Prostate Cancer Treatment

What is prostate cancer?

Prostate cancer is the most common cancer in men (not counting skin cancer) in the U.S. It tends to occur mainly in older men. In most cases prostate cancer is found before it has spread to other parts of the body. Cancer that hasn’t spread is easier to treat and cure.

Understanding the prostate gland

The prostate is a sex gland in men. The prostate is about the size of a walnut, but it can grow larger as men age. It sits below the bladder and in front of the rectum. It surrounds the upper part of the urethra. This is the tube that carries urine and semen out of the body. The prostate is part muscle and part gland. It has ducts that open into the urethra.

The prostate gland’s main purpose is to secrete a fluid that makes up most of semen. This is the fluid that carries sperm. It’s made in the gland cells of the prostate. During a man’s orgasm, the muscle parts of the prostate help to send the fluid into the urethra. It’s mixed with other fluids and sperm that were made in the testicles to form semen. The semen then leaves the body through the tip of the penis during ejaculation.

What are the different types of prostate cancer?

Cancer is tumors or growths that can grow into nearby tissues and spread to other parts of the body. Nearly all types of prostate cancer start in the gland cells. These are the cells that make the prostate fluid. These types of cancer are called adenocarcinoma. Other types of cancer can also start in the prostate. These include small cell carcinoma, transitional cell carcinoma, and sarcoma. But these types of cancer are rare. Most men with prostate cancer have adenocarcinoma.

Other types of growths can happen in the prostate. Some types of growth are not cancer (benign). These types of growths include:

  • Benign prostatic hyperplasia. As a man ages, the prostate can grow larger. This is called benign prostatic hyperplasia (BPH). It’s a common condition. BPH is not prostate cancer. It does not turn into prostate cancer. But BPH can cause the prostate to press on the urethra. This can lead to symptoms, such as trouble urinating, which might need to be treated.

  • Prostatic intraepithelial neoplasia (PIN). This is an abnormal prostate growth that may be found with a prostate biopsy. It is not prostate cancer. PIN can be low grade or high grade. Low-grade PIN is common, especially as men get older. Most healthcare providers don’t consider it to be a concern. Men who have high-grade PIN have a chance that cancer is somewhere else in the prostate.

Prostate cancer growth and spread

Prostate cancer tends to grow slowly. It can often be found and treated while it is still just in the prostate. In fact, some cases of prostate cancer may not need to be treated right away. But other cases of prostate cancer can grow quickly. The first place cancer grows in the body is called the primary site or primary tumor.

If prostate cancer is not treated and continues to grow, it can grow into other parts of the prostate. Over time it may grow outside of the prostate and into nearby tissues, such as the seminal vesicles. When cancer spreads to other parts of the body, this is called metastasis. Once the cancer has grown outside the prostate, it can spread to nearby lymph nodes. These are bean-sized glands all around the body that are part of the immune system. If prostate cancer spreads to distant parts of the body, most often it goes to the bones first. It may also spread to other organs, such as the lungs, liver, or brain.

Talk with your healthcare provider

If you have questions about prostate cancer, talk with your healthcare provider. Your healthcare provider can help you understand more about this cancer.

When it comes to your health, some decisions are easier than others to make. For example, it may be a no-brainer to opt for regular blood pressure checks. Deciding on treatment for prostate cancer can be a lot trickier. Men with early stage disease have a number of choices. And according to recent research, it isn’t always clear which treatment may be best.

Which prostate cancer treatments work

Prostate cancer is one of the most common cancers in men. But it’s usually a slow-growing disease. It can often be cured if it hasn’t yet spread outside the prostate. For these cases, one or more of the following treatments may work:

  • Surgery to remove the tumor from the prostate

  • Radiation therapy. This uses high-energy X-rays or another form of radiation to kill or stop the growth of cancerous cells.

  • Watchful waiting. This means not taking action right away. Instead, your doctor keeps an eye on the cancer to see if it starts to cause symptoms.

So which approach is best? It’s hard to tell. No study to date has directly compared all types of treatment over a long period of time. But one recent study tried to do so using statistical analysis.

Researchers compiled 21 past studies that included more than 7,300 men with early stage prostate cancer. They used data from these studies to compare the safety and effectiveness of several standard treatments. These included watchful waiting, a type of surgery called prostatectomy, and several forms of radiation therapy.

No treatment was rated superior in terms of survival. Some therapies did fare better when the researchers looked at certain side effects. Overall, though, they caution that more research is needed.

What to consider

When deciding on early stage prostate cancer treatment, it’s best to work closely with your doctor. He or she can help you consider all the benefits and risks of each approach. For example, if you don’t have any symptoms, watchful waiting may be a good choice. The cancer may never grow large enough to become life threatening. So treating it may cause needless side effects.

You may also want to consider cost. One study found that many men don’t look at cost, especially if they have health insurance. They may instead choose more aggressive and more expensive treatments. One example is robotic prostatectomy. It’s a type of surgery in which a mechanical arm helps surgeons make more precise incisions in the prostate. Despite its growing popularity, it hasn’t been shown to be any better than more traditional surgery.

Taking an active part in the decision can help you choose the best treatment. Below are some questions to ask your doctor:

  • Do I need to have treatment right away?

  • Which treatment do you recommend and why?

  • What are the benefits of the treatment?

  • Does it have any side effects, such as urinary or sexual problems?

  • What do I need to do to get ready for treatment?

  • How long will it take me to recover afterward?


Online Medical Reviewer: Alteri, Rick, MD
Online Medical Reviewer: Holloway, Beth, RN, M.Ed.
Date Last Reviewed: 3/23/2015
© 2013 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.

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