thing people want to think about, it's an important part of your health and an expert medical care team can guide you to the solutions that are most tailored for you, your wishes and your body. If you'd like to learn even more about prostate cancer, watch our other related videos or visit mayoclinic.org. We wish you well.
Prostate cancer occurs in the prostate gland, which is located just below the bladder in males and surrounds the top portion of the tube that drains urine from the bladder (urethra). This illustration shows a normal prostate gland and a prostate with a tumor.
Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm.
Prostate cancer is one of the most common types of cancer. Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.
Prostate cancer that's detected early — when it's still confined to the prostate gland — has the best chance for successful treatment.
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Prostate cancer may cause no signs or symptoms in its early stages.
Prostate cancer that's more advanced may cause signs and symptoms such as:
- Trouble urinating
- Decreased force in the stream of urine
- Blood in the urine
- Blood in the semen
- Bone pain
- Losing weight without trying
- Erectile dysfunction
When to see a doctor
Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.
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The prostate gland is located just below the bladder in men and surrounds the top portion of the tube that drains urine from the bladder (urethra). The prostate's primary function is to produce the fluid that nourishes and transports sperm (seminal fluid).
It's not clear what causes prostate cancer.
Doctors know that prostate cancer begins when cells in the prostate develop changes in their DNA. A cell's DNA contains the instructions that tell a cell what to do. The changes tell the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die.
The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. In time, some abnormal cells can break away and spread (metastasize) to other parts of the body.
Factors that can increase your risk of prostate cancer include:
- Older age. Your risk of prostate cancer increases as you age. It's most common after age 50.
- Race. For reasons not yet determined, Black people have a greater risk of prostate cancer than do people of other races. In Black people, prostate cancer is also more likely to be aggressive or advanced.
- Family history. If a blood relative, such as a parent, sibling or child, has been diagnosed with prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher.
- Obesity. People who are obese may have a higher risk of prostate cancer compared with people considered to have a healthy weight, though studies have had mixed results. In obese people, the cancer is more likely to be more aggressive and more likely to return after initial treatment.
Complications of prostate cancer and its treatments include:
- Cancer that spreads (metastasizes). Prostate cancer can spread to nearby organs, such as your bladder, or travel through your bloodstream or lymphatic system to your bones or other organs. Prostate cancer that spreads to the bones can cause pain and broken bones. Once prostate cancer has spread to other areas of the body, it may still respond to treatment and may be controlled, but it's unlikely to be cured.
- Incontinence. Both prostate cancer and its treatment can cause urinary incontinence. Treatment for incontinence depends on the type you have, how severe it is and the likelihood it will improve over time. Treatment options may include medications, catheters and surgery.
- Erectile dysfunction. Erectile dysfunction can result from prostate cancer or its treatment, including surgery, radiation or hormone treatments. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.
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You can reduce your risk of prostate cancer if you:
Choose a healthy diet full of fruits and vegetables. Eat a variety of fruits, vegetables and whole grains. Fruits and vegetables contain many vitamins and nutrients that can contribute to your health.
Whether you can prevent prostate cancer through diet has yet to be conclusively proved. But eating a healthy diet with a variety of fruits and vegetables can improve your overall health.
- Choose healthy foods over supplements. No studies have shown that supplements play a role in reducing your risk of prostate cancer. Instead, choose foods that are rich in vitamins and minerals so that you can maintain healthy levels of vitamins in your body.
- Exercise most days of the week. Exercise improves your overall health, helps you maintain your weight and improves your mood. Try to exercise most days of the week. If you're new to exercise, start slow and work your way up to more exercise time each day.
- Maintain a healthy weight. If your current weight is healthy, work to maintain it by choosing a healthy diet and exercising most days of the week. If you need to lose weight, add more exercise and reduce the number of calories you eat each day. Ask your doctor for help creating a plan for healthy weight loss.
Talk to your doctor about increased risk of prostate cancer. If you have a very high risk of prostate cancer, you and your doctor may consider medications or other treatments to reduce the risk. Some studies suggest that taking 5-alpha reductase inhibitors, including finasteride (Propecia, Proscar) and dutasteride (Avodart), may reduce the overall risk of developing prostate cancer. These drugs are used to control prostate gland enlargement and hair loss.
However, some evidence indicates that people taking these medications may have an increased risk of getting a more serious form of prostate cancer (high-grade prostate cancer). If you're concerned about your risk of developing prostate cancer, talk with your doctor.
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By Mayo Clinic Staff
Oct. 01, 2022