Prostate cancer signs, symptoms, risk factors and FAQs

Slow growth still warrants close monitoring

Most prostate cancers grow slowly and may never develop beyond the early stages, and may require only closely monitoring the prostate. The vast majority of prostate cancers are adenocarcinomas, which develop from the gland cells that make the prostate fluid that is added to the semen.

Other types of cancer that can start in the prostate include:

  • Small cell carcinomas
  • Neuroendocrine tumors (other than small cell carcinomas)
  • Transitional cell carcinomas
  • Sarcomas

However, these other types of prostate cancer are quite rare.

Pay attention to symptoms

Prostate cancer may not present with any symptoms in the early stages, but more advanced stages can cause signs and symptoms, including:

  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in semen
  • Discomfort in the pelvic area
  • Bone pain
  • Erectile dysfunction

Risk factors

Even though we don’t know the exact cause of prostate cancer, we do know these factors can increase your risk:

  • Age. Risk increases as you get older.
  • Race. Black men carry a greater risk of prostate cancer than do men of other races, and the cancer is more likely to be aggressive or advanced.
  • Family history. If men in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher.
  • Obesity. More likely to have an advanced disease.
Father and son Camping

What function does the prostate serve?

The prostate makes some of the fluid in semen to help carry sperm through the urethra and out the penis.

Can prostate cancer kill you?

Yes, in the most serious cases. The 5-year survival rate is nearly 100% for prostate cancer that is found early and has not spread beyond the prostate. However, when prostate cancer has spread to parts of the body like the lungs or liver, those cases have a 5-year survival rate of only 30%.

What about the sexual side effects, like erectile dysfunction (ED) and loss of sex drive? Will I ever get back to normal? When?

Prostate cancer or its treatment, including surgery, radiation and hormone treatments can result in ED and loss of sex drive.

Part of your personalized treatment plan may include medications and/or vacuum devices that can help you achieve erections and restore your libido. You may even decide to have surgery to treat ED. Your provider will discuss the timeline for your recovery.

What is a dangerous prostate-specific antigen (PSA) blood test level? Are PSA tests accurate?

A PSA blood test is a fairly accurate screening test for prostate cancer. PSA is a protein made by cells in the prostate gland, found mostly in semen but a small amount is also found in blood. The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesn’t have prostate cancer.

Most men without prostate cancer have PSA levels under 4 ng/mL of blood. When prostate cancer develops, the PSA level often goes above 4. Men with a PSA level between 4 and 10—often called the borderline range—have about a 1 in 4 chance of having prostate cancer. A PSA of more than 10 means the chance of having prostate cancer is over 50%. If your PSA level is high, you might need further tests to look for prostate cancer.

What is a Gleason score or grade, and how do I interpret it?

The Gleason system assigns a grade based on how much the cancer looks like normal prostate tissue:

  • Grade 1. The cancer looks a lot like normal prostate tissue.
  • Grades 2 through 4. The cancer has features between normal and very abnormal.
  • Grade 5. Cancer looks very abnormal.

Almost all cancers are grade 3 or higher. Because prostate cancers often have areas with different grades, a grade is assigned to the two areas that make up most of the cancer. These two grades are added to yield the Gleason score or Gleason sum. The first number assigned is the grade that is most common in the tumor.

Cancers with a Gleason score of 6 or less are well differentiated or low-grade. Cancers with a Gleason score of 7 are moderately differentiated or intermediate-grade. Cancers with Gleason scores of 8 to 10 are poorly differentiated or high-grade.

How do I decide the best treatment for me?

You will work with your multidisciplinary team to determine the best treatment for your case and life wishes. We’ll educate you at every step and fully involve you and your family in every decision to help you beat cancer and make the most of your life beyond cancer.

What about incontinence? How bad is it and how long does it last?

Both prostate cancer and its treatment can cause urinary incontinence. Your treatment plan will address this based on the type you have, the severity and the likelihood it will improve over time. Your options may include medications, catheters and surgery.

Does high sexual frequency reduce the risk of prostate cancer?

No, there are no valid studies proving that frequent ejaculations help reduce risk.

Do eggs cause prostate cancer?

This has not been proven. A recent study funded by the U.S. National Institute of Health and carried out through the Harvard School of Public Health, the University of California in San Francisco, Brigham and Women’s Hospital and Harvard Medical School looked at the link between eating two and a half eggs or more per week to lethal forms of prostate cancer. The results were not definitive.

Conversely, it has also not been conclusively proven that you can prevent prostate cancer through diet, but eating a healthy diet with a variety of fruits and vegetables can improve your overall health.