Prostate Cancer

Prostate cancer is a condition that begins in the prostate, often resulting from genetic mutations.

Symptoms of prostate cancer include progressive problems with urination, blood in urine, body pain and erectile dysfunction.

There are many options for diagnosing prostate cancer, and its progress or stage determines treatment options.

The risk of developing prostate cancer increases with age. Regular screenings (if you’re eligible) are vitally important. Screening also increases the likelihood of catching prostate cancer in its earlier stages, when it is easier to treat.

Prostate cancer types and symptoms

What is prostate cancer?

The prostate is a small gland in the male reproductive system that produces seminal fluid. The prostate is located just below the bladder and in front of the rectum.

Cancer beginning in the prostate occurs when abnormal cells begin to grow out of control in the prostate tissue, often first detected as an unusual lump in the tissue. The tumors beginning in these organs can spread to lymph nodes, tissues and other organs in the lower abdomen as the cancer progresses.

Are there different types of prostate cancer?

There are different types of prostate cancer. The most common type is adenocarcinoma of the prostate.

• Acinar adenocarcinomas are cancers that develop in the gland cells lining the prostate gland. Most people with prostate cancer have this type.
• Ductal adenocarcinomas start in the ducts (tubes) of the prostate gland. This type of cancer tends to grow and spread more quickly than acinar adenocarcinoma.
• Transitional cell cancer in the prostate starts in cells that line the urethra, a tube carrying urine to the outside of the body. This cancer usually starts in the bladder and spreads into the prostate, but it can start in the prostate and spread into the bladder entrance and nearby tissues.
• Squamous cell cancers develop from flat cells that cover the prostate, tending to grow and spread more quickly than adenocarcinoma in the prostate.
• Small cell prostate cancer is a type of neuroendocrine cancer made up of small round cells.

Learn more about bladder cancer>>

What are the symptoms of prostate cancer?

Symptoms differ between patients, but those experiencing early stages of prostate cancer may experience the following:

• Weak or interrupted (“stop-and-go”) flow of urine
• Sudden urge to urinate
• Frequent urination (especially at night)
• Trouble starting the flow of urine
• Trouble emptying the bladder completely
• Pain or burning while urinating
• Blood in the urine (called hematuria) or semen
• A pain in the back, hips, or pelvis that doesn’t go away

Related: Prostate cancer symptoms explained by Siteman Cancer Center>>

These symptoms are similar to another non-cancerous condition called benign prostatic hypertrophy (BPH), an enlargement of the prostate that can occur as a person ages. The prostate may get bigger and block the urethra or bladder, causing trouble urinating or sexual problems. Although it is not cancer, surgery may be needed.

Are there complications to prostate cancer?

Common complications for prostate cancer include erectile dysfunction (ED), urinary incontinence, metastasis and severe pain if the cancer spreads to the bones.

Prostate cancer stages

Like other cancers, prostate cancer progresses in stages, during which symptoms may change or become more severe. The following stages are used to track the progress of both squamous cell carcinoma or adenocarcinoma of the prostate:

• Stage I: Cancer in this stage is usually slow growing. The cancerous tumor cannot be felt, and the cancer cells may appear like healthy cells. PSA levels are low.
• Stage II: The tumor is found only in the prostate and is small, but may have an increased risk of growth. PSA levels are medium or low.
• Stage III: The tumor is growing or the cancer is high grade, and PSA levels are high. All of these factors indicate an advanced cancer that is likely to grow and spread.
• Stage IV: The cancer has spread beyond the prostate to other surrounding tissues or organs.

Prostate cancer causes, risk factors and prevention

What causes or contributes to the development of prostate cancer?

While there are no singular causes for any type of cancer, it is common for prostate cancer to originate from genetic mutations inherited from family members.

Are there risk factors for developing prostate cancer?

Anything that increases the risk of getting a disease is called a risk factor. Having a risk factor does not mean that someone will get a particular type of cancer; not having risk factors doesn’t mean that someone will not get a particular type of cancer.

The most common risk factors for developing prostate cancer include:

Can prostate cancer be prevented? How?

Because many of the risk factors of prostate cancer are related to genetics and age, it is hard to prevent prostate cancer.

Weight can play a role in developing this condition, so maintaining a healthy lifestyle, hormone and insulin levels can reduce risk.

Prostate cancer diagnosis and treatment

How is prostate cancer diagnosed?

Prostate cancer patients almost always have an excellent prognosis if their cancer is caught early.

Experts recommend that people with prostates speak with their doctors to develop a regular screening plan for prostate cancer. Screening is recommended after the age of 45 for patients with normal risk, while those with higher risk should start screenings at 40.

There are two methods of screening for prostate cancer: the PSA blood test and a digital rectal exam.

• PSA test: Prostate specific antigen, or PSA, is a substance made by the prostate. The PSA blood test measures the level of PSA in your blood. An increased amount of PSA in the blood can be a possible sign of prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate. The PSA test is the primary screening technique for prostate cancer. Siteman physicians pioneered this test and have successfully developed the free PSA test as a way of increasing the accuracy of cancer detection.
• Digital rectal exam: During a digital rectal exam, the doctor or nurse inserts a gloved finger into the rectum to check for an enlarged prostate, lumps or abnormal areas.

If potential prostate cancer is detected during screening, the following tests and procedures may be used to detect or diagnose prostate cancer and determine the stage of its progress:

• Urine and blood-based biomarkers: These tests evaluate a patient’s blood and urine for signs of potential prostate cancer. Depending on the results, doctors may decide that a patient’s high PSA score does not indicate cancer.
• MRI: This type of imaging test helps your urologist identify which part of the prostate to biopsy and check for signs of cancer in the surrounding tissue.
• Transrectal ultrasound: During this imaging test, a probe about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal structures to create a picture. Siteman physicians use newer ultrasound technology that allows for higher resolution imaging of the prostate, which is only available at a few locations in the world.
• Biopsy: Biopsies remove a sample of cells from the prostrate to look for any mutations within the cells. Biopsies come in different forms, with some being less invasive than others. These include MRI-fusion, transrectal biopsy, and transperineal biopsy.

Once prostate cancer is diagnosed, it is given a grade: a number from 2 to 10 that indicates how aggressive it is, with 10 being the highest. The grade is called a Gleason score, and it’s based on the tissue samples collected from the prostate during the biopsy. Depending on the patient’s PSA level and Gleason score, additional tests may be done to determine if the cancer has spread to other parts of the body (called metastasis).

Read more: What to know about cancer screening guidelines in 2026>>

What options are available for prostate cancer treatment? Are any treatments more common or successful?

There are multiple factors of prostate cancer that require medical attention. Several methods of treatment may be necessary to address all patient symptoms. Treatment also depends on cancer stage. Treatment methods include:

• Active surveillance: Active surveillance means monitoring a low-grade and non-aggressive prostate cancer instead of pursuing immediate treatment. Many prostate cancers that are diagnosed early with PSA screening can be watched safely. With careful monitoring, they will not cause the patient any pain or impact quality of life before the conclusion of their natural lifespan. Essentially, the patient has prostate cancer but undergoes no treatment for it. This allows them to forgo side effects from treatment while not reducing their life span.
• Surgery: Two main surgical procedures are standard for prostate cancer. A prostatectomy is a procedure to remove the prostate gland. A transurethral resection does not take out the entire prostate, but instead removes a portion of prostate tissue. Patients might undergo this procedure as part of a broader treatment program.
• Radiation therapy: The goal of prostate radiation is to cure the cancer. It can sometimes be used as an alternative to surgery. Patients with lower-risk disease can be treated with radiation alone, often with shorter courses to minimize the number of trips to the treatment center. Radiation can also be given to relieve cancer symptoms.
• Systemic therapy: Systemic therapies for prostate cancer treat cancer cells in the prostate as well as those that have spread to other locations around the body (called metastatic prostate cancer). The patient can ingest them as pills or receive them through an IV or an injection. Hormone therapy is the main systemic therapy used in the treatment of prostate cancer. Hormone therapy prevents prostate cancer cells from getting the hormones they need to grow. Patients may receive chemotherapy in certain cases.
• Focal therapy: This novel approach to treating prostate cancer destroys the tumor within the prostate. Not all prostate cancers can be treated safely with focal therapy, and this is an ongoing area of research. In focal therapy, surgeons can use energy to get rid of the tumor. These include cryoablation (freezing), laser ablation, or high-intensity frequency ultrasound (HIFU). High-quality imaging is critical for focal therapy. By visualizing the tumor with precision on MRI scans or other imaging tests, your doctor can pinpoint the location of the cancer and target those cells with different types of treatments.

Learn more: Prostate cancer treatment options at Siteman Cancer Center>>

What is the prognosis for prostate cancer? Is there a cure?

The prognosis and treatment options depend on the following:

• The stage of the cancer (whether it affects part of the prostate, involves the whole prostate, or has spread or metastasized to other places in the body)
• Whether the tumor can be completely removed by surgery
• The patient’s general health

Overall, the prognosis of prostate cancer is very good. Most patients diagnosed after PSA screening are in earlier stages of cancer. For patients with prostate cancer, prognosis depends on additional factors, including:

• The stage of the cancer — whether the cancer has spread to other places in the body
• Gleason score
• The level of PSA elevation

What research or innovative treatment is ongoing for prostate cancer?

Siteman has a number of innovative treatment options for prostate cancer.

Radiation oncologists at WashU Medicine were among the first in the U.S. to deliver external beam radiation using Intensity-Modulated Radiation Therapy (IMRT). This technique enhances the delivery of high doses of radiation. WashU Medicine physicians at Siteman also use advanced-imaging methods such as MRI and PET scans – a technique known as Image-Guided Radiation Therapy (IGRT) – to focus treatment on the prostate, reducing the amount of radiation to the bladder and rectum.

As part of a research medical center, physicians at the Siteman Cancer Center at Barnes-Jewish Hospital and WashU Medicine have access to a wide range of clinical trials to test new therapies as they emerge. Many of our physicians are principal investigators in these trials, which cover medical oncology, surgery, and radiation therapy.

Who treats prostate cancer?

Siteman Cancer Center provides the highest level of care for patients with prostate cancer. As internationally recognized leaders in the field, WashU Medicine physicians at Siteman Cancer Center treat an average of 1000 prostate patients a year.

Siteman Cancer Center offers screening, care options and treatments for patients with prostate cancer.

Our WashU Medicine physicians are part of a multidisciplinary team including urologists, medical oncologists, radiation oncologists and other specialists. The team offers personalized treatment plans based on the patient’s needs. Our approach promotes collaboration to find the best solutions for patients and often reduces the number of necessary appointments. The prostate cancer team also includes skilled staff nurses, nurse practitioners, and medical assistants.