Prostate cancer
Prostate cancer begins in the prostate, a small gland below the bladder. Its behavior ranges from slow-growing disease that may be monitored to cancer that needs prompt treatment.
Questions for your care team
- 01What are my PSA, Grade Group, and stage?
- 02Is active surveillance reasonable, or should I start treatment?
- 03How could each option affect urinary, sexual, or bowel function?
- 04Would imaging, genetic testing, or a clinical trial change my options?
Overview
Most prostate cancers are adenocarcinomas. The care team considers PSA, biopsy grade (Gleason score or Grade Group), how much of the gland is involved, and whether the cancer has spread. PSA can also rise for non-cancer reasons, so it is not a diagnosis by itself.
Signs and symptoms
Early prostate cancer often causes no symptoms. Trouble starting or maintaining urine flow, frequent urination (especially at night), blood in urine or semen, or pelvic or bone pain can have many causes. New, persistent, or worsening symptoms deserve medical evaluation.
Evaluation and diagnosis
Evaluation may include medical and family history, a PSA blood test, examination, and sometimes prostate MRI. If results suggest cancer, a biopsy is used to confirm it and assess grade. Imaging may be used to determine stage when appropriate. PSA screening is a personal decision: discuss possible benefits, false alarms, biopsies, and overdiagnosis with a clinician.
Treatment approaches
Options depend on risk group, stage, grade, PSA, health, and preferences. Some lower-risk cancers are followed with active surveillance. Other localized cancers may be treated with surgery or radiation. More advanced disease may be treated with hormone therapy, other systemic medicines, chemotherapy, radiation, or a clinical trial—sometimes in combination.