Overview & Definition

Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate—a walnut-size gland below the bladder that helps produce seminal fluid. It is the most common cancer (aside from skin cancers) diagnosed in men in the U.S. and one of the leading causes of cancer death among men. Many prostate cancers grow slowly; some are aggressive and can spread (metastasize) to lymph nodes, bones, and other organs.

Anatomy & Where It Starts

The prostate surrounds the urethra just below the bladder. Most prostate cancers are adenocarcinomas that begin in gland cells. Atypical changes such as prostatic intraepithelial neoplasia (PIN) may be seen near cancers. Because the gland sits near the bladder, urethra, and seminal vesicles, tumors can affect urinary and sexual function as they grow.

Risk Factors

• Age: risk rises sharply after age 50.
• Race/ethnicity: non-Hispanic Black men have higher risk and are more likely to be diagnosed at a later stage.
• Family history: a first-degree relative with prostate cancer increases risk.
• Inherited gene changes: some cases are linked to mutations (e.g., BRCA1, BRCA2, HOXB13) and other DNA-repair genes.
• Lifestyle & other factors: obesity and certain exposures may influence risk; evidence varies.

Having risk factors does not mean you will develop prostate cancer, and some men develop it without known risk factors.

Signs & Symptoms

• Urinary changes: weak/slow stream, starting and stopping, frequent urination (especially at night), urgency, burning or pain
• Blood in urine or semen
• Painful ejaculation or erectile difficulties
• Persistent pain in lower back, hips, or pelvis (can suggest spread to bone)
• Unintended weight loss or fatigue in advanced disease

Screening

Screening aims to find cancers likely to cause harm if untreated. The most common test is the prostate-specific antigen (PSA) blood test; a digital rectal exam (DRE) may also be used. Elevated PSA can occur from cancer or benign conditions like benign prostatic hyperplasia (BPH) and prostatitis. Because screening has benefits and potential harms (false positives, overdiagnosis), decisions should be made after discussing individual risks and preferences with a clinician.

Diagnosis, Grading & Staging

Treatment Options

Management is personalized to cancer aggressiveness, spread, overall health, and patient goals. Options include:

• Active surveillance for low-risk disease with close monitoring (PSA, imaging, repeat biopsy).
• Surgery (radical prostatectomy; nerve-sparing approaches in selected cases).
• Radiation therapy (external-beam radiation, brachytherapy); often combined with androgen-deprivation therapy (ADT) for higher-risk disease.
• Systemic therapies for advanced or metastatic cancer: ADT, androgen-signaling inhibitors, chemotherapy, targeted therapies (including PARP inhibitors for some DNA-repair mutations), and immunotherapy in selected settings.
• Supportive care to manage symptoms and maintain quality of life (e.g., bone-strengthening agents for bone metastases).

Prognosis

Many prostate cancers are slow-growing and highly treatable, especially when confined to the prostate. Outcomes depend on grade, stage, PSA level, molecular features, and response to therapy. Even when not curable, modern treatments can control disease and help men live longer with a good quality of life.

Sources & Attribution

Adapted primarily from the U.S. National Cancer Institute (NCI) and supported by CDC and MedlinePlus:

• NCI — Prostate Cancer (Patient): cancer.gov/types/prostate
• NCI — PSA Test Fact Sheet: cancer.gov/types/prostate/psa-fact-sheet
• NCI — Screening (PDQ® Patient): cancer.gov/types/prostate/patient/prostate-screening-pdq
• CDC — Prostate Cancer Basics & Statistics: cdc.gov/prostate-cancer
• MedlinePlus — Prostate Cancer Overview: medlineplus.gov/prostatecancer.html

This content is for education only and does not replace professional medical advice. Discuss screening and treatment decisions with a qualified clinician.