The prostate is a part of the male reproductive system. The prostate is about the size of a walnut and weighs about one ounce. The prostate is below the bladder and in front of the rectum. The prostate surrounds the urethra. The urethra is a tube that carries urine from the bladder out through the penis. Therefore, men with an enlarged prostate have difficulty in urinating. It can disrupt the flow of urine from the bladder.

 Prostate cancer is marked by an uncontrolled growth of cells in the prostate gland Growths in the prostate can be benign (not cancer) or malignant (cancer). Prostate cancer cells can spread by breaking away from a prostate tumor. They can travel through blood vessels or lymph nodes to reach other parts of the body

Cancer stage grouping

Doctors assign the stage of the cancer by combining the T, N, and M classifications.

  • Stage I: Cancer in this early stage is usually slow growing. The tumor cannot be felt and involves one-half of 1 side of the prostate or even less than that. PSA levels are low. The cancer cells look like healthy cells.
  • Stage II: The tumor is found only in the prostate. PSA levels are medium or low. 
  • Stage IIA: The tumor cannot be felt and involves half of 1 side of the prostate or even less than that. PSA levels are medium, and the cancer cells are well differentiated. 
  • Stage IIB: The tumor is found only inside the prostate, and it may be large enough to be felt. The PSA level is medium. The cancer cells are moderately differentiated.
  • Stage IIC: The tumor is found only inside the prostate, and it may be large enough to be felt. The PSA level is medium. The cancer cells may be moderately or poorly differentiated.
  • Stage III: PSA levels are high, the tumor is growing, or the cancer is high grade. 
  • Stage IIIA: The cancer has spread beyond the outer layer of the prostate into nearby tissues. It may also have spread to the seminal vesicles. The PSA level is high.
  • Stage IIIB: The tumor has grown outside of the prostate gland and may have invaded nearby structures, such as the bladder or rectum.
  • Stage IIIC: The cancer cells across the tumor are poorly differentiated, meaning they look very different from healthy cells.
  • Stage IV: The cancer has spread beyond the prostate.
  • Stage IVA: The cancer has spread to the regional lymph nodes.
  • Stage IVB: The cancer has spread to distant lymph nodes, other parts of the body, or to the bones.

Risk factors

  • Age: The risk of prostate cancer increases with age, especially after age 50
  • Race: For reasons not yet determined, Black people have a greater risk of prostate cancer than do people of other races
  • Family history: If a blood relative, such as a parent, sibling or child, has been diagnosed with prostate cancer, your risk may be increased
  • Obesity: People who are obese may have a higher risk of prostate cancer
  • Smoking: Studies show prostate cancer risk may double for heavy smokers.
  • Diet and lifestyle: may affect the risk of prostate cancer. It isn’t clear exactly how. Your risk may be higher if you eat more calories, animal fats, refined sugar and not enough fruits and vegetables
  • Chemical exposures: There is some evidence that firefighters can be exposed to chemicals that may increase their risk of prostate cancer.
  • Inflammation of the prostate: Some studies have suggested that      prostatitis (inflammation of the prostate gland) may be linked to an increased risk of prostate cancer

Signs and Symptoms of Prostate Cancer

  • Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
  • Blood in the urine or semen
  • Trouble getting an erection (erectile dysfunction or ED)
  • Losing weight without trying
  • Pain in the hips, back (spine), chest (ribs), or other areas from cancer that has spread to bones
  • Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord


Prostate screening test 

  • Digital rectal exam (DRE): During a DRE, doctor inserts a gloved, lubricated finger into the rectum to examine the prostate, which is adjacent to the rectum to find abnormal parts of the prostate by feeling the area using the finger.
  • Prostate-specific antigen (PSA) test: A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that’s naturally produced by prostate gland. It’s normal for a small amount of PSA to be in your bloodstream. However, if a higher than usual level is found, it may indicate prostate infection, inflammation, enlargement, or cancer.

Diagnosing prostate cancer

  • Transrectal ultrasound (TRUS): During a transrectal ultrasound, a small probe, about the size and shape of a cigar, is inserted into the rectum. The probe uses sound waves to create a picture of prostate gland.
  • Magnetic resonance imaging (MRI): In some situations, doctor may recommend an MRI scan of the prostate to create a more detailed picture. MRI images may help your doctor plan a procedure to remove prostate tissue samples.
  • Biopsy: A biopsy is the removal of a small amount of tissue for examination under a microscope to get a tissue sample, a surgeon most often uses transrectal ultrasound and a biopsy tool to take very small slivers of prostate tissue. The tissue sample is analyzed in a lab to determine whether cancer cells are present.

Determining whether the cancer has spread

  • Bone scan: It is important to know that structural changes to the bone to identify the metastasis of cancer to bone.
  • Computerized tomography (CT) scan: A CT scan can be used to measure the tumor’s size.
  • Magnetic resonance imaging (MRI): MRI can be used to measure the tumor’s size, and a scan can focus specifically on the area of the prostate or on the whole body.
  • Positron emission tomography (PET) scan: A PET scan is a way to create pictures of organs and tissues inside the body.


  • Surveillance

Active surveillance – It means monitoring the cancer closely who have a low risk of their cancer spreading. Can be done by  prostate-specific antigen (PSA) blood test about every 6 months and a digital rectal exam (DRE) at least once a year. Prostate biopsies and imaging tests may be done every 1 to 3 years as well. With active surveillance, will know very quickly if the cancer grows.  If that happens, then doctor will suggest next step.

Watchful Waiting – It does not involve regular biopsies or other active surveillance tools. It is best for men with prostate cancer who do not want or cannot have therapy. It is also good for men who have other medical conditions that would interfere with more aggressive forms of treatment.

  • Localized Therapy

Surgery to remove the prostate

  • Open prostatectomy: The surgeon operates through a single long skin incision (cut) to remove the prostate and nearby tissues
  • Laparoscopic prostatectomy: The surgeon makes several smaller incisions and uses special long surgical tools to remove the prostate
  • Transurethral resection of the prostate (TURP): This operation is more often used to treat men with non-cancerous enlargement of the prostate. But it is also sometimes used in men with advanced prostate cancer to help relieve symptoms, such as trouble urinating. (It is not used to try to cure the cancer.)

Side effects of prostate surgery

  • Urinary incontinence 
  • Erectile dysfunction 
  • Loss of fertility 
  • Lymphedema 
  • Change in penis length 
  • Inguinal hernia 

Radiation Therapy

Radiation therapy uses high-energy rays to kill or slow the growth of cancer cells. Radiation can be used as the primary treatment for prostate cancer 

Side Effects of Radiation Therapy

incontinence and bowel problems. Urinary problems usually improve over time.


It is the controlled freezing of the prostate gland. The freezing destroys cancer cells. Cryotherapy is done under anesthesia.

Side Effects of Cryotherapy

Incontinence and other urinary or bowel problems. Erectile dysfunction is likely. Worth noting is the risk of a fistula between the urethra and the rectum

Focal therapies

Focal therapies are less-invasive treatments that destroy small prostate tumors without treating the rest of the prostate gland. These treatments use heat, cold, and other methods to treat cancer.

  • Systemic Therapy 

Hormonal Therapy or Androgen Deprivation Therapy

This therapy uses drugs to block or lower testosterone and other male sex hormones that fuel cancer or removes the testicles and glands that produce testosterone with a procedure called an orchiectomy


Chemotherapy uses drugs to destroy cancer cells anywhere in the body. It is used for advanced stages of prostate cancer. It is also used when cancer has metastasized (spread) into other organs or tissue.


Immunotherapy is the use of medicines to stimulate a person’s own immune system to recognize and destroy cancer cells more effectively.

Follow-up care

  • Follow up  visits will usually include PSA blood tests, possibly with digital rectal exams (DREs) if your prostate hasn’t been removed. These will probably begin within a few months Even after treatment
  • Get regular physical activity men who exercise regularly after treatment might be less likely to die from their prostate cancer than those who don’t
  • Quit smoking men who smoke are more likely to have their prostate cancer 
  • Nutrition and dietary supplements include eating a diet rich in fruits and vegetables and lower in animal fats might be helpful.
  • Feelings of depression, anxiety, or worry are normal when prostate cancer is a part of life. Get emotional support from friends and family, religious groups, support groups, professional counselors, or others. 
  • Sexuality and feeling good about your body Prostate cancer treatment can often affect sexual function. Information and support can help you cope with these changes over time

Disclaimer: All contents on this site are for general information and in no circumstances, information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility for any damage done by the misuse or use of the information.

References  (American Cancer Society) (cancer net (ASCO))  (Myoclinic) (urology care foundation)