Prostate Cancer

What it is

Overview

Prostate cancer is the most common non-skin cancer in American men. It forms in the cells of the prostate gland, which produces seminal fluid. The vast majority of prostate cancers are adenocarcinomas. Most grow slowly and may never cause harm, but aggressive forms can spread rapidly and become life-threatening.

Biology

How It Develops

Prostate cancer begins when cells in the prostate accumulate DNA mutations — particularly in the androgen receptor and PTEN tumor suppressor pathways. Because prostate cell growth is driven by androgens (testosterone, DHT), hormonal signaling plays a central role in both tumor initiation and treatment. Elevated PSA levels often signal early-stage disease.

Warning signs

Symptoms

• —Frequent or difficult urination
• —Weak or interrupted urine flow
• —Blood in urine or semen
• —Pain or burning during urination
• —Painful ejaculation
• —Pain in the lower back, hips, or pelvis (advanced stage)

Detection

Diagnosis Methods

• —PSA (prostate-specific antigen) blood test
• —Digital rectal exam (DRE)
• —Prostate biopsy (guided by MRI-fusion)
• —MRI of the prostate
• —Bone scan and CT for staging
• —Genomic tests (Oncotype DX Prostate, Decipher)

Medical care

Treatment Options

• —Active surveillance (for low-risk disease)
• —Surgery (radical prostatectomy, robotic-assisted)
• —Radiation therapy (external beam or brachytherapy)
• —Hormone therapy (androgen deprivation)
• —Chemotherapy (docetaxel for advanced disease)
• —Immunotherapy and PARP inhibitors

Data

Statistics

Prevention

Risk Factors

• —Age over 50
• —African American heritage (higher risk and worse outcomes)
• —Family history of prostate or BRCA-linked cancers
• —BRCA1/BRCA2 or Lynch syndrome mutations
• —High-fat diet

Further reading

Resources