What Is Prostate Cancer? Symptoms, Stages, Diagnosis, Treatment, and More

Types of Prostate Cancer
Adenocarcinomas
Acinar Adenocarcinoma This is the most common subtype, starting in the parts of the gland that make the fluid in semen, known as the acini. Variations of this type include pleomorphic giant cell adenocarcinoma, signet ring cell-like carcinoma, and sarcomatoid carcinoma.
Ductal Adenocarcinoma This rare, aggressive type starts in the tubes that carry secretion to the urethra. Some prostate cancers have both types of acinar and ductal cells.
Neuroendocrine or Small Cell Carcinomas
- Small Cell Carcinoma The most common type of neuroendocrine prostate cancer, this aggressive type consists of cells that appear small under a microscope.
- Treatment-Related Neuroendocrine Carcinoma This type also has the same aggressive variant of prostate cancer and can develop from adenocarcinoma after hormone therapy.
Other Rare Types
- Squamous cell carcinoma
- Adenoid cystic carcinoma, or basal cell carcinoma
- Lymphoma
- Urothelial carcinoma
- Sarcoma
Signs and Symptoms of Prostate Cancer
- Problems with peeing, including weak or interrupted flow, peeing more often than usual, or feeling like you can’t completely empty your bladder
- Pain or burning while peeing
- Blood in your pee or semen
- Pain in the hips, spine, or ribs because some types of prostate cancer can spread to the bones
These may be signs of prostate cancer. Or, more likely, they are caused by something else, such as benign prostate hyperplasia (BPH), a noncancerous growth of the prostate. However, you should see your doctor if you experience these symptoms.
Causes and Risk Factors for Prostate Cancer
There are some factors that may increase the risk of developing prostate cancer, including:
- Age Nearly 60 percent of all prostate cancers are diagnosed in men who are over 65 years of age, according to the American Medical Association. However, around 1 in 10 new prostate cancer diagnoses occur in men under 55 years of age, and the outlook is often worse for men who have a prostate cancer diagnosis at a younger age.
- Race It is not clear why, but Black men in the United States are far more likely to develop prostate cancer than white men, and often at a younger age. Black men are also more than twice as likely as white men to die of prostate cancer.
- Family History Having a father or brother can more than double a person’s prostate cancer risk. The risk increases if you have multiple relatives with prostate cancer, especially if they were younger than average at diagnosis. And you’re at a higher risk of prostate cancer if you have a brother with it than if you’ve got a father with the disease.
- Obesity This has links to more dangerous, higher-grade tumors. One study concluded that every five-point increase in body mass index (BMI) raises the risk of death from prostate cancer by 10 percent.
How Is Prostate Cancer Diagnosed?
Your doctor may perform a number of tests to diagnose prostate cancer, including:
- Digital Rectal Exam A doctor uses a gloved finger to feel for abnormalities in the prostate. This is useful in men who have symptoms as well as those who don’t. It can also help a doctor decide if further tests are necessary after a cancer diagnosis or check how prostate cancer is responding to treatment.
- Prostate-Specific Androgen (PSA) Blood Test This measures the amount of PSA circulating in the body. PSA is a protein that both cancerous and noncancerous tissue in the prostate produces. Generally, PSA levels are higher for more advanced prostate cancers.
- Biopsy A doctor specializing in cancer treatment, known as an oncologist, extracts cancerous tissue, examines it under a microscope, and compares it with normal prostate tissue. They will use the Gleason score to estimate how likely it is to spread.
- Imaging Tests Various tests are available, such as computerized tomography (CT), magnetic resonance imaging (MRI) scans, and prostate-specific membrane antigen (PSMA) positron emission tomography (PET) scanning. PSMA PET scans check if the prostate cancer has spread.
- Bone Scans These can determine if cancer has spread to the bones.
Not everyone needs prostate cancer screening. However, the American Cancer Society guidelines suggest that men with an average prostate cancer risk should discuss with their doctors whether they’d benefit from screening after 50 years of age, as long as they have a life expectancy of more than 10 years.
Men in high-risk groups, such as Black men or those with a family history, should have these discussions from age 45 onward. Men in the highest risk groups (those with multiple close relatives who had prostate cancer at an early age) should discuss screening at 40 years of age.
A PSA blood test is a common screening tool, and a doctor may also use a digital rectal examination.
PSA Levels
In general, higher PSA levels mean a higher likelihood of cancer, and PSA levels over 4 nanograms per milliliter (ng/mL) might be cause for concern. At that level, your doctor might order another PSA test to confirm the finding. If your PSA level stays high, your doctor might schedule more PSA tests at regular intervals or a digital rectal exam.
Stages of Prostate Cancer
- Stage 1 In this stage, a doctor can’t feel the cancer, and typical screening tools aren’t likely to pick it up.
- Stage 2 The tumor has grown but is still small and hasn’t spread beyond the prostate. PSA screening may not detect cancer at this stage because PSA levels will be low to medium.
- Stage 3 PSA levels are high, and the Gleason score may be higher. The cancer may have spread to nearby tissues, the seminal vesicles, or the bladder or rectum.
- Stage 4 Also called advanced prostate cancer or metastatic prostate cancer, stage four means that the cancer has spread beyond the prostate to other parts of the body, including the distant lymph nodes, liver, bladder, or bones.
These stages also have different grade groups and relate to different Gleason scores, depending on a combination of where the cancer has spread and the PSA level. Prostate cancer staging is complex and affects both your treatment and outlook, so ask your doctor to explain what this means for you.
Treatment and Medication Options for Prostate Cancer
Different types of treatment are available for men with prostate cancer. Some treatments are standard, while other treatments may be available to you through clinical trials to expand or improve the standard treatments that are currently available.
Medication Options
A cancer care team prescribes medications for prostate cancer to block hormones, kill cancer cells, or boost the immune system.
Hormone Therapy This treatment, also called androgen deprivation therapy (ADT), removes or blocks the action of male sex hormones called androgens that cause prostate cancer to grow.
Medications include:
- Luteinizing hormone-releasing hormone agonists, such as leuprolide (Lupron, Lupron Depot, Eligard, Prostap, Viadur), goserelin (Zoladex), degarelix (Firmagon), and relugolix (Orgovix), to stop the testicles from making testosterone
- Antiandrogens, such as apalutamide (Erleada), darolutamide (Nubeqa), flutamide (Euflex, Euflexin), and enzalutamide, to block the action of androgens
- Abiraterone acetate (Zytiga) to prevent cancer cells from making androgens
Chemotherapy This treatment uses drugs to stop the growth of cancer cells, either by killing them or by stopping them from dividing. A person may take chemotherapy medications by mouth or receive them by infusion or injection into a vein or muscle.
Surgery
- Radical Prostatectomy A surgeon removes the prostate, surrounding tissue, and seminal vesicles. They can perform this procedure through a cut in the abdomen or perineum or by using keyhole (laparoscopic) or robot-assisted surgery.
- Pelvic Lymphadenectomy This procedure involves removing lymph nodes in the pelvis to check their tissue for cancer cells.
- Transurethral Resection of the Prostate (TURP) A surgeon removes tissue from the prostate using a tool they insert through the urethra. They may perform this to relieve symptoms like a blocked urine flow before trying other treatments.
- Cryosurgery or Cryotherapy This treatment is currently only available in clinical trials and uses an instrument to freeze and destroy prostate cancer cells.
Radiation Therapy
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells.
- External Radiation Therapy A machine outside the body sends radiation toward the cancer. Approaches include conformal radiation (shaping beams to the tumor) and hypofractionated radiation (larger doses over fewer days). Proton therapy is a form of external radiation therapy that is more precise than other formats and may reduce the side effects of radiation.
- Internal Radiation Therapy Also known as brachytherapy, this uses radioactive seeds, needles, or wires placed directly into or near the cancer.
- Radiopharmaceutical Therapy A radioactive substance is used to treat cancer. For example, radium-223 (an alpha emitter) is injected into the bloodstream to treat prostate cancer that has spread to the bone.
Watchful Waiting and Active Surveillance
Watchful waiting involves closely monitoring the condition without giving treatment until signs or symptoms develop. Doctors usually use it for men with limited life expectancy due to age or other health problems, usually for advanced prostate cancer.
During active surveillance, a cancer care team may follow early-stage cancer in healthy men who’d prefer to avoid the side effects of treatment but are still looking to cure the disease. Active surveillance essentially postpones radiation therapy or surgery until the first sign that the cancer is progressing.
Erectile Dysfunction Management
Options for achieving an erection are available, including:
- Oral medications
- Locally applied therapies like prostaglandin, sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra, Staxyn), and avanafil (Stendra)
- A device known as a penis pump that pulls blood into the penis using a vacuum seal
- Implants under general anesthesia that allow a man to press a release button and achieve an erection
Which measure you use may depend on your preferences, other health conditions, and your doctor’s advice. Many people who’ve had prostate cancer treatment have active and fulfilling sex lives afterward.
Disparities and Inequities in Prostate Cancer
A review suggests that some social factors, including unequal access to medical facilities, financial and insurance factors, and changing guidelines, may have led to this difference in survival rates.
For example, in the Veterans Affairs system, where Black men have access to the same level of care as white men, the gap in survival rates is much closer than in the general population. Also, when the screening guidelines recommended less testing for prostate cancer, this led to fewer screenings in Black men. In turn, more Black men died from prostate cancer because doctors didn’t identify their disease early enough to give them life-extending treatment.
Genes, hormones, and inflammation could play a key role in the differences in cancer development between races, even in situations in which Black men have comprehensive insurance and access to good medical care.
Lifestyle Changes and Prevention of Prostate Cancer
Manage Your Body Weight Through Diet and Exercise
- Moving more and engaging in physical activity
- Eating a healthy diet full of fruits, vegetables, and whole grains
- Avoiding or limiting red and processed meats and highly processed foods
Get Emotional Support for Side Effects
Prostate Cancer Outlook
Prostate Cancer Complications
Prostate cancer has several possible complications that can lead to further health problems and affect quality of life. These can include:
- Spreading Cancer Prostate cancer can move into other areas, such as other organs or the bones, and lead to pain or fractures in areas like the hips or spine. This is known as metastatic prostate cancer.
- Erectile Dysfunction Both prostate cancer and the surgeries, radiation therapy, and medications that treat prostate cancer can cause problems getting or maintaining an erection.
- Leaking Urine The cancer and treatment can also cause issues with how your bladder works, leading to leaking urine or urinary incontinence.
Support for People With Prostate Cancer
Prostate Cancer Foundation
The Prostate Cancer Foundation (PCF) provides simple handbooks and videos that explain your diagnosis without the medical jargon. They connect men who have prostate cancer with an online community of people who truly understand the journey, while providing down-to-earth advice on diet and exercise and finding available doctors and clinical trials. They also offer guidance and support on paying for treatment and other costs of care.
Zero Prostate Cancer
Zero Prostate Cancer helps people with prostate cancer find support. They have a dedicated helpline, ZERO360, which you can call for support in navigating insurance and payment challenges. They also have a mentorship program called MENtor that pairs you with someone who’s already had prostate cancer and can guide you through the journey. Zero Prostate Cancer also connects people with financial grants and assistance and has a massive network of local and online support groups for caregivers and partners as well as patients.
The Takeaway
- Prostate cancer is one of the most common cancers among men, but advancements in detection and treatment contribute to a high survival rate.
- It often progresses slowly, allowing time for effective treatment, but if symptoms like difficulty urinating develop, consult with a healthcare professional as soon as possible.
- If you are over 50 years old, discuss with your doctor whether prostate cancer screening is right for you.
- Different treatment options are available, from surgery to targeted therapies, and many men maintain a good quality of life after treatment — but, depending on the cancer and individual, some men don’t need prostate cancer treatment right away.
FAQ
Resources We Trust
- Mayo Clinic: Prostate Cancer: Screening and Treatment Options
- Cleveland Clinic: Prostate Cancer
- Prostate Cancer Research Institute: Prostate Cancer Staging Guide
- American Cancer Society: Prostate Cancer
- Prostate Cancer Foundation: Black Men: Know Your Risk
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- Types of Prostate Cancer: Common and Rare Forms. Mayo Clinic. July 19, 2025.
- Signs and Symptoms of Prostate Cancer. American Cancer Society. January 7, 2025.
- Berg S. What Doctors Wish Patients Knew About Prostate Cancer. American Medical Association. March 7, 2025.
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- Prostate Cancer Risk Factors. American Cancer Society. November 22, 2023.
- Black Men and Prostate Cancer. American Cancer Society Cancer Action Network. November 5, 2025.
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- Tests to Diagnose and Stage Prostate Cancer. American Cancer Society. March 21, 2025.
- Prostate Cancer Stages. American Cancer Society. November 22, 2023.
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- Goserelin Acetate. National Cancer Institute. January 7, 2025.
- Firmagon (Degarelix for Injection) for Subcutaneous Use. U.S. Food and Drug Administration. February 2020.
- Phillips C. Relugolix Approval Expected to Alter Treatment for Advanced Prostate Cancer. National Cancer Institute. January 26, 2021.
- Antiandrogens (Oral) — Apalutamide, Darolutamide, Enzalutamide. Washington State Health Care Authority. April 16, 2025.
- CanMED: HCPCS. National Cancer Institute.
- Enzalutamid. National Cancer Institute. March 11, 2025.
- Abiraterone Acetate. National Cancer Institute.
- Chemotherapy for Prostate Cancer. Johns Hopkins Medicine.
- Olaparib. National Cancer Institute.
- Sipuleucel-T. National Cancer Institute. October 11, 2019.
- Zoledronic Acid (Intravenous Route). Mayo Clinic. February 1, 2026.
- Proton Therapy. Mayo Clinic. July 22, 2023.
- Erectile Dysfunction After Prostate Cancer. Johns Hopkins Medicine.
- Which Drug for Erectile Dysfunction? Harvard Health Publishing. August 9, 2022.
- Lowder D et al. Racial Disparities in Prostate Cancer: A Complex Interplay Between Socioeconomic Inequities and Genomics. Cancer Letters. April 10, 2022.
- Can Prostate Cancer Be Prevented? American Cancer Society. November 22, 2023.
- About Moderate Alcohol Use. Centers for Disease Control and Prevention. January 14, 2025.
- Van Thomme G. 5 Things to Know About Dairy and Cancer Risk. MD Anderson Cancer Center. November 9, 2023.
- After Treatment: Living as a Prostate Cancer Survivor. American Cancer Society. November 22, 2023.
- Jacklin C et al. “More Men Die With Prostate Cancer Than Because of It” — An Old Adage That Still Holds True in the 21st Century. Cancer Treatment and Research Communications. 2021.
- Survival Rates for Prostate Cancer. American Cancer Society. January 13, 2026.

Tawee Tanvetyanon, MD, MPH
Medical Reviewer
Tawee Tanvetyanon, MD, MPH, is a professor of oncologic sciences and senior member at H. Lee Moffitt Cancer Center and Morsani College of Medicine at the University of South Florida in Tampa. He is a practicing medical oncologist specializing in lung cancer, thymic malignancy, and mesothelioma.
A physician manager of lung cancer screening program, he also serves as a faculty panelist for NCCN (National Comprehensive Cancer Network) guidelines in non-small cell lung cancer, mesothelioma, thymoma, and smoking cessation. To date, he has authored or coauthored over 100 biomedical publications indexed by Pubmed.
