Prostate cancer is one of the most common types of cancer affecting men, particularly as they get older. Understanding the signs of prostate cancer, its potential causes, and risk factors can help men recognize changes in their health and know when to seek medical advice. However, prostate cancer does not always cause noticeable symptoms in its early stages, which makes appropriate medical evaluation important.
In this guide, we’ll explain what prostate cancer is, where the prostate is located, and how prostate cancer develops. We’ll also cover common early symptoms, potential causes, risk factors, diagnosis, prostate cancer treatment options, and when to talk to a healthcare provider.
What Is Prostate Cancer?
Prostate cancer develops when cells in the prostate gland begin to grow abnormally and uncontrollably. The prostate is a small gland that plays an important role in the male reproductive system. Some prostate cancers grow slowly and may remain limited to the prostate for a long time, while others can grow more quickly and spread to nearby tissues or other parts of the body.
The behavior of prostate cancer can vary significantly from one person to another. This is why factors such as the cancer's characteristics, stage, overall health, and individual circumstances are considered when healthcare providers determine the appropriate approach to evaluation and treatment.
Where Is the Prostate Located?
The prostate is a small gland located below the bladder and in front of the rectum. It surrounds part of the urethra, the tube that carries urine out of the body.
The prostate is part of the male reproductive system and produces fluid that contributes to semen. Because the prostate is located close to the bladder, urethra, and reproductive organs, changes in the prostate can sometimes affect urination or sexual function.
What Happens When Prostate Cancer Develops?
Prostate cancer begins when prostate cells develop abnormal changes that cause them to grow and divide in an uncontrolled way. Over time, these abnormal cells can form a tumor within the prostate.
Some prostate cancers grow slowly and may remain confined to the prostate, while more aggressive cancers can invade nearby tissues or spread to other parts of the body. The extent and characteristics of the cancer help healthcare providers determine its stage and guide treatment decisions.
It is also important to note that prostate cancer can develop without causing noticeable symptoms, particularly in its early stages. This is one reason why discussing prostate health and appropriate screening or evaluation with a healthcare provider can be important.
How Common Is Prostate Cancer?
Prostate cancer is one of the most frequently diagnosed cancers in men. The risk increases with age, with most cases occurring in older men.
Although prostate cancer is common, not every prostate tumor behaves in the same way. Some grow very slowly and may not cause significant problems, while others can be more aggressive. Age, family history, genetics, and other factors can influence a person's risk of developing prostate cancer.
What Are the Symptoms of Prostate Cancer?
Prostate cancer does not always cause symptoms, especially during its early stages. When symptoms do occur, they can vary depending on the size and location of the tumor and whether the cancer has spread beyond the prostate.
Some prostate cancer signs may also be caused by non-cancerous prostate conditions, such as benign prostatic hyperplasia (BPH) or prostatitis. Therefore, experiencing one or more of these prostate cancer signs does not necessarily mean you have prostate cancer, but persistent or concerning changes should be evaluated by a healthcare provider.
Early signs of prostate cancer
Early signs of prostate cancer may not cause any noticeable symptoms. When symptoms are present, they can include changes in urination or other changes related to the urinary and reproductive systems.
Possible early signs of prostate cancer:
- Difficulty starting urination
- A weak or interrupted urine stream
- Needing to urinate more frequently
- Increased urination at night
- A feeling that the bladder has not completely emptied
- Blood in the urine or semen
Because these symptoms can have several possible causes, they should not be used on their own to determine whether someone has prostate cancer.
Urinary Symptoms
Because the prostate surrounds part of the urethra, changes in the prostate can affect the flow of urine.
Urinary symptoms associated with prostate cancer may include:
- Difficulty starting or stopping urination
- A weak or slow urine stream
- Frequent urination, particularly at night
- An urgent need to urinate
- Difficulty emptying the bladder completely
- Pain or burning during urination
- Blood in the urine
These symptoms are not specific to prostate cancer. Conditions such as an enlarged prostate or urinary tract problems can cause similar urinary changes, which is why medical evaluation may be necessary to determine the underlying cause.
Prostate cancer or its treatment can sometimes be associated with changes in sexual or reproductive function.
Possible symptoms or changes may include:
- Difficulty getting or maintaining an erection
- Pain during ejaculation
- Blood in the semen
- Changes in ejaculation
However, these symptoms can occur for many different reasons and do not necessarily indicate prostate cancer. A healthcare provider can help determine whether further evaluation is appropriate.
Symptoms of Advanced Prostate Cancer
When prostate cancer progresses beyond the prostate, symptoms may become more noticeable and can depend on where the cancer has spread.
Advanced prostate cancer may cause:
- Persistent pain in the back, hips, pelvis, or other bones
- Unexplained weight loss
- Persistent fatigue
- Swelling in the legs
- Weakness or numbness in the legs
- Difficulty urinating or loss of bladder control
These symptoms can have causes unrelated to cancer as well. However, new, persistent, or worsening symptoms, particularly severe pain, significant weakness, or difficulty controlling the bladder or bowel, should receive prompt medical attention.
Prostate Cancer Causes
The exact cause of prostate cancer is not fully understood. At a cellular level, prostate cancer develops when changes in the DNA of prostate cells disrupt the normal controls that regulate cell growth, division, and cell death. These abnormal cells can continue to grow and eventually form a tumor.
Having a particular risk factor does not mean that someone will develop prostate cancer. Instead, risk factors are characteristics or exposures associated with a higher likelihood of developing the disease.
How Do Prostate Cells Become Cancerous?
Healthy cells normally follow carefully controlled processes that determine when they should grow, divide, repair DNA damage, or die. Prostate cancer can develop when genetic changes interfere with these controls.
Some DNA changes can activate genes that promote cell growth, while others can disable genes that normally suppress uncontrolled cell division or repair damaged DNA. As these changes accumulate, prostate cells may begin growing and dividing abnormally, potentially leading to the formation of cancer.
These genetic changes can be inherited from a parent or acquired during a person's lifetime. Most cases of prostate cancer are not caused by a single identifiable genetic change, and researchers are still studying how different genetic and biological factors interact.
Genetic Changes and Prostate Cancer
Genetics can play an important role in prostate cancer. Some men inherit gene changes that increase their susceptibility to the disease, while other genetic changes develop in prostate cells over time.
Inherited variants in genes involved in DNA repair, including BRCA1, BRCA2, CHEK2, ATM, PALB2, and certain mismatch-repair genes, have been associated with an increased risk of prostate cancer. The BRCA2 gene is particularly important because inherited BRCA2 changes are associated with a higher risk of prostate cancer.
A strong family history of prostate or certain other cancers may sometimes indicate an inherited genetic susceptibility. In these situations, a healthcare provider may recommend genetic counseling or testing based on the person's personal and family history.
Can Hormones Contribute to Prostate Cancer?
Yes. Hormones called androgens, including testosterone and dihydrotestosterone (DHT), play an important role in the normal growth and function of the prostate. Because prostate cells depend on androgen signaling, researchers have investigated whether these hormones can contribute to prostate cancer development.
Androgens can promote prostate cell growth, and laboratory and clinical evidence supports an important role for androgen signaling in prostate cancer. However, having a higher testosterone level does not mean that a person will necessarily develop prostate cancer, and research has not established a simple relationship between testosterone levels and prostate cancer risk.
Read more: How to Increase Testosterone Naturally?
What Are the Risk Factors for Prostate Cancer?
A risk factor is something associated with a higher chance of developing a disease. It is important to distinguish a risk factor from a direct cause: having one or more risk factors does not mean that a person will develop prostate cancer, and some men develop the disease without having any obvious risk factors.
The most established prostate cancer risk factors include age, family history, inherited genetic changes, and ancestry. Other factors, including body weight, diet, physical activity, and certain environmental exposures, have been studied, but their relationship with prostate cancer is less certain or may vary depending on the type of cancer.
Age
Age is one of the strongest risk factors for prostate cancer. The disease is uncommon in younger men, and the likelihood of developing it increases substantially as men get older.
According to the American Cancer Society, prostate cancer is rare in men younger than 40, while the chance of developing it rises rapidly after age 50.
Because age cannot be changed, it is considered a non-modifiable risk factor. However, age can be important when discussing prostate cancer screening and early detection with a healthcare provider.
Family History and Genetics
A family history of prostate cancer can increase a person's risk, particularly when a close relative such as a father or brother has had the disease. The risk can be higher when multiple relatives have been affected or when prostate cancer was diagnosed at a younger age.
Inherited genetic variants can also contribute to prostate cancer risk. Changes in genes such as BRCA1, BRCA2, and other DNA-repair genes may increase susceptibility in some individuals. However, inherited genetic risk accounts for only a portion of prostate cancer cases.
Men with a strong family history of prostate or certain other cancers may benefit from discussing their personal risk with a healthcare provider and, when appropriate, considering genetic counseling.
Race and Ethnicity
Ancestry is another recognized prostate cancer risk factor. Prostate cancer occurs more frequently in Black men, particularly those of African ancestry, than in men of other racial or ethnic groups. Black men are also more likely to be diagnosed at a younger age and to experience more aggressive disease.
The reasons for these differences are not fully understood. Researchers believe that a combination of genetic, environmental, social, and healthcare-related factors may contribute.
Lifestyle and Other Risk Factors
Researchers have investigated several lifestyle and environmental factors in relation to prostate cancer. However, the evidence is not equally strong for all of them.
Because several of these associations are still being studied, they should not be presented as proven direct causes of prostate cancer.
Can Prostate Cancer Be Prevented?
There is currently no guaranteed way to prevent prostate cancer. Some important risk factors, including age, ancestry, and inherited genetics, cannot be changed. However, certain healthy habits may help support overall health and may lower the likelihood of developing some forms of prostate cancer or more advanced disease.
Healthy Lifestyle and Prostate Cancer Risk
Maintaining a healthy lifestyle is a reasonable approach to supporting prostate and overall health.
This can include:
- Maintaining a healthy body weight
- Staying physically active
- Eating a balanced diet rich in vegetables, fruits, and whole grains
- Limiting highly processed foods and sugar-sweetened beverages
- Limiting red and processed meats
- Avoiding smoking
Current evidence does not show that lifestyle changes can completely prevent prostate cancer. Instead, these habits should be viewed as part of an overall approach to reducing cancer risk and supporting long-term health.
Diet and Prostate Health
There is no specific prostate cancer prevention diet proven to eliminate the risk of the disease.
Research has examined the potential relationship between prostate cancer and foods or nutrients such as dairy products, calcium, vegetables, soy, and various supplements, but findings have not established a single food or supplement that reliably prevents prostate cancer.
A practical approach is to focus on an overall balanced eating pattern rather than relying on individual supplements or so-called prostate health products. Supplements such as vitamin E and selenium, for example, have not been shown to prevent prostate cancer, and some research has raised concerns about potential risks from supplementation.
Can Screening Prevent Prostate Cancer?
Screening does not prevent prostate cancer from developing. Instead, its purpose is to help detect prostate cancer earlier, before symptoms appear or while the disease may be easier to treat.
Prostate cancer screening may involve tests such as a prostate-specific antigen (PSA) blood test, sometimes combined with other assessments. Whether and when screening is appropriate depends on factors such as age, overall health, family history, ancestry, and individual preferences.
Because screening has both potential benefits and limitations, men should discuss their individual risk and screening options with a healthcare provider rather than relying on a single universal screening schedule.
How Is Prostate Cancer Diagnosed?
Diagnosing prostate cancer usually involves several steps rather than a single test. A healthcare provider may consider a person’s symptoms, medical and family history, physical examination, PSA blood test, and imaging results when deciding whether further evaluation is needed.
If prostate cancer is suspected, additional testing may be recommended. Although tests such as PSA and DRE can identify findings that may need further investigation, a prostate biopsy is generally required to confirm the diagnosis. Imaging and other tests can then help determine how extensive the cancer may be and guide treatment decisions.
Prostate-Specific Antigen (PSA) Test
The prostate-specific antigen (PSA) test is a blood test that measures the amount of PSA, a protein produced by cells in the prostate, in the bloodstream.
PSA testing can be used as part of prostate cancer screening in men without symptoms and can also be used when symptoms or other findings raise concerns about prostate cancer. However, an elevated PSA level does not automatically mean that someone has cancer. Conditions such as benign prostate enlargement or inflammation can also affect PSA levels. Conversely, a PSA level within a typical range does not completely rule out prostate cancer.
If the PSA result is concerning, a healthcare provider may consider additional evaluation, which can include repeat testing, other laboratory tests, imaging, or a prostate biopsy depending on the individual situation.
Digital Rectal Exam (DRE)
A digital rectal exam (DRE) is a physical examination in which a healthcare provider gently inserts a gloved, lubricated finger into the rectum to feel the prostate.
The provider may look for abnormalities such as areas that feel unusually hard, irregular, or enlarged. A DRE can provide additional information about the prostate, but it cannot by itself confirm or rule out prostate cancer. It is generally considered alongside PSA results, medical history, symptoms, and other findings.
Prostate Biopsy
A prostate biopsy involves taking small samples of prostate tissue so they can be examined under a microscope for cancer cells.
A biopsy is generally the test used to confirm prostate cancer. If cancer is found, the biopsy can also provide important information about how abnormal the cancer cells look and how likely the cancer may be to grow or spread. This information contributes to the cancer's Grade Group or Gleason score.
Before or during a biopsy, imaging such as MRI or transrectal ultrasound may be used to help identify and target suspicious areas of the prostate. Depending on the clinical situation, biopsies may be performed through the rectum or through the skin between the scrotum and anus.
Imaging Tests for Prostate Cancer
Imaging tests can provide detailed information about the prostate and surrounding tissues. They may be used to help determine whether a biopsy is appropriate, guide biopsy sampling, or evaluate whether cancer may have spread beyond the prostate.
Common imaging approaches include:
Not everyone with suspected or newly diagnosed prostate cancer needs every imaging test. The tests selected depend on factors such as PSA level, biopsy findings, clinical examination, and the suspected extent of the disease.
How Is Prostate Cancer Staged?
After prostate cancer has been confirmed, staging determines how extensive the cancer is and whether it has spread beyond the prostate. Staging is important because it helps healthcare providers estimate the extent of disease and select appropriate treatment options.
Prostate cancer staging commonly considers the TNM system:
- T (Tumor): Describes the size and local extent of the primary tumor.
- N (Nodes): Indicates whether nearby lymph nodes are involved.
- M (Metastasis): Indicates whether the cancer has spread to distant parts of the body.
Doctors also consider the PSA level and Grade Group, which is based on the Gleason score from the biopsy. These factors can be combined to place localized prostate cancer into a risk group that helps guide treatment decisions.
What Are the Treatment Options for Prostate Cancer?
There is no single prostate cancer treatment that is appropriate for everyone. Treatment depends on factors such as the cancer's stage, Grade Group, PSA level, whether it has spread, the person's age and overall health, and individual preferences.
For some men with slow-growing, localized prostate cancer, immediate treatment may not be necessary. Others may need surgery, radiation therapy, hormone therapy, chemotherapy, or a combination of treatments. The treatment plan should be determined with a qualified healthcare team after the cancer has been fully evaluated.
Active Surveillance
Active surveillance may be an option for some men with low-risk or slow-growing prostate cancer.
Rather than treating the cancer immediately, the healthcare team closely monitors it using appropriate tests and examinations. Monitoring may include PSA testing, physical examinations, imaging, and repeat biopsy when indicated.
If there are signs that the cancer is becoming more aggressive or growing, treatment can then be considered. Active surveillance is different from simply ignoring the cancer because it involves ongoing medical monitoring.
Surgery
Surgery may be considered when prostate cancer is localized, and the person is an appropriate candidate for an operation.
The main surgical approach is radical prostatectomy, which involves removing the prostate and, in some cases, nearby tissues and seminal vesicles. Nearby lymph nodes may also be removed depending on the individual's risk and clinical situation.
Potential side effects can include urinary incontinence and erectile dysfunction, although the likelihood varies depending on factors such as the type of surgery and the individual's health.
Radiation Therapy
Radiation therapy uses high-energy radiation to destroy or damage cancer cells.
It may be used to treat prostate cancer that remains within or around the prostate and can sometimes be combined with hormone therapy, particularly for higher-risk disease. Radiation can also have a role in treating cancer that has spread or returned after initial treatment, depending on the circumstances.
Common approaches include external beam radiation therapy and brachytherapy, in which radioactive material is placed in or near the prostate.
Hormone Therapy
Hormone therapy, also called androgen deprivation therapy (ADT), reduces the effect or availability of male sex hormones called androgens, which can stimulate the growth of prostate cancer cells.
Hormone therapy may be used alongside radiation therapy for certain localized or locally advanced cancers, or as part of treatment for prostate cancer that has spread. It can also be used when cancer returns after previous treatment.
Chemotherapy and Other Systemic Treatments
Chemotherapy uses medicines that travel through the bloodstream to target cancer cells throughout the body. It may be considered particularly when prostate cancer has spread or when the disease requires systemic treatment.
Depending on the characteristics and stage of the cancer, other systemic treatments may also be considered, including newer hormone-targeting medicines, targeted therapies, immunotherapy in selected cases, or treatments based on specific genetic changes in the cancer.
Because treatment choices can differ substantially between patients, a cancer specialist may use the tumor's stage, Grade Group, PSA level, genetic information, previous treatments, and overall health to determine which options are appropriate.
Read more: Vasectomy Reversal
When Should You See a Doctor About Prostate Cancer Symptoms?
Because early prostate cancer may cause no noticeable symptoms, it is not always possible to identify the disease based on symptoms alone. At the same time, urinary or sexual changes can have many causes that are not cancer, including benign prostate conditions.
You should consider speaking with a healthcare provider if you develop persistent or unusual changes in urination, blood in the urine or semen, unexplained sexual changes, or ongoing pain in areas such as the pelvis, back, or hips.
A healthcare provider can review your symptoms and medical history and determine whether further evaluation, such as a PSA test, physical examination, or other testing, is appropriate.
It is also important to seek prompt medical attention for severe or rapidly worsening symptoms, particularly significant difficulty urinating, new weakness or numbness in the legs, or loss of bladder or bowel control.
Having these symptoms does not mean you have prostate cancer. Many of them can occur because of other prostate, urinary, or reproductive conditions. The purpose of medical evaluation is to identify the underlying cause rather than trying to diagnose prostate cancer based on symptoms alone.
How Can Avee Health Help With Prostate Health?
If you are experiencing urinary changes, sexual symptoms, or other concerns related to prostate health, speaking with a healthcare provider can help determine whether further evaluation is appropriate. Avee Health provides virtual healthcare services for patients in British Columbia, making it possible to start the medical evaluation process online when appropriate.
Avee does not diagnose or treat prostate cancer directly through its virtual platform. Instead, an online visit can help a healthcare provider assess your concerns, determine whether additional testing is appropriate, and help coordinate the next steps when further medical evaluation is needed.
Talk to a Doctor Online
If you have concerns about prostate health or symptoms such as changes in urination,Avee Health telehealth services make it easier to begin your healthcare journey from the comfort of home.
Through Avee Health's Medical Care, patients in British Columbia can discuss their symptoms and health concerns with a physician virtually. The provider can review relevant medical information and determine whether additional assessment or testing may be appropriate.
This can be particularly useful when you are unsure whether your symptoms require further medical evaluation.
Get a Lab Requisition When Appropriate
Depending on your symptoms, medical history, and the healthcare provider's assessment, laboratory testing may be recommended.
For example, a PSA blood test may be considered when appropriate as part of an evaluation of prostate health. If testing is medically indicated, Avee Health's Lab Requisition service can help eligible patients obtain a laboratory requisition through an online consultation.
A PSA test alone cannot diagnose prostate cancer. If results or other findings require further investigation, a healthcare provider can recommend the appropriate next step.
Get a Referral to a Specialist
Some prostate-related concerns may require assessment by a specialist, particularly when additional investigation or specialized care is needed.
When medically appropriate, an Avee physician can provide a Specialist Referral to help connect patients with the appropriate specialist in British Columbia.
Conclusion
Prostate cancer is a common cancer in men, but it does not always cause noticeable symptoms in its early stages. Understanding its symptoms, potential causes, risk factors, and available diagnostic approaches can help you recognize when a change in your health may warrant medical evaluation. Importantly, symptoms such as urinary difficulties or sexual changes do not necessarily mean you have prostate cancer, as several non-cancerous conditions can cause similar problems.
If you have persistent or concerning symptoms, speaking with a healthcare provider is an important first step. For patients in British Columbia, Avee Health can provide an online medical consultation to discuss prostate-related concerns and determine whether further testing or specialist evaluation may be appropriate. From an initial assessment to a lab requisition or specialist referral when needed, virtual care can help you take the next step toward appropriate medical care.
For more information, you can visit avee health blog and read our other articles, which are reviewed by healthcare professionals.
Frequently Asked Questions
Can prostate cancer cause no symptoms?
Is prostate cancer curable?
Does an enlarged prostate mean prostate cancer?
Can prostate cancer affect sexual function?
Can prostate cancer spread to other parts of the body?
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